State and Sociodemographic Trends in US Cigarette Smoking With Future Projections

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Cigarette smoking continues to impose significant health burdens across US states.
• Understanding trends in smoking prevalence is crucial for addressing health disparities.

Purpose of the Study:

• To estimate if differing sociodemographic trends in smoking prevalence since 1992 will reduce the prevalence gap between states by 2035.
• To project future smoking prevalence and compare it with public health targets.

Main Methods:

• Analysis of 18 state-representative US Tobacco Use Supplement to the Current Population Surveys (TUS-CPS) from 1992 to 2022.
• Nonlinear time series analysis to project smoking prevalence trends through 2035.
• Comparison of smoking prevalence changes across sociodemographic groups and state tertiles based on 1990s prevalence.

Main Results:

• All state tertiles showed significant declines in smoking prevalence from 1992-2022.
• Projections indicate a narrowing of the prevalence gap by 2035, with notable declines in young adults (18-24 years) in historically high-prevalence states.
• Slower declines in older adults (50+ years) were observed in lower-prevalence states, potentially slowing overall health consequence reduction.

Conclusions:

• The gap in cigarette smoking prevalence between historically high and low prevalence states is expected to decrease by 2035.
• Accelerated declines among young adults in high-prevalence states are the primary driver of this narrowing gap.
• Persistent slower declines among older adults may impede the reduction of smoking-related health consequences in certain states.