CDC: Fewer U.S. smokers but rate uneven based on race, ethnicity

The number of adults in the United States who smoke cigarettes has decreased, but the decline has been uneven among racial and ethnic groups, researchers said.

Between 2011 and 2020, the prevalence of adult smokers declined from 19% to 12.5%, according to a paper released Thursday by the Centers for Disease Control and Prevention. In 1965, the year after the release of a U.S. Surgeon General report showing the detrimental health consequences of smoking, the rate was roughly 42%.

In New York, the adult cigarette smoking rate hit a new low of 12% in 2020, state health officials said. On Long Island, the age-adjusted percentage of adults who smoke was 9.7% in Suffolk in 2021, while the number was 7.5% in Nassau, according to state data.

Still, secondhand smoking kills more than 20,000 people statewide each year, according to a state Department of Health release from last year.

The CDC study, which used 2011-20 data from an annual household survey, found that the largest percentage point decline in smoking preference was among the white population, moving from 20.6% to 13.3%. The Black population marked a change of 19.4% to 14.4%, while the Hispanic community moved from 12.9% to 8%. 

Native American and Alaska Native populations saw smoking prevalence go from 31.5% in 2011 to 27.1% in 2020, though researchers say the difference was not significant.

Targeted smoking cessation efforts

The study, health experts say, indicates how tobacco education campaigns and public health measures have worked over the years. But the numbers are also a reminder of the need for targeted smoking cessation efforts within certain communities, along with the tobacco industry’s targeted marketing to certain groups and the disproportionate barriers to getting health care, they said. 

"I think banning smoking in public places was helpful. I think educational programs have been helpful," said Dr. Norman Edelman, a professor in Stony Brook’s Department of Medicine. 

Edelman, who developed the Cancer Institute of Long Island, according to his profile on the Stony Brook University website, added, "But I think most people agree that it's the price of cigarettes that really makes a big difference."

Although the decrease in cigarettes can be linked to several factors, Edelman said, easy access to cheap cigarettes, particularly on reservations and in different parts of the country, could be a driver of some of the disparities.

Brian Armour, senior author of the research and associate science director at the CDC’s Office on Smoking and Health, said "progress has been uneven among racial and ethnic groups, and more work needs to be done to address these tobacco-related disparities and reduce smoking."

“Unjust and unfair systems, practices, policies, and conditions have negatively affected population groups, based on race and ethnicity,” he also noted. 

Proposed ban on menthol cigarettes

For instance, menthol cigarettes, with their cooling sensation, can hide the irritation a smoker feels when using a product, possibly making it harder to quit. For decades, the product was heavily marketed to Black consumers. And between 1980 and 2018, Black Americans represented slightly more than 40% of the nation’s menthol-smoking-related premature deaths, according to a study from the University of Michigan.

Last year, the U.S. Food and Drug Administration announced a proposed ban on menthol cigarettes and flavored cigars. 

Earlier this year, Gov. Kathy Hochul proposed a ban of menthol cigarettes. Despite the FDA saying it would not enforce the ban against individual consumers for possession, some activists have expressed concern about criminalization of people of color with the proposed bans. 

Dr. Amgad Makaryus, of the Nassau University Medical Center, said several of the identified communities needed more targeted efforts to increase smoking cessation. Support groups and nicotine gum are effective treatments, but they might not be easily accessible in some communities with higher smoking prevalence, said Makaryus, who serves a large underserved patient population. 

"They might not have the same access to the mass media campaigns where you tell people to quit smoking," he said, later noting that: "These efforts have to be [further] extended to all the population."

By Tiffany Cusaac-Smith

tiffany.cusaac-smith@newsday.com@T_Cusaac

Education: Howard University 

Tiffany Cusaac-Smith came to Newsday in 2023 after being a race and history reporter at USA TODAY, where she wrote enterprise and spot articles examining how the past shapes the present. Previously, she worked as the race and justice reporter at the USA TODAY Network of New York, covering issues such as criminal justice reform, housing, environmental justice, health care and politics. At The Journal News/lohud.com in Westchester County, she covered Yonkers, the state's third-largest city. She also worked at The Associated Press in Atlanta.

Honors and Awards: Criminal justice reporting fellowship with the National Press Foundation;  New York News Publishers Association award for distinguished investigative reporting;  Contributed reporting for Best of Gannett honor; Member of Table Stakes, a program funded by the Knight-Lenfest Local News Transformation Fund and managed by the American Press Institute to transform local news.