Cigarette smoking among women and men in the United States, 1900-1979

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(5) working paper department of economics. CIGARETTE SMOKING AMONG WOMEN AND MEN IN THE UNITED STATES, 1900-1979* Jeffrey E. Harris. Number 264. August 1980. massachusetts institute of. " I. technology 50 memorial drive Cambridge, mass. 02139.

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(7) CIGARETTE SMOKING AMONG WOMEN AND MEN IN THE UNITED STATES, 1900-1979* Jeffrey E. Harris. Number 264. August 19 80. *To appear in: The Health Consequences of Smoking for Women, A Report of the Surgeon General U.S. Department of Health and Human Services, Office of the Assistant Secretary for Health, Washington, D.C., 1980. .. Author address. &. phone. Massachusetts Institute of Technology E52-171 Cambridge, MA. 02139 617-253-2677.

(8) Digitized by the Internet Archive in. 2011 with funding from IVIIT. Libraries. r. http://www.archive.org/details/cigarettesmoking264harr.

(9) -2-. TABLE OF CONTENTS. List of Figures List of Tables. Introduction The Rise of Cigarette Smoking:. 1900-1950. The Emergence of Filtertip Cigarettes: 1951-1963. Increasing Public Health Awareness: 1964-1979 Exposure to Cigarette Smoke Among Successive Birth Cohorts. Cigarette Smoking among Young Women Summary. References. J.HARRIS. DRAFT.

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(11) -3-. LIST OF FIGURES Figure. 1,. Annual consumption. cigarettes. of. filtertip. and. cigarettes per person aged 18 years and over, 1900-1979, Figure. 2.. Percentage of adult current cigarette. smokers. in. the greater Milwaukee area, 1924-1979,. Figure. 3.. Changes in the. prevalence. of. cigarette. smoking. among successive birth cohorts of men, 1900-1978,. Figure. 4,. Changes in the. prevalence. of. cigarette. smoking. among successive birth cohorts of women, 1900-1978,. Figure. 5,. Mean. age. of. onset. of. regular. smoking. among. successive birth cohorts of women and men. Figure. 6,. Accumulated years of cigarette smoking per. person. among successive birth cohorts of women and men, 1978,. Figure. 7,. Proportion of years smoking. filtertip. cigarettes. among successive birth cohorts of women and men, 1975,. J.HARRIS. ;. '. '. DRAFT.

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(13) -4-. LIST OF TABLES Table. 1,. Estimates of the Prevalence Among. Smoking. Surveys, 1935. Table. 2.. Quitting. Adults, -. States,. Regular. Cigarette. Selected. National. 1979.. Estimated Among. United. of. of. Attempted. and. Recent. Cigarette. Smokers,. Rates. Adult,. Successful United. States, 1970 - 1979,. Table. 3,. Regular. Estimated Percentage Distribution of Adult. Cigarette Smokers According to F.T.C. "Tar" Content. of Primary Brand, United States,. Table. 4,. Frequency, United States, 1965 5.. 1970 - 1979,. Estimated Percentage Distribution of Adult Current. Cigarette Smokers According to. Table. Current. Reported -. Daily. Consumption. 1979,. Estimated Percentage of Current, Regular Cigarette. Smokers, Ages 12 - 18, United States, 1968 - 1979,. J,. HARRIS. DRAFT.

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(15) -5-. Introduction This chapter traces the evolution of cigarette. generations. successive. among. during. twentieth. the. demonstrates. century.. women. that. American. of. women. and men. evidence. available. The. differed. have. smoking. from men in their. historical onset of widespread cigarette use, in the rate of. diffusion of smoking among each new birth cohort, intensity. cigarette. of. their. in. and their use of various. smoking,. types of cigarettes.. conclusions. main. Four. from. emerge. analysis.. this. First, although men rapidly took up smoking during the early. decades. of. this. century,. proportion of adult female. the. cigarette smokers did not exceed one-quarter until the onset of World War II.. among. The peak. intensity. women born after 1920.. Second, as. past rates of quitting and lower past. occurred. smoking. of a. result of higher of. rates. initiation. among men, as well as other changes in the type of cigarette. consumed,. the. smoking characteristics of women and men are. now becoming increasingly similar.. cigarette smoking among adult declining.. This. American. women. and. increasing. youngest. public. generation. awareness. in the nature of the cigarette product.. J.HARRIS. the. is. of. of. women.. the. health. consequences of smoking has resulted in significant. about. men. conclusion applies to all age groups, but. with less certainty to the Fourth,. Third, the prevalence of. effects. of. these. changes. Yet little is known. product. changes. on. the. DRAFT.

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(17) -6-. initiation,. maintenance. cessation. and. of. smoking,. particularly among women. Since the last review of cigarette smoking in the. Report of the Surgeon General have. been. performed. (26). ,. two new national surveys. under the sponsorship of the National. Center for Health Statistics and the National Education.. This. 1979. chapter. relies. in. part. Institute. of. on the recent,. preliminary results of these surveys.. J.HARRIS. DRAFT.

