Most U.S. adults who smoke cigarettes want to quit, but few are successful, CDC report says

A majority of adult smokers in the United States want to kick the habit, but only half of them try, and less than 10% are successful, according to a new national study released Thursday.

Experts said the data, from a 2022 survey, shows smokers who want to quit need more support and easier access to treatment such as counseling and medication.

Financial barriers, such as insurance coverage, prevent some smokers from getting the cessation services they need. And the survey showed not all doctors discuss treatment options with their patients who still smoke.

“Medication recalls and shortages have contributed to declines in prescriptions for cessation medication,” the authors wrote in the study, published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. They also said “gaps exist" in both what health care providers know about cessation treatments and guidelines for them to follow. 

"Not all physicians and nurse practitioners are comfortable prescribing medication [for smoking cessation]," said Jennifer Sidi-Stevens, a nurse practitioner and director of Northwell Health's Center for Tobacco Control. "There needs to be more education and outreach to all kinds of doctors, not just pulmonologists."

Smoking is the No. 1 cause of preventable disease and death across the globe, according to the American Lung Association, even though it has decreased markedly in the United States from 20.9% in 2005 to 11.5% in 2021.

People who smoke are more likely to develop heart disease, stroke and lung cancer than nonsmokers.

Restrictive laws, taxes and public press have helped reduce smoking rates in New York and around the country. In 2001, the smoking rate in New York State was 23%. By 2021, it had dropped dramatically, to 12%. The rates are lower on Long Island, with Nassau at 7.5% and Suffolk at 9.4%.

Data in the report showed about two-thirds of the 28.8 million U.S. smokers, or 67.7%, wanted to quit; 53.3% actually tried to do it; and 8.8% stopped smoking.

"The data have been pretty consistent over the years in showing that the majority of people who smoke want to quit," said J. Lee Westmaas, scientific director of behavioral research at the American Cancer Society.

Disparities in treatment

Adults who smoked menthol cigarettes had more interest in quitting but were less likely to receive advice and treatment, the study said. Previous studies have shown this finding is especially true of Black or African American adults, a high proportion of whom smoke menthol cigarettes in part because of “aggressive, targeted marketing” of menthol cigarettes to this population group, the authors said.

More than 42% of white adults who wanted to quit smoking used treatments, followed by 33.6% of non-Hispanic adults of another race, 32.6% of Black adults, 28.8% of Hispanic adults and 15.9% of non-Hispanic Asian adults.

Uninsured adults were the least likely to receive advice from a doctor, assistance, or any treatment to help them stop smoking.

"A major barrier is that many people aren’t aware of all the treatments available, some of them free, that can help them quit," Westmaas said. "Unfortunately, even many health care providers also don’t know about the existence of effective treatments for cessation, which is something that could be addressed in their training."

The study also broke out the statistics by region. About 69% of smokers in the Northeast, which includes Long Island, were interested in quitting and 8.3% were able to do so.

One barrier: Insurance coverage

Treatment for smoking cessation can include counseling as well as the use of nicotine replacement therapy via patches and gum. Two medications, Chantix (varenicline) and Wellbutrin (bupropion), also are prescribed to help curb craving for nicotine.

Sidi-Stevens said an effective method is to start with the medication for one or two weeks, then stop smoking and move on to use the nicotine replacement therapy.

“Medicaid will pay for the counseling and medication but not the patches or gum,” she said. “A lot of private insurers won’t pay for it, either. It has always been a barrier.”

Authors of the study pointed out that in 2022, only 20 states in the nation had Medicaid programs that covered smoking cessation.

State Department of Health officials said its Tobacco Control Program has numerous education, treatment and counseling services to support "individuals who want to quit smoking" and it "understands that quitting smoking is a personal and often difficult challenge."

Those services include the New York State Quitline (1-866-NY-QUITS) and free nicotine replacement therapy. The agency also provides grants to programs that work with underserved communities and people disproportionately affected by tobacco use, including those with low incomes and substance abuse disorders. Other grants educate local leaders about the dangers and social injustices of tobacco marketing.

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.