Tobacco Use Among Adults - New York State, 2002

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Prevalence and Trends in Tobacco Use, Cessation, and Exposure to Second-Hand Smoke among New York State Adults: Behavioral Risk Factor Surveillance System

Executive Summary

This report summarizes information obtained from the Behavioral Risk Factor Surveillance System (BRFSS) for 2002 regarding rates of cigarette use, cessation, and exposure to second-hand smoke in New York State adults.

This report is intended for tobacco control program staff, researchers, healthcare providers, local health departments and community partners. Information provided includes comparisons of findings for 2002 to previous year’s BRFSS results pertaining to key program indicators of: (1) prevalence of current smokers including everyday and some day smokers, (2) number of cessation attempts within the past 12 months, (3) information on media and marketing, and (4) exposure to second-hand smoke.

This information supports the programmatic goals of the New York State Tobacco Control Program, which are to: (1) prevent the initiation of tobacco use among youth and young adults, (2) promote cessation from tobacco use, (3) eliminate exposure to second-hand smoke, and (4) decrease the social acceptability of tobacco use.

Key findings from this report show non-significant changes in prevalence of current smokers in New York State overall (23.2% in 2001 to 22.3% in 2002), with significant decreases among women aged 18-24 years (35.5% in 2001 to 21.7% in 2002, p<0.05), and aged 25-34 years (23.5% in 2001 to 17.4% in 2002, p<0.05). The statewide rate of current everyday smokers decreased significantly from 19.2% in 1996 to 16.9% in 2002, p<0.05. Significant decreases in prevalence of current smokers in New York City were observed among specific population groups; the frequency of current smokers aged 18-24 years declined from 29.4% in 2001 to 15.2% in 2002 (p=0.01), and, the frequency of smoking among individuals with 4 or more years of college education decreased from 19.7% in 2001 to 12.1% in 2002 (p<0.01). Rates of individuals who are some day smokers for New York City decreased significantly from 7.9% in 2001 to 5.0% in 2002 (p=0.01).

Significant increases in the number of current smokers who made at least one attempt to stop smoking cigarettes in the past 12 months occurred in both New York State and New York City. In New York State, 62.5% of current smokers made an attempt to quit smoking in 2002, an increase from 57.2% in 2001 (p<0.05). In New York City, 68.5% of current smokers made a quit attempt in 2002, up from 59.1% in 2001 (p<0.05).

Of special note is the 73.5% rate for Black smokers in New York State who have made a quit attempt in the past 12 months, which nearly matches the Healthy People 2010 target for cessation attempts of 75%.1

Cessation information is disseminated to the public through various media marketing venues. Cessation information provided on television and radio reached more than 85% of adult smokers, whereas information from billboards, health care providers and family/friends reached approximately 55% of the adult smoking population with cessation information.

Rules regarding smoking in the home have become more stringent in residences where a smoker resides. The percentage of smokers in New York State who allow smoking in some places in the home decreased significantly from 33.8% in 2000 to 27.2% in 2002 (p<0.05) and the percentage of smokers who do not allow smoking anywhere in the home increased significantly from 28.6% in 2000 to 36.1% in 2002 (p<0.05).

Progress toward Tobacco Control Program goals to promote cessation and eliminate exposure to secondhand smoke has been made. Increased cessation attempts by everyday smokers, the broad dissemination of cessation information, and the greater stringency regarding secondhand smoke exposure in the home all suggest that important changes are underway . These changes may be attributed to multiple causes that include the combined efforts of interventions of the Tobacco Control Program, its community partners, media efforts for clean indoor air and legislative efforts that have increased the cost of cigarettes.

Continued progress towards Tobacco Control Program goals is expected as the New York State Clean Indoor Air Law of 2003 takes effect and coordinated tobacco control action takes place across the state. Statewide evaluation and surveillance is key to providing feedback regarding program progress and its efforts toward achieving program goals and objectives.

