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Nearly One-Fourth of Delaware Adults
Now Use Tobacco Products


Cigarette smoking prevalence among Delaware adults held steady at 17.7 percent (confidence interval of 15.9 - 19.5 percent) in 2016, according to the Delaware Behavioral Risk Factor Survey (BRFS).   This is statistically the same as the 2015 prevalence of 17.4 percent. 

However, when considering all the other forms of tobacco currently being used, total tobacco use prevalence is now 24.2 percent of adult Delawareans.

More than half (55.5 percent) of Delaware adults now say they have never smoked.  Another 26.8 percent of respondents were former smokers.  The BRFS defines "current smoker" as anyone who smokes every day or some days during the week.  Only 12.4 percent of respondents say they smoke cigarettes every day; while 5.2 percent call themselves "some-day smokers."   The "some-day smokers" group includes younger adults who are just starting to smoke, but also includes smokers who are cutting back or trying to quit.   

A majority of smokers (56.8 percent) said they had tried to quit smoking during the past year.

There were no statistically significant differences in smoking prevalence by county.   

Cigarette Smoking by County, 2016
  Statewide New Castle County Kent Co. Susssex County

Current Smokers

17.7%  17.3% 17% 19%

 

Although men have a slightly higher smoking prevalence (19 percent) than women (16.4 percent), the difference is not statistically significant when confidence intervals are considered.   There are also no statistically significant differences by race or ethnicity.

Smoking has significantly decreased over the past decade among 18-24 year old adults, at least partly because smoking had decreased among high school students who have now entered the adult category.  In 2016 only 11.8 percent of respondents in the 18-24 age group reported smoking cigarettes (down from 26.9% a decade ago).  The age group with the highest cigarette smoking prevalence is now adults between the ages of 25 and 34; 23.3 percent of adults 25-34 are smokers.   Only 9.4 percent of adults age 65 and older are smokers.

Although the BRFS does not ask at what age adults initiated smoking, the Division of Public Health conducts a companion survey called the Adult Tobacco Survey (ATS).   According to the 2016 ATS, among adults who currently smoke, 76 percent first tried smoking before age 18, and 20.5 percent first tried smoking after they turned 18 but before age 21.   Only 3.5% of Delaware adults first tried smoking after age 21.

Higher Risk

Some groups of adults have a significantly greater risk of becoming smokers, including people with disabilities and with depression or other mental health conditions. 

Among adults reporting a significant number of "poor mental health days" each month, 35.6 percent are smokers, compared to only 15.5 percent of adults who reported no or few poor mental health days.   Likewise, 33.1 percent of adults who reported depressive disorders smoke cigarettes, compared to 14.5% of adults without depression. 

Among adults reporting any kind of disability, 28 percent were smokers, compared to 14.8 percent of adults without disabilities.

The highest smoking prevalence (33.3 percent) is among adults with an income of less than $15,000 per year, according to the BRFS.    The best predictor of smoking is educational level.  While 29 percent of adults with less than a high school education smoke cigarettes, only 8.5 percent of adults with a college degree are smokers.

Graph:  Smoking decreases and educational level increases.

 

Other Tobacco Products

The tobacco industry has introduced and heavily marketed a number of new tobacco products during the past decade, most of which have the same health risks as cigarettes.  Measuring the use of these other tobacco products is, therefore, as important as measuring prevalence of cigarette smoking.   

In 2016, 8.4 percent of Delaware adults reported using these other tobacco products — including cigars, little cigars or cigarillos, hookahs, pipes, bidis, kreteks, orbs, and strips.  These products are more popular among men and young adults.   About 13 percent of men reported using other tobacco products, and 22.6 percent of 18-24 young adults use them.

Little cigars have become more popular, with 6.3 percent of adult men reporting smoking little cigars during 2016.

Smokeless tobacco includes traditional products such as chewing tobacco and snuff, but more recently also includes snus (pronounced snooce).  Snus is flavored tobacco powder in teabag-like packets that are held between the lips and gums and do not require spitting.  While smokeless tobacco is not popular among women (only about 1 percent use it), 3.4 percent of men report using smokeless tobacco.  Use is highest (5.1 percent) among young adults age 18 to 24.

Electronic Devices or e-Cigarettes

Among teenagers, experimentation with electronic or e-cigarettes became very popular, starting in 2015.   According to the 2015 Youth Risk Behavior Survey of public high school students, 23.5 percent students had used e-cigarettes in the past month, and 2.3 percent were smoking or "vaping" e-cigarettes daily.

Experimentation with e-cigarettes is also catching on with adults.   According to the 2016 BRFS, about 4 percent of Delaware adults currently use e-cigarettes, about the same prevalence as the 2014 survey.  However, 9.6 percent of 18- to 24-year-old adults are "current users" of e-cigarettes.

In 2016, more than half of the adults who "vaped" e-cigarettes (54.1 percent) also were current smokers, thereby increasing potential harm.  Among current smokers, 23 percent also used e-cigarettes at least some days of the week.

Total Tobacco Use

While 17.7 percent of Delaware adults smoke cigarettes, the total percent of adults who use tobacco products is significantly higher.   The Delaware BRFS has calculated "total tobacco use" based on reported use of cigarettes, cigars, little cigars, e-cigarettes, smokeless tobacco, hookahs, and other tobacco products.  The formula takes into account the fact that many adults use multiple types of tobacco products. 

The total tobacco use prevalence for 2016 is 24.2 percent — or nearly a quarter of the state's adult population.



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