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Quitting smoking has major and immediate health benefits for men and women of all ages. Quitting smoking dramatically reduces the risk of lung and other cancers, coronary heart disease, stroke, and chronic lung disease. For example, 10 years after a person quits smoking, his or her risk of lung cancer is decreased to about one-third to one-half of that of a person who continues to smoke; with continued abstinence from smoking, the risk of lung cancer decreases even further.
Although quitting smoking is beneficial at any age, the earlier in life a person quits, the more likely it is that he or she will avoid the devastating health effects of continued tobacco use. Few smokers can quit successfully on their first attempt; most people will require several attempts before they are able to permanently quit. This emphasizes the need for smokers to begin trying to quit as early in life as possible.
Attempt to quit: Percentage of adult smokers aged 18 years and older who attempted smoking cessation in the past 12 months. This “attempt to quit” includes both current (everyday and some days) smokers at the time of the survey who quit smoking for one day or longer during the past 12 months and recent former smokers (those who quit smoking less than one year ago).
Successful quitting: Percentage of current smokers who initiated smoking at least two years ago and recent former smokers (aged 18 years and older) who had successfully quit smoking 6 to 12 months ago.
Quit Attempts of One Day or Longer
Overall, quit attempts of one day or longer remained stable between 1998 and 2005 and rose during the period between 2005 and 2010. The trends by sex show increases over the entire period between 1998 and 2010 for both men (44.4 percent in 1998 to 48.7 percent in 2010) and women (46.1 percent in 1998 to 51.9 percent in 2010). There was no change in rates among adults aged 18 to 24 years based on age ; however, among those aged 25 years and older, there was a significant increase from 43.6 percent in 1998 to 48.6 percent in 2010.
In population subgroups considered by poverty status, there was a small but significant rise in attempts over the whole period of 1998 to 2010 for those greater than or equal to 200 percent of the poverty level. In contrast, those at less than 200 percent of the poverty level had no change in attempt to quit between 1998 and 2007 but a significant rise in attempts from 45.9 percent in 2007 to 51.4 percent in 2010. There were no differences in trends based on level of education.
Attempt-to-quit rates have significantly increased across all races/ethnicities (i.e., Hispanics, non-Hispanic whites, and non-Hispanic blacks). The increase over the entire period of 12.6 percentage points for Hispanics is significantly greater than the 3.7 percentage point increase for non-Hispanic whites.
Recent Successful Quitting 6-12 Months Ago
During this period, trends in rates of successfully quitting were stable or showed no change for the various subgroups defined by race/ethnicity, poverty status, or level of education.
Quit Attempts of One Day or Longer
In 2010, 50.2 percent of smokers aged 18 years and older (48.7 percent for men, 51.9 percent for women) stopped smoking for one day or longer because they were trying to quit. Attempt-to-quit rates were higher among adults aged 18 to 24 years (60.6 percent) than among adults aged 25 years and older (48.6 percent).
The percentages of those attempting to quit was very similar among Hispanics (54.8 percent) and non-Hispanic blacks (55.9.0 percent) but were slightly lower for non-Hispanic whites (48.8 percent). These percentages by poverty level were also similar (49.4 percent for those at greater than or equal to 200 percent of the poverty level and 51.4 percent for those at less than 200 percent of the poverty level). Based on education level for adults aged 25 years and older, the corresponding percentages were 45.6 for those with less than a high school education, 46.2 for those with a high school education, and 51.0 for those with greater than a high school education.
Recent Successful Quitting 6-12 Months Ago
In 2010, 6.2 percent of adults (6.2 percent for men and 6.2 for women) aged 18 years and older had successfully quit smoking 6 to 12 months ago. Rates of successfully quitting were 8.2 percent for adults aged 18 to 24 years and 5.9 percent for adults aged 25 years and older.
Based on race/ethnicity, the percentage that successfully quit smoking in 2010 was higher among Hispanics (8.9 percent) and non-Hispanic whites (6.1 percent) relative to non-Hispanic blacks (3.5 percent).
By poverty level, the corresponding percentages were 7.2 for those at greater than or equal to 200 percent of the poverty level and 5.0 for those at less than 200 percent of the poverty level. Based on education level for adults aged 25 years and older, these percentages were 3.1 for those with less than a high school education, 4.7 for those with a high school education, and 7.8 for those with more than a high school education.