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(19) -7-. The Rise of Cigarette Smoking: 1900 - 1950. Although the use of cigarettes in was. observed. as early as 1854. (44,50), consumption did not. increase dramatically until after 1900. 1,. consumption. capita. per. of. all. As shown in. types. transient decline during the Great from. [INSERT FIGURE. a. consumption. Depression,. (52), 1. ABOUT HERE,]. nationally. continuous,. representative. series. of. prevalence rates during the period 1900-1950 is not. smoking. Nevertheless, numerous sources. publicly available. pieced. Despite. cigarettes per capita in 1920 to 3,522. 665. cigarettes per capita in 1950. A. Figure. cigarettes. of. increased by more than tenfold from 1900 to 1920.. increased. States. United. the. can. be. to characterize the differential growth of. together. cigarette smoking among women and men. Figure and. depicts estimates of the. 2. current. female. percentage. smokers. cigarette. In. 1923,. first. the. reported. year. percent of males aged 18 years and over. of. male. greater. the. in. Milwaukee area, as compiled by the Milwaukee. of. Journal. (40). this survey, 51,8. cigarettes.. smoked. Sixty percent of male cigarette smokers also smoked pipes or cigars.. In total,. of tobacco. (40). 87 percent of adult males used some type. ,. Although earlier survey estimates of male smoking rates are unavailable, it. consumption. J.HARRIS. prior. appears. that. the. rise. of. cigarette. to 1923 reflected both the conversion of. DRAFT.

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(21) -8-. 5000r. 4000 8.. S E u CO § o. CO. 3000. 2000. 1000. o 1900. '10. '20 ~. '30 .. '40. '50. 70. '80. year. Annual consumption of cigarettes and filtertip Figure 1. cigarettes per person aged 18 years and over, 1900-1979. Total per U.S. Department of Agriculture (52). Source: 1940-79 include 1917-19 and for consumption data capita Total per capita consumption for 1979 overseas forces. Per capita consumption of is preliminary estimate. from annual data on the cigarettes derived filtertip production. of total cigarette filtertip share. HARRIS. DRAFT.

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(23) -9-. established male non-cigarette tobacco smoking. and. and. marketing. Innovations. I,. cigarette. in. cited as influential. been. have. factors in this rapid growth a. cigarette. to. the recruitment of a new generation of younger. male smokers during World War. production. users. (41,50,69),. cigarettes,. Camel. of lighter Burley smoking tobaccos with previously. blend. dominant Turkish cigarette tobaccos, were introduced, in and. months attained. within. a. Two similar. national market.. brands. Lucky Strike and Chesterfield, followed in 1916. respectively (41,50,69).. 1919,. Industries Board. estimated. During World War. soldiers. that. 1-91'3. of. and. I,. the War. the. Allied. consumed 60 to 70 percent more tobacco than they had. Armies. used in civilian life. (30,31),. Cigarettes continued to dominate other forms of tobacco 1920. among male smokers throughout the 1935,. cigar. and. and. 1930 's.. 2). ,. while the percentages. users had declined substantially.. cigarette consumption frequency among men smokers from. 3,7. 1935. (40).. packs. per. 1. and. 2).. of. Average increased. week in 1923 to 4.8 packs per week in. Consumption among men accelerated during World (Figures. By. percent of adult males in the greater Milwaukee. 62,5. area smoked cigarettes (Figure. pipe. 's. In. 1944,. more. than. War. II. 25 percent of. cigarettes produced in the U.S. were distributed to overseas forces (31), typically for free or at low cost (41), to. point. where. J.HARRIS. the. subsequent shortages developed in the domestic. .. DRAFT.

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(25) 10-. market.. By. Milwaukee. 67.1. 1948,. confirmed. 69,1. of. cigarette. ^. males. adult. of. area smoked cigarettes (Figure. of the prevalence. year.. percent. 2). This estimate. .. among. use. the. in. urban. men. is. by other local consumer surveys performed in that. For example,. percent. in. adult male smoking. in 1949,. Omaha,. 67.4. were. rates. percent in Birmingham, 69,4. percent in Philadelphia, 63.9 percent in Seattle,. 63.4. and. percent in San Jose (39). [INSERT FIGURE. 2. ABOUT HERE,]. The growth of cigarette smoking among. much later. in the face of strong social taboos.. noted that "the ultra smart set. began. smoke. to. women occurred. and. women. social. at the turn of the century.". (15,. Gottsegen leaders p.. 149).. By 1906, American "girl stenographers" were reported smoking. cigarettes clandestinely. (5,. p.. By 1919, some younger. 181).. women in New York were reported smoking "with. a. trace of defiance". cited in (52)).. In 1926,. a. parties 1919,. By 1922, New York women were smoking openly (10). The first advertisement showing. 1919. dinner. (New York Times, March 16,. on the streets and in bus tops. Lorillard's. at. publicity. young woman in. a. a. woman. smoking. for Helmar cigarettes. Liggett and Myers'. was. (46,50).. Chesterfield. advertisement did not smoke but pleaded, "Blow some my way." (6).. In. April,. 1927,. a. Philip Morris advertisement for. Marlboro cigarettes noted that "Women, when all,. quickly. J.HARRIS. develop. discriminating. they. taste.". smoke and. at. that. DRAFT.

