At least one-third of all cancer deaths in the United States are attributed to cigarette smoking, with lung cancer being the most common type of cancer among smokers. In addition to cancer, smokers are at increased risk for other health problems, including emphysema, stroke, and heart disease (1). However, quitting smoking significantly decreases these health risks in the short and long term. November 17th marks the 36th Great American Smokeout, a national event sponsored by the American Cancer Society encouraging smokers to quit.

Using the 2010 Southeastern Pennsylvania (SEPA) Household Health Survey, this article provides an overview of current smokers as well as attempts at smoking cessation among adults 18 years and older in Southeastern Pennsylvania. This article also includes findings from new tobacco-related questions added to the 2010 survey about the location of cigarette purchases and about purchasing loose cigarettes. These new questions were asked only of adults residing in Philadelphia. The Household Health Survey is a random digit dial telephone survey of over 10,000 households in the five-county SEPA region of Bucks, Chester, Delaware, Montgomery and Philadelphia Counties.

Demographic and Socioeconomic Profile of Current Smokers in SEPA

One in five (20.2%) adults ages 18 and over in SEPA are current smokers, representing an estimated 608,000 adults in the region. Additionally, one in ten (9.8%) children live in a household where someone smokes inside the home, representing approximately 93,000 children.

Philadelphia has a higher percentage of adults who smoke (one in four adults, 25.2%), while the other counties have a lower percentage of adults who smoke (14.4% of adults in Chester County, 16.2% in Montgomery County, 18.9% in Bucks County, and 20.0% in Delaware County).

Current smoking status also varies by age, gender, race/ethnicity, education, and poverty status. Younger adults are more likely to smoke than older adults. Almost one fourth of adults (23.9%) aged 18 to 39 currently smoke. The percent of older adults who currently smoke gradually decreases by age group—22.2% of 40-49 year olds, 22.2% of 50-59 year olds, 16% of 60-74 year olds, and 7.2% of adults 75 years and older.

Men are similarly as likely as women to smoke (21.2% and 19.6%, respectively).

African American adults are more likely to smoke (26.4%) than White (18.9%), Latino (20%), and Asian (13.2%) adults. Higher-educated adults are less likely to be current smokers than less-educated adults. Almost two-fifths of adults with less than a high school diploma (38.5%) are current smokers compared to 28.6% of high school graduates, 23.4% of adults with some college, 12% of adults with a college degree, and 6.5% of adults with post college education.

Over one-third of adults (34.1%) living below 150% of the Federal Poverty Level are current smokers, while 17.2% of adults at or above 150% of the poverty line are current smokers.

Cigarette Purchases in Philadelphia

New to the 2010 Household Health Survey, questions regarding the location of cigarette purchases were asked of Philadelphia residents. The majority of adults residing in Philadelphia bought their last pack of cigarettes at a convenience or corner store (63.4%). Other common places to buy cigarettes are at the gas station (14.5%) or the grocery store (7.3%).

Single cigarettes, also know as “loosies,” have been purchased by one in ten smokers (10.9%) in Philadelphia. Male smokers (14.1%) are more likely to buy single cigarettes than female smokers (8.1%).

Adults under the age of 40 are the age group most likely to buy single cigarettes, as 20.7% of 18 to 39 year old smokers bought single cigarettes compared to adults 40-49 years (6.9%), 50-59 years (6.5%), and 60 years or older (2.6%).

Asian smokers are more likely than any other racial/ethnic group to buy single cigarettes—two-fifths of Asian smokers (41.4%) have bought single cigarettes compared to 26.2% of Latino smokers, 15.0% of African American smokers, and 2.1% of White smokers. 

More than one in five Philadelphia smokers (21.0%) with less than a high school degree bought single cigarettes compared with 9.3% of high school graduates, 9.7% of adults with some college, 3.9% of college graduates, and 6.9% of adults with post-college education bought single cigarettes.

Health and Access to Care

One-quarter (25.2%) of adult smokers residing in SEPA report fair or poor health compared to 13.9% of non-smokers.

Currently smoking is also related to increased stress levels—about two-fifths of adult smokers (38.4%) report being under an extreme amount of stress compared to 22.4% of adults who do not smoke.

About one-sixth of adults (16.4%) who currently smoke also have had asthma at some point in their life.

One-fifth of adults (20.3%) who are current smokers exercise less than once per week or not at all, compared with 18.4% of adults who are non-smokers.

Over half of adults (53.3%) who once had a substance use problem that is no longer a problem also currently smoke.

Nearly one in six adult smokers (16.1%) do not have health insurance compared with 7.5% of adults who do not smoke. Additionally, more than one in ten adult smokers (12.4%) do not have a regular source of health care compared to 9.7% of adults who do not smoke.

Smoking Cessation

There are immediate and long-terms benefits to quitting smoking, including lower blood pressure, circulation improvement, and decreased cancer risk. Just one year after smoking, a former smoker can decrease his or her risk of coronary heart disease by half compared to a continuing smoker (2).

Over half of the current adult smokers (57.7%) in SEPA report trying to quit smoking in the past year, representing about an estimated 350,000 adults. The majority of adult smokers (61.1%) attempted to quit on their own, without assistance. Other methods of quitting include Chantix/Zyban (10.4%), nicotine patches, gum, inhalers or lozenges (19%), and a combination of other methods (9.5%).

For tips on how to quit smoking, go to the American Cancer Society’s Guide to Quitting Smoking found here: http://www.cancer.org/acs/groups/cid/documents/webcontent/002971-pdf.pdf

For more information about the findings presented in this article, please contact Sarah Ingerman at singerman@phmc.org.

References:

(1) http://www.cancer.org/Cancer/CancerCauses/TobaccoCancer/CigaretteSmoking/cigarette-smoking-who-and-how-affects-health

(2) http://www.cancer.org/Healthy/StayAwayfromTobacco/GuidetoQuittingSmoking/guide-to-quitting-smoking-benefits