Methodology

The Behavioral Risk Factor Surveillance System (BRFSS) is an annual random-digit-dialing telephone survey of the civilian non-institutionalized adult population designed by the Centers for Disease Control and Prevention (CDC) to monitor trends in the prevalence of behavioral risk factors and utilization of preventive services associated with the leading causes of illness, injury, disability, and death in the population. The survey has been conducted annually in the State since 1985, and knowledge gained from this survey is used to inform and guide the New York State Tobacco Control Program’s efforts. 2

SAS and SUDAAN (Software Statistical Analysis of Correlated Data) software were used for the data analysis which includes frequencies and cross-tabulations, computation of 95% confidence intervals and statistical tests of significance.3

Information is reported for the geographic regions of New York State, New York City and New York State exclusive of New York City, referred to as the rest of the state.

Current cigarette smokers are those who have smoked at least 100 cigarettes in a lifetime and currently smoke everyday or some days. Everyday smokers are those who now smoke every day. Some day smokers are those who now smoke cigarettes some days, but not every day.

Cessation rates are determined by those current smokers who have indicated they had stopped smoking for one day or longer during the past 12 months because they were trying to quit smoking.

Prevalence of Current Smokers

Prevalence of current smokers in New York State decreased slightly from 23.2% in 2001 to 22.3% in 2002. A larger reduction of current smokers was observed among those in New York City from 21.1% to 18.6%, and no change was noted for those in the rest of state. None of these changes were statistically significant (see Tables 1-3).

Prevalence of current smokers by gender, age, race and educational status in New York State, New York City and the rest of the state showed significant decreases among smokers aged 18-24 years in New York City, from 29.4% in 2001 to 15.2% in 2002 (p=0.01), and among smokers with 4 or more years of college education, from 19.7% in 2001 to 12.1% in 2002 (p<0.01) (see Tables 1-3).

Figures 1 and 2 show rates of current smokers by gender and age for New York State. Smoking among females aged 18-24 years decreased significantly from 35.5% in 2001 to 21.7% in 2002 (p<0.05) and for those aged 25-34 years from 23.5% in 2001 to 17.4% in 2002 (p<0.05).

Between 1996 and 2002, significant reductions in the proportion of current smokers who smoke daily and significant increases in the proportion of current smokers who smoke only some days, have been noted statewide (see Table 4). For New York City, a significant reduction of some day smokers occurred, from 7.9% in 2001 to 5.0% in 2002 (p=0.01) (see Table 5).

The average number of cigarettes smoked per day by everyday smokers did not change significantly from 2000 to 2002 for smokers in New York State, New York City or the rest of the state.

New York State 2001 2002
    n % C.I.** n % C.I.**
Total 3882 23.2 21.6-24.8 4449 22.3 20.8-23.8
Gender Male 1607 26.1 23.6-28.6 1748 25.8 23.3-28.3
Female 2275 20.7 18.7-22.7 2701 19.2 17.5-20.9
 
Age (yrs.) 18-24 317 33.0 26.7-29.3 331 29.0 23.2-34.8
25-34 796 28.7 25.0-32.4 829 23.9 20.5-27.3
35-44 874 26.3 22.8-29.8 928 27.5 24.1-30.9
45-54 748 25.5 22.0-29.0 888 23.7 20.4-27.0
55-64 480 17.2 13.3-21.1 595 19.3 15.4-23.2
65+ 596 10.8 8.1-13.5 815 10.7 8.1-13.3
 
Race/
Ethnicity
White,Non-Hispanic 2761 24.9 23.0-26.5 3188 23.2 21.5-24.9
Black,Non-Hispanic 361 17.9 13.4-22.4 424 19.7 15.3-24.1
Hispanic 478 21.9 17.5-26.3 460 21.5 16.9-26.1
Other 224 21.4 15.1-27.7 310 21.7 16.1-27.3
 
Education < High School 383 29.7 24.2-35.2 437 32.1 26.9-37.3
High School 1052 27.9 24.9-30.9 1272 26.7 23.8-29.6
Some College 1004 25.3 22.0-28.6 1089 24.4 21.2-27.6
College Grad+ 1431 14.8 12.7-16.9 1632 13.1 11.2-15.0

No significant changes from 2001-2002.

