Stability of smoking status in the US population: a longitudinal investigation

AIMS: To determine smoking transitions in a representative sample of US adults. DESIGN: Longitudinal study using data from the National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-02; wave 2, 2004-05). SETTING: The general US adult population. PARTICIPANTS: A total of 33 309 adults (53.6% female) classified as wave 1 current daily, current non-daily, former daily, former non-daily or never smokers. MEASUREMENTS: Smoking transitions were determined from waves 1 and 2 data. FINDINGS: Smoking status remained stable for the majority of current daily (79.8%), former daily (95.8%), former non-daily (96.3%) and never (97.1%) smokers. Among current non-daily smokers, 54.5% quit smoking while 22.5% increased to daily smoking. Current daily smokers who were older [30-44, odds ratio (OR) = 0.62; 95% confidence interval (CI) = 0.49-0.78; 45+, OR = 0.75; 95% CI = 0.61-0.93] and unmarried (OR = 0.80, 95% CI = 0.66-0.96) were less likely to report smoking cessation. Current daily smokers who were Hispanic (OR = 2.15, 95% CI = 1.65-2.81) and college educated (OR = 1.27, 95% CI = 1.05-1.53) were more likely to report smoking cessation. Relapse in former daily smokers was greater in women (OR = 1.44, 95% CI = 1.01-2.06) and lower in older adults (OR = 0.44; 95% CI = 0.27-0.74). Smoking initiation occurred less in women (OR = 0.65; 95% CI = 0.49-0.87) and Hispanic adults (OR = 0.57; 95% CI = 0.36-0.91) and more in unmarried adults (OR = 1.84; 95% CI = 1.37-2.47) and adults with less education (OR = 1.63; 95% CI = 1.09-2.44). CONCLUSIONS: From 2001 to 2005, smoking status was extremely stable in the US population. Specific gender, race and educational groups need increased prevention and intervention efforts.