摘要：Objectives. We assessed the prevalence and sociodemographic correlates of tobacco use among US adults. Methods. We used data from the 2009–2010 National Adult Tobacco Survey, a national landline and cell phone survey of adults aged 18 years and older, to estimate current use of any tobacco; cigarettes; cigars, cigarillos, or small cigars; chewing tobacco, snuff, or dip; water pipes; snus; and pipes. We stratified estimates by gender, age, race/ethnicity, education, income, sexual orientation, and US state. Results. National prevalence of current use was 25.2% for any tobacco; 19.5% for cigarettes; 6.6% for cigars, cigarillos, or small cigars; 3.4% for chewing tobacco, snuff, or dip; 1.5% for water pipes; 1.4% for snus; and 1.1% for pipes. Tobacco use was greatest among respondents who were male, younger, of non-Hispanic “other” race/ethnicity, less educated, less wealthy, and lesbian, gay, bisexual, or transgender. Prevalence ranged from 14.1% (Utah) to 37.4% (Kentucky). Conclusions. Tobacco use varies by geography and sociodemographic factors, but remains prevalent among US adults. Evidence-based prevention strategies are needed to decrease tobacco use and the health and economic burden of tobacco-related diseases. Tobacco use remains the single largest preventable cause of disease and premature death among both men and women in the United States. 1 Health effects associated with tobacco use include heart disease, many types of cancer, pulmonary disease, adverse reproductive outcomes, and the exacerbation of multiple chronic health conditions. 2 Cigarette smoking alone has been estimated to cause 443 000 deaths per year in the United States, including approximately 49 400 deaths attributed to secondhand smoke exposure. 3 In addition, cigarette smoking has been estimated to cost the United States $96 billion in direct medical expenses and $97 billion in lost productivity per year. 3 Despite significant progress over the past several decades, 4 declines in the prevalence of cigarette smoking and the use of other tobacco products among US adults have stalled in recent years. 5,6 Monitoring the extent of the tobacco epidemic can assist in guiding decisions about tobacco control strategies for the overall population and high-risk subpopulations. The World Health Organization recognizes that monitoring tobacco use is an important and effective tobacco control approach in its MPOWER model and encourages the collection of data on tobacco use prevalence and consumption by demographic subdivisions, both nationally and regionally. 7 In the United States, the report Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs (KOI report) identified valid and reliable measures for tobacco-related indicators and provided a guide for tobacco control surveillance at the national, state, and local levels. 8 The National Adult Tobacco Survey (NATS) is the first adult tobacco use survey designed within the framework of the KOI report. 9 NATS establishes a comprehensive standard for assessing the prevalence of tobacco use and the factors promoting and impeding tobacco use at both the national and state levels. We analyzed NATS data to determine the national prevalence and sociodemographic correlates of tobacco use among US adults, both overall and for multiple tobacco products. We also calculated state-specific estimates for overall tobacco use and for cigarette smoking.