**95% Confidence Interval

New York City 2001 2002
  n % C.I.** n % C.I.**
Total 1314 21.1 18.5-23.7 1383 18.6 16.1-21.1
Gender Male 543 23.5 19.3-27.6 508 23.2 18.8-27.6
Female 771 18.8 15.7-21.9 875 14.9 12.1-17.7
 
Age (yrs.) 18-24* 121 29.4 20.5-38.3 117 15.2 8.3-22.1
25-34 352 23.9 18.5-29.3 352 20.3 15.3-25.3
35-44 285 21.0 15.1-26.9 285 25.8 19.2-32.4
45-54 229 22.7 16.2-29.2 234 16.7 11.3-22.1
55-64 150 18.5 11.6-25.4 165 22.0 13.8-30.2
65+ 149 11.1 5.6-16.6 201 9.6 4.6-14.6
 
Race/
Ethnicity
White,Non-Hispanic 579 25.5 21.3-29.7 598 20.2 16.4-24.0
Black,Non-Hispanic 240 16.4 11.2-21.6 291 15.4 10.7-20.1
Hispanic 340 21.6 16.5-26.7 302 18.0 12.9-23.1
Other 126 16.6 9.3-24.0 159 20.3 12.1-28.5
 
Education < High School 193 23.1 16.2-27.0 201 22.1 15.4-28.8
High School 296 21.1 15.9-26.3 328 22.2 16.6-27.8
Some College 281 21.1 15.7-26.5 304 20.2 14.8-25.6
College Grad+* 540 19.7 15.6-23.8 541 12.1 9.1-15.1

*Significant change from 2001-2002, p<0.05.

**95% Confidence Interval

New York State Exclusive of New York City 2001 2002
  n % C.I.** n % C.I.**
Total 2568 24.4 22.4-26.4 3066 24.3 22.5-26.1
Gender Male 1064 27.5 24.4-30.6 1240 27.1 24.1-30.1
Female 1504 21.7 19.1-24.3 1826 21.6 19.4-23.8
 
Age (yrs.) 18-24 196 35.0 26.7-43.3 214 37.8 30.8-45.6
25-34 444 32.6 27.7-37.5 477 26.9 22.3-31.5
35-44 589 29.1 24.8-43.4 643 28.3 24.4-32.2
45-54 519 27.0 22.7-31.3 654 26.6 22.6-30.6
55-64 330 16.6 11.9-21.3 430 17.9 13.8-22.0
65+ 447 10.6 7.5-13.7 614 11.1 8.1-14.1
 
Race/
Ethnicity
White,Non-Hispanic 2182 24.8 22.7-26.9 2590 23.8 21.9-25.7
Black,Non-Hispanic 121 20.8 12.2-29.4 133 28.3 19.2-37.4
Hispanic 138 22.4 14.2-30.6 158 27.6 19.0-36.2
Other 98 27.5 17.0-37.9 151 23.1 15.3-30.9
 
Education < High School 190 37.3 29.1-45.5 236 42.4 34.7-50.1
High School 756 31.0 27.3-34.7 944 28.8 25.4-32.2
Some College 723 27.2 23.1-31.1 785 26.2 22.3-30.1
College Grad+ 891 12.1 9.7-14.5 1091 13.6 11.2-16.0

No significant changes from 2001-2002.

**95% Confidence Interval

 

Figure 1. Prevalence of Current Smoking for Males by Age: New York State BRFSS 2001-2002

No significant changes from 2001-2002.

Figure 1. Prevalence of Current Smoking for Females by Age: New York State BRFSS 2001-2002

* Significant change from 2001-2002, p<0.05.

Year Current Smokers (%) Everyday Smokers (%)* Some day Smokers (%)*
1996 23.3 19.2 4.0
1997 23.1 19.1 4.0
1998 24.1 18.4 5.7
1999 21.8 17.0 4.8
2000 21.6 15.9 5.7
2001 23.2 16.6 6.6
2002 22.3 16.9 5.4

*Trend analysis indicates significant change from 1996-2002, p<0.05.

