The number of adult smokers in the United States has remained constant since 2004, according to a report published this week by the US Centers for Disease Control and Prevention (CDC).

Based on the CDC's numbers, 20.8% of US adults smoked in 2006, compared to the 20.9% who were smoking in 2004 and 2005, data that suggests a marked slowdown from the steady declines seen in previous years.

Who's Smoking?

The CDC analyzed data from the 2006 National Health Interview Survey (NHIS), a questionnaire that evaluated the smoking habits of 24,275 adults 18 and older. Of the group, 20.8% currently smoked, and among those individuals, 44.2% had made an effort to stop smoking in the last 12 months.

Slightly more men (23.9%) than women (18.0%) still light up. Only 10.4% of Asians surveyed still smoked, followed by Hispanics (15.2%), non-Hispanic whites (21.9%), non-Hispanic blacks (23%), and American Indians/Alaskan Natives (32.4%). And overall, the likelihood that a person might smoke decreased as education level increased.

Numbers were especially high among those who had already been diagnosed with smoking-related chronic diseases (36.9%), including certain cancers. That indicates a need for more aggressive cessation messages directed at this population, the researchers say, especially given data that shows that continued smoking has harmful effects on treatment and survival.

Behind the Numbers

There are likely several reasons for the standstill in smoking rates. The authors of the study point to the 20.3% decrease in funding for comprehensive state-sponsored smoking cessation and prevention programs from 2002 to 2006. On top of that, many states have re-allocated funds previously devoted to tobacco control, says Thomas J. Glynn, Ph.D., director of the American Cancer Society's Cancer Science and Trends and International Tobacco programs.

Also to blame: tobacco companies have offset the burden of cigarette price increases by offering coupons, two-for-one deals, and other incentives to smokers, retailers, and wholesalers. Approximately 81% of tobacco-industry marketing efforts were related to discounting strategies, according to the report.

Call to Action

In order to get the numbers down, tobacco control advocates need to turn the heat up, Glynn says. The American Cancer Society is calling for tighter regulations on cigarettes, from increasing workplace laws and cigarette tax increases to granting the Food and Drug Administration the authority to regulate tobacco products.

"Tobacco use rates could even begin to rise rather than stagnate if strong, effective action is not taken now," says Glynn.

Citation: "Tobacco Use Among Adults -- United States, 2006." Published in the Nov. 9, 2007 Morbidity and Mortality Weekly Report (Vol. 56, No. 44: 1157-1161). First author: VJ Rock, MPH, US Centers for Disease Control and Prevention.