Decline in Smoking Stalls: U.S. Adult Rate Remains at 21%

Some of the young people in Karen White’s smoking-cessation class believe slender cigars such as Black & Mild aren’t as bad for you as cigarettes.

"They think it’s not as harmful," said White, co-pastor of Kingdom Living Temple, which holds services in Henrico County.

But the slim cigars, which come in flavors such as apple and cherry-vanilla, can have as much or more tobacco and nicotine as a cigarette, experts say. And though they are not meant to be inhaled, some who smoke them do inhale.

"They think they know, but they don’t know," said White, who teaches the stop-smoking class as part of her church’s outreach ministry. The class is offered through the American Lung Association with funding from the Virginia Tobacco Settlement Foundation.

Smoking rates are no longer declining as they once were — and health advocates are worried. According to the Centers for Disease Control and Prevention, the steady decline in smoking seen from 1997 to 2004 has stalled among adults and youth.

From 2004 to 2006, the U.S. adult smoking rate stayed the same — about 21 per cent. In Virginia, an estimated 19 percent of adults were smokers in 2006. That is slightly down from 2005, but the difference may not be statistically significant. Survey data show youth smoking rates have also stalled.

"Everybody is pretty well-aware the decline in youth smoking that began several years ago has bottomed out," said Dr. Robert L. Balster, a professor of pharmacology and toxicology at Virginia Commonwealth University. "There are a lot of different explanations . . . that I have heard. I don’t know which ones are best supported."

For adults, Balster said, the data are better. One theory suggests that those who had an easier time quitting did so early on during the anti-smoking push.

People whose dependence was not so severe already have quit, Balster said. "The remaining percent is a pretty addicted bunch. That wouldn’t be quite so applicable to youth" because those numbers include those new to smoking, he said.

Federal officials believe the reason rates are stagnant may have to do with several things. Dollars for comprehensive state programs to curb tobacco use have declined about 20 percent. And though tobacco companies in recent years have spent fewer dollars promoting cigarettes, the $13.1 billion spent in 2005 is still significant. Most of that spending was in the form of discounts to retailers or wholesalers so they could reduce the price to consumers.

The Campaign for Tobacco-Free Kids is pushing for higher tobacco taxes — money that would help fund health insurance for children — and for cigars to be treated the same as cigarettes. Some cities and states have enacted, or are pushing for, stricter regulations on cigars, including banning flavored ones.

"A lot of cigarettes are pretending to be little cigars," said Eric Lindblom, director of policy research at The Campaign for Tobacco-Free Kids based in Washington. "They pay much lower taxes. They evade state regulation. They get lower prices so kids can afford to smoke them."

Technically, cigars are wrapped in tobacco leaf and cigarettes are wrapped in paper. Cigars can be sold in smaller quantities, such as a five-pack. Marketing and advertising restrictions are also looser. Federal officials just this year started requiring cigars to carry health-warning labels like cigarettes.

"While cigarette companies have been stopped from selling flavored cigarettes, cigar companies are selling every flavor you can think of," Lindblom said. "Alcohol-based flavors, fruit flavors, making them much more attractive to kids."

The popularity of slender cigars has the attention of the big tobacco firms. Altria Group Inc. recently acquired John Middleton Inc., which makes the Black & Mild brand. The company noted in a news release plans to "accelerate the Black & Mild brand’s market share growth," which is strongest in the South.

Evan Moore, 19, smoked from age 15 until last year, when he enrolled in White’s smoking-cessation class.

He said he often got his cigarettes on sale during promotions that offered two packs for the price of one. Mostly he smoked Newport cigarettes, but also cigars.

"I could go though a pack of Black & Mild in a couple of hours," said Moore, referring to a pack of five. He quit, he said, because he was playing sports, and smoking was affecting his breathing.

Alicia Janee Morris, 19, had a different reason for quitting — she was pregnant with son Zyon, now 3 months old.

"My son was more important than cigarettes," Morris said. She said she started smoking at 14 because everybody else was doing it. At first, she only smoked with her friends.

"Then I was doing it on my own," she said. "I kind of got addicted."

Contact staff writer Tammie Smith at TLsmith@timesdispatch.com or (804) 649-6572.