  New York State New York City Rest of State
Year n % C.I.** n % C.I.** n % C.I.**
Everyday Smokers
2001 3882 16.6 15.2-18.0 1314 13.2 16.7-20.3 2568 18.5 11.1-15.3
2002 4449 16.9 15.6-18.2 1383 13.6 11.4-15.8 3066 18.6 17.0-20.3
Someday Smokers
2001 3882 6.6 5.7-7.5 1314 7.9 6.2-9.6 2568 5.9 4.9-6.9
2002 4449 5.4 4.6-6.3 1383 5.0* 3.6-6.4 3066 5.7 4.6-6.7

*Significant change from 2001-2002, p<0.05.

**95% Confidence Interval

  New York State New York City Rest of State
Year n Avg Std Dev n Avg Std Dev n Avg Std Dev
Everyday Smokers
2000 544 16.8 9.9 157 14.1 8.6 387 17.9 10.2
2002 677 16.2 9.7 171 14.0 9.6 506 17.0 9.6
Someday Smokers
2000 188 5.5 5.0 79 5.3 4.8 109 5.6 5.3
2002 206 5.2 4.8 66 4.3 3.8 140 5.6 5.2

No significant changes from 2000-2002.

  New York State New York City Rest of State
  n % C.I.** n % C.I.** n % C.I.**
Within past month
2000 864 2.4 1.2-3.5 255 3.1 0.7-5.5 609 2.1 0.8-3.3
2002 1142 2.2 1.0-3.3 266 3.5 0.3-6.7 876 1.7 0.7-2.8
Within past 3 months
2000 864 1.6 0.7-2.5 255 2.0 1.0-3.0 609 1.4 0.4-2.4
2002 1142 1.9 1.0-2.8 266 3.7 1.3-6.1 876 1.3 0.4-2.2
Within past 6 months
2000 864 3.7 0.9-6.4 255 3.2 0.9-5.5 609 3.9 0.1-7.6
2002 1142 3.4 2.1-4.8 266 3.6 1.3-5.9 876 3.4 1.8-5.0
Within past year
2000 864 5.7 3.8-7.6 255 7.1 3.0-11.2 609 5.1 3.1-7.1
2002 1142 2.8* 1.8-3.9 266 4.3 1.6-7.1 876 2.4* 1.3-3.5
Within past 5 years
2000 864 18.6 15.4-21.9 255 16.6 11.6-21.5 609 19.5 15.4-23.6
2002 1142 15.7 13.2-18.2 266 16.9 11.1-22.7 876 15.3 13.2-18.2

*Significant change from 2000-2002, p<0.05.

**95% Confidence Interval

Cessation

The percentage of everyday smokers (those who have smoked 100 cigarettes in their lifetime and now smoke every day) in New York State and New York City who made an attempt to quit smoking in the past 12 months increased significantly from 2001-2002 (p<0.05). (See Table 8).

Non-significant increases among everyday smokers in New York State who made cessation attempts were also observed when comparing rates by gender and race (see Figure 3). The percent of black smokers who have made a quit attempt in the past 12 months (73.5%) is close to the Healthy People 2010 (HP2010) target for cessation attempts of 75%.

Figure 3. Percent adult current everyday smokers who have stopped smoking for one day or more in the past 12 months by gender and race:  New York State BRFSS 2001-2002

  New York State New York City Rest of State
Year n % ±C.I.** t p-value n % ±C.I.** t p-value n % ±C.I.** t p-value
2001 661 49.6 4.7 2.58 0.010 175 50.8 8.6 2.23 0.026 486 49.1 5.6 1.68 0.093
2002 740 57.9* 4.2 194 64.2* 8.1 546 55.5 4.9

*Significant change from 2001-2002, p<0.05.

**95% Confidence Interval

Marketing

The percentage of smokers and former smokers who have heard, read or seen cessation information in various marketing venues increased non-significantly from 2000 to 2002 (see Table 9). Importantly, over 90% of current and former smokers were exposed to cessation information in one or more media outlets. Television or radio reached more than three fourths of the adult population that smoke, while family/friends/coworkers, newspapers and other printed materials, billboards and health care providers reach more than the majority of adult smokers and former smokers (see Table 10).

