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Epidemiology of tobacco use in the United States

Abstract

Efforts to understand trends in and patterns of lung cancer are well served by studies of trends in and patterns of tobacco use. In the United States, the manufactured cigarette emerged as the tobacco product of choice shortly after the turn of the twentieth century. Lung cancer emerged after years of inhalation of cigarette smoke, first among men and then among women. The massive public health education campaign that began after scientists recognized the dangers of cigarette smoking has contributed to large reductions in cigarette use and subsequent smoking-attributable morbidity and mortality. Since 1965, the prevalence of cigarette smoking among US adults has declined by almost half, with positive trends observed among persons in almost all sociodemographic groups and efforts to reduce disparities recognized as an important goal in public health. An epidemiologic approach to understanding and controlling patterns of tobacco use is proposed. The model focuses on the agent (tobacco products), host (consumer or potential consumer), vector (tobacco companies and other users), and environment (with influences from families, social sources, culture, history, politics, law, and media). Accelerating progress in reducing tobacco use will accelerate reductions in tobacco-attributable morbidity and mortality.

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Acknowledgements

This work is dedicated to the memory of John Slade, MD. I am grateful for the assistance of Allison Berkowitz, Patrick O'Malley, Anna Sandoval, Angela Trosclair, and Jun Yang in the preparation of this manuscript. The writing of this report was partially supported by three grants from the Robert Wood Johnson Foundation: Project ImpacTeen (Frank Chaloupka, University of Illinois at Chicago, Principal Investigator); the Research Network on the Etiology of Tobacco Dependence (Richard Clayton, University of Kentucky, Principal Director), and the Innovators Combating Substance Abuse Program (John Slade, University of Medicine and Dentistry of New Jersey, Original Principal Investigator); as well as by shared resources of the Roswell Park Cancer Center Support Grant P30 CA16056-26, from the National Cancer Institute.

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Giovino, G. Epidemiology of tobacco use in the United States. Oncogene 21, 7326–7340 (2002). https://doi.org/10.1038/sj.onc.1205808

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Keywords

  • epidemiology
  • tobacco use
  • cigarette smoking

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