Changes in Cross-Sectional Measures of Cessation, Numbers of Cigarettes Smoked per Day, and Time to First Cigarette—California and National Data

Per capita consumption of cigarettes and smoking prevalence have been declining since the 1960s (U.S. DHHS 2000), but trends in these measures ceased to decline and became flat during the mid-1990s. These observations suggest that smoking cessation rates may also have fallen because those who could easily quit may have done so and left behind a more-addicted and hardened target population of smokers. This chapter presents the decline in national cessation rates observed between the 1992/93 and 1995/96 Current Population Surveys (CPS) and explores whether these declines in cessation are accompanied by changes in smoking behavior or in the pattern of cessation activity consistent with hardening of the residual smoking population. Data from the 1990, 1996, and 1999 California Tobacco Surveys (CTS) are also examined. California has experienced a decline in both per capita consumption and prevalence over the last decade well in excess of that seen nationally (Gilpin et al. 2001). If a hardened population of residual smokers is developing because those who could be induced to quit using current tobacco control strategies have already quit, then it might be most evident in California where the largest gains in reducing smoking with current tobacco control approaches have occurred. Changes in cessation, number of cigarettes smoked per day, and time to first cigarette (a measure of addiction) occurring between 1990 and 1999 in California are explored for evidence of hardening. One of the clearest measures of change in smoking behavior is the per capita consumption of cigarettes. Figure 8-1 presents the U.S. per capita consumption from 1950 to 2000. It shows a progressive declin