  New York State New York City Rest of State
Year n % C.I.** n % C.I.** n % C.I.**
2000 528 85.8 82.1-89.5 174 82.4 74.8-90.1 354 87.3 83.3-91.4
2002 1009 91.4 89.2-93.6 282 89.9 85.6-94.3 727 92.0 89.5-94.5

No significant changes from 2000-2002.

**95% Confidence Interval

  New York State New York City Rest of State
n % C.I.** n % C.I.** n % C.I.**
2000 457 85.8 82.2-89.3 149 88.5 82.9-94.2 308 84.6 80.1-89.1
2002 930 87.6 85.1-90.1 254 88.8 83.1-94.4 676 87.1 84.4-89.8
2000 458 46.6 40.9-52.3 149 54.1 44.9-63.3 309 43.4 36.4-50.4
2002 917 55.5 51.7-59.3 251 63.2 55.7-70.7 666 52.5 48.1-57.0
2000 458 59.7 53.7-65.6 149 62.7 53.7-71.8 309 58.3 50.8-65.8
2002 932 58.6 54.8-62.4 255 62.1 54.7-69.6 677 57.3 52.8-61.7
2000 458 76.1 71.4-80.7 149 76.5 68.6-84.4 309 75.9 70.2-81.6
2002 932 64.4 60.7-68.0 255 63.6 56.1-71.0 677 64.7 60.5-68.8
2000 457 74.4 69.8-79.1 148 79.3 72.5-86.1 309 72.4 66.4-78.3
2002 929 13.0 10.2-15.7 253 16.9 10.8-23.0 676 11.5 8.5-14.4
2000 456 13.1 9.5-16.7 147 18.6 10.8-26.4 309 10.7 7.0-14.4
2002 929 13.0 10.2-15.7 253 16.9 10.8-23.0 676 11.5 8.5-14.4
2000 NA     NA     NA    
2002 925 5.7 4.1-7.4 251 6.9 3.6-10.1 674 5.3 3.4-7.2

No significant changes from 2000-2002.

**95% Confidence Interval

Exposure to Secondhand Smoke

Rules regarding smoking in the home have changed significantly among smokers and non-smokers. The percentage of smokers in New York State who live in homes where smoking is allowed in some places decreased significantly from 33.8% in 2000 to 27.2% in 2002 (p<0.05) and the percent of smokers who live in homes where smoking is not allowed increased significantly from 28.6% in 2000 to 36.1% in 2002 (p<0.05). Smokers in the rest of the state who live in homes where smoking is allowed in some places decreased significantly from 32.3% in 2000 to 25.3% in 2002 (p<0.05) (see Tables 11-12).

The percentage of non-smokers in New York State who live in homes where smoking is not allowed remained steady at about 73%.

The percentage of New Yorkers employed in jobs where smoking is not allowed did not change between1999 to 2002 (see Table 13). It is important to note that, in July 2003, New York State passed a Clean Indoor Air law prohibiting smoking in most workplaces. These indicators will be closely monitored for the effect on workplace exposure to second-hand smoke.

  New York State New York City Rest of State
n % C.I.** n % C.I.** n % C.I.**
 
No one is allowed to smoke anywhere Smoker 2000 470 28.6 23.8-33.4 151 25.4 17.3-33.5 319 30.1 24.1-36.1
2002 897 36.1* 32.2-40.0 241 34.3 26.4-42.3 656 36.8 32.3-41.3
 

Non-smoker

2000 1,545 73.7 71.7-76.3 532 75.8 71.5-80.1 1,013 72.5 69.2-75.8
2002 3,237 72.9 71.1-74.7 999 73.6 70.3-77.0 2,238 72.5 70.4-74.7
 
Smoking is allowed in some places Smoker 2000 470 33.8 28.9-38.7 151 37.2 28.1-46.3 319 32.3 26.5-38.1
2002 897 27.2* 23.8-30.7 241 32.4 25.3-39.5 656 25.3* 21.4-29.1
 