Increase to 80 percent the proportion of adult current smokers (aged 18 years and older) who stopped smoking for a day or longer because they were trying to quit.
Increase to 8 percent the proportion of adult smokers (aged 18 years and older) who successfully quit smoking for at least 6 months or longer in the past 12 months.
Adults aged 25 years and older attempt to quit smoking less often than adults aged 18 to 24 years.
Non-Hispanic whites had a lower percentage of quit attempts than either non-Hispanic blacks or Hispanics, while non-Hispanic blacks were less likely to successfully quit smoking than Hispanics and non-Hispanic whites.
Those with incomes less than 200 percent of the poverty level succeeded in quitting smoking less often than those at or greater than 200 percent of the poverty level.
Those with less than or equal to a high school education made fewer attempts to quit smoking and successfully quit smoking less often than those with greater than a high school education.
Efforts to increase successful quitting are most effective when multiple techniques are used, including clinical (individual or group-based), regulatory (such as smoke-free indoor air laws), and economic interventions (for example, increasing excise taxes). Media campaigns and other social strategies are also effective in increasing successful quitting.
A number of approaches have proven effective in helping smokers quit, including behavioral counseling (individual, group, and telephone-based) and medications. The U.S. Food and Drug Administration (FDA) has approved seven medications for treating tobacco dependence. Behavioral counseling and medication are effective when used alone but are more effective when used together. Telephone quitlines have been shown to be effective in providing wide access to evidence-based cessation counseling and are effective with diverse populations. However, most people attempting to quit do not make use of these evidence-based strategies. Increasing the proportion of smokers who use evidence-based interventions holds some promise for decreasing the overall prevalence of smoking.
The National Network of Tobacco Cessation Quitlines is a state/federal partnership that provides tobacco users in every state with access to the tools and resources they need to quit smoking. The toll-free number 1-800 QUIT NOW (1-800-784-8669) serves as a single point of access to state-based quitlines. The Smokefree.gov website (www.smokefree.gov) offers a variety of tools designed to help people quit smoking. Site features include an online step-by-step cessation guide, phone numbers for telephone support, a link to instant messaging with NCI counselors, facts about quitting and smoking, and self-help materials with links for downloading or ordering. Smokefree.gov was developed by NCI with assistance from CDC. The site is free to the public. Smokefree Women (women.smokefree.gov) and SmokefreeTXT (http://smokefree.gov/smokefreetxt/default.aspx), extensions of Smokefree.gov, include a special focus on topics important to women and young adults, respectively. SmokefreeTXT is a free mobile service designed for young adults across the United States. SmokefreeTXT was created to provide 24/7 encouragement, advice, and tips to help smokers stop smoking for good.
Low-income Americans are more likely than other Americans to be addicted to tobacco products. As of 2010, Medicaid programs in 50 states and Washington, D.C., provide coverage for at least one tobacco-dependence treatment for some portion of the Medicaid eligible population. However, only eight states provided coverage for all FDA-approved medications, and only one state (Oregon) provided coverage for all treatments recommended by the Public Health Service’s Clinical Practice Guideline. Additionally, some states employ measures that limit access, including copayments, limitations on number of treatment courses, and not allowing combined treatments. In addition, four states reported providing tobacco-dependence treatment to pregnant women only. Enhanced access to tobacco-dependence treatment among the Medicaid population will assist more low-income tobacco users to quit, and contribute to reducing cancer deaths and cancer-related health disparities in this population. (See chapter on Medicaid Coverage in this report.)
State support of quitlines remains problematic. CDC has recommended minimum levels of funding for state-level comprehensive tobacco control programs (including quitlines); fully funding state tobacco control programs at the CDC-recommended level would require states to dedicate 15 percent of annual total tobacco-generated funds. Overall, states currently dedicate less than 2 percent of the $25.6 billion that will be collected this fiscal year to tobacco prevention and cessation programs; in fiscal year 2012, states cut funding for tobacco prevention and cessation programs to the lowest level since 1999, when they first received tobacco settlement funds. States have cut funding for these type of tobacco control programs by 12 percent in the past year and by 36 percent in the past four years; no state funded tobacco control programs at the CDC-recommended level.