Public Health

Those Damned Smokers Are Preventing Us From Meeting National Health Objectives


The government's latest survey data indicate that the prevalence of smoking among American adults has leveled off at around 21 percent. "This prevalence had not changed significantly since 2004," says the CDC, "suggesting a stall in the previous 7-year (1997–2004) decline in cigarette smoking among adults in the United States." The CDC worries that at this rate the "national health objective" of reducing smoking prevalence to less than 12 percent by 2010 may not be met.

Over the longer term, however, the decline in the smoking rate is remarkable: It has been cut in half since its peak of 43 percent in the mid-1960s. Per capita cigarette consumption, which peaked at 4,345 in 1963, is now under 2,000. Notably, the rate of decline was fastest in the first couple of decades after the 1964 surgeon general's report linking smoking to lung cancer and other diseases. Three-quarters of the drop in prevalence had occurred by 1990. Since then, not coincidentally, anti-smoking measures have become increasingly coercive, focusing on heavy taxes and smoking bans rather than education and persuasion. The people who continue to smoke clearly are less susceptible to appeals based on health concerns than the people who have quit or chosen not to take up the habit in the last few decades, so achieving "national health objectives" will require sterner measures than the "countermarketing" recommended by the CDC. Proliferating and increasingly stringent smoking bans, coupled with punitive taxes along the lines of New York City's $3-a-pack levy, might do the trick. I have a feeling we're going to find out.