Non-smoker 2000 1,545 15.2 13.1-17.3 532 14.6 11.1-18.1 1,013 15.6 13.0-18.2
2002 3,237 8.8* 7.6-10.0 999 10.8 8.4-13.3 2,238 7.8* 6.5-9.1
 
Smoking is permitted anywhere/***There are no rules about smoking in the home Smoker 2000 470 37.5 32.5-42.5 151 37.4 28.3-46.5 319 37.6 31.6-43.6
2002 897 36.7 32.9-40.4 241 33.3 26.1-40.5 656 37.9 33.6-42.3
 
Non-smoker 2000 1,545 11.1 9.3-12.9 532 9.5 6.7-12.3 1,013 11.9 9.6-14.2
2002 3,237 18.3* 16.7-19.9 999 15.5* 12.8-18.3 2,238 19.7* 17.8-21.6

*Significant change from 2000-2002, p<0.05

**95% Confidence Interval

***Additional response

These two responses were combined into one response category for BRFSS 2000 and treated as separate responses for BRFSS 2002. For the purpose of this analysis, the two responses are combined.

  New York State New York City Rest of State
  n %
change
t p-value n %
change
t p-value n %
change
t p-value
Smoker 2001 470 7.5 2.35 0.019 151 8.9 1.55 0.122 319 6.7 1.76 0.078
2002 897 241 656
Non-smoker 2001 1,545 -0.8 -0.51 0.613 532 -2.2 -0.80 0.422 1.013 0.0 -0.02 0.985
2002 3,237 999 2,238
Smoker 2001 470 -6.6 -2.16 0.031 151 -4.8 -0.82 0.415 319 -7.1 -1.99 0.047
2002 897 241 656
Non-smoker 2001 1,545 -6.4 -5.14 0.000 532 -3.8 -1.73 0.084 1.013 -7.8 -5.17 0.000
2002 3,237 999 2,238
Smoker 2001 470 -0.9 -0.28 0.780 151 -4.1 -0.70 0.484 319 0.4 0.09 0.926
2002 897 241 656
Non-smoker 2001 1,545 7.2 5.95 0.000 532 6.0 3.02 0.003 1.013 7.8 5.14 0.000
2002 3,237 999 2,238

  New York State New York City Rest of State
  n % C.I.** n % C.I.** n %t C.I.**
1999 1,253 83.7 81.3-86.1 451 85.6 81.9-89.3 802 82.6 79.5-85.7
2002 2,069 81.3 79.1-83.4 636 78.3 73.9-82.6 1,433 82.8 80.5-85.1
1999 1,253 10.1 8.1-12.1 451 8.4 5.4-114 802 11.1 8.5-13.7
2002 2,069 11.2 9.5-12.9 636 12.0 8.6-15.3 1,433 10.8 8.9-12.7
1999 1,253 1.8 0.9-2.7 451 1.4 0.2-2.6 802 2.1 0.9-3.3
2002 2,069 1.8 1.0-2.5 636 1.9 0.2-3.5 1,433 1.7 0.9-2.5
1999 1,253 4.4 3.1-5.7 451 4.6 2.4-6.8 802 4.2 2.7-5.7
2002 2,069 5.8 4.5-7.1 636 7.9 4.9-10.9 1,433 4.7 3.5-6.0

No significant changes from 1999-2002.

* *95% Confidence Interval

References

  1. US Department of Health and Human Services. Healthy People 2010: National Health Promotion and Disease Prevention Objectives. Washington: US Department of Health and Human Services, Public Health Service, 2000.
  2. Shah, BV, Barnwell, BB, Bieler, GS. SUDAAN Software for the Statistical Analysis of Correlated Data, User’s Manual, release 7.0 1996. Research Triangle Park, North Carolina, 1996.
  3. Remington PL, Smith MY, Williamson DF, Anda RF, Gentry EM, Hogelin GC. Design, characteristics, and usefulness of state-based behavioral risk factor surveillance: 1981-87. Public Health Rep 1988; 103: 366-75.