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(27) -11-. Figure 2. Percentage of adult current cigarette smokers in the greater Milwaukee area, 1924-1979. Prior Source: Milwaukee Journal consumer analyses (40). to 1941, the wording of the question eliciting cigarette From 19 41 use and the type of respondent are not recorded. to 1954, men were asked, "Do you smoke cigarets?" while all respondents were asked, "Do any women in your family smoke cigarets?" From 1955 to 1959, all respondents were asked, "Do any men (women) in your household smoke cigarets with (without) a filter tip?" From 1960 to 1965 and in 1967, both men and women were asked "Have you bought, for your own use, cigarets with (without) a filter tip in the past 30 days?" In 1966 and frcm 1968 to 1979, both men and women were asked, "Have you bought, for your own use, cigarets with (without) a filter tip in the past 7 days?" Data for women fron 1976 to 1979 (open circles) represent filtertip cigarette smokers only. All percentages reflect adults aged 18 years and over. HARRIS. DRAFT.

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(29) -12-. Marlboro cigarettes were as "Mild as May.". 1928,. In. (2).. Lucky Strike Advertisement urged women to "Reach for instead 149).. of. 1934,. In. By. (28).. a. Sweet.". (33,. pp.. Lucky. a. 58-61; 43, pp 58-59;. a. 50,. p.. Eleanor Roosevelt smoked cigarettes publicly. handbags. 1940,. compacts. cosmetic. and. were. typically designed to hold cigarettes (17). Although the Milwaukee Journal. (40). reported that. percent of adult women smoked cigarettes in 1934. 16.7. (Figure 2),. estimates of women's smoking prevalence are sporadic.. prior. Wessel estimated. that. cigarettes. 1924. in. consumed. women (68).. percent. 5. Moody's. all. of. Service. Investors. estimated that women smoked 12 percent of cigarettes in 1929 The average daily consumption of. (45).. compared If. to men smokers,. smokers. men. cigarettes. Journal's. per 1934. is not. as. survey. women report. smokers,. as. documented for this period.. approximately. consumed day. women. twice. smokers. (cf.. many. as. the Milwaukee. women's daily consump-. that. tion totalled 135 packs per year as coHipared to 244 pa'cks per year for male smokers), and. smoking prevalence rates in Figure. representative,. and. if. the. if 2. estimates. there were approximately. yields. a. prevalence. 16 percent. The Milwaukee. J.HARRIS. in. :. are taken as nationally. decade (53), then Wessel's estimate yields smoking. -^. male. of. 5. percent. more adult males than adult females during the 1920 to. female. -. 1924. and. a. 6. 1930. percent adult. Moody's estimate. prevalence in 1929. Journal. series. •;. ^. in. Figure. 2. must. be. DRAFT.

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(31) -13-. interpreted. changes. of. light. in. type of survey. the. in. respondent and the wording of questions designed smoking practices. (see caption to Figure 2.). population. urban. American women.. series. elicit. to. Moreover, this. not be representative of all. may. Nevertheless, the publicly available survey. data sources are consistent. conclusion. with. that. smoking. rates among women did not exceed one-quarter until the onset of World War II.. applications. Based on 10,000. policies. insurance. for. 1930-40, Ley (34) estimated age-standardized smoking. during. rates of 63.9 percent of men and 20.8 percent of women. years and over.. 15. In 1935,. aged. Fortune Magazine, in the first. nation-wide survey (14), reported that 52.5 percent of adult men and 18.1 percent of adult women smoked cigarettes,. (See. Table. 65.5. below.) Among those under. 1. percent. of. men. and. of. percent. 39.7. age,. of. men. and. 9.3. Urban-rural differences in. women were smokers.. smoking were significant.. of. of women were smokers.. percent. 26.2. Among those over 40 years,. percent. years. 40. The proportion of smokers. ranged. from 61.4 percent of men and 31.2 percent of women in cities. with. population. over. one milltion, to 44.1 percent of men. and 8.6 percent of women. under. 2,500.. A. survey. in. of. rural. areas. reported. smokers. 23. an. additional. population. 250 urban women by the Market. Research Corporation in 1937 and. with. 26. percent. regular. percent occasional smokers. (49).. J.. HARRIS. .. :. DRAFT.

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(33) -14-. After 1940, women's smoking rates accelerated,. generations. entered. areas,. "Occupation. particularly younger women. women,. of. force. labor. the. and Environment". also. (See. In. Gallup Poll reported 48 percent adult male. smokers. percent. 1949,. adult. smokers. female. In. (3).. findings were 54 percent male and. consumer surveys of urban areas in 1948. Local. chapter 1944,. the. and. 36. the Gallup. female. percent. 33. urban. in. the. in this Report).. new. as. (39). (3).. revealed. 37.6 percent adult women cigarette smokers in Milwaukee. also Figure 2),. Birmingham,. percent. 34.3. in Philadelphia,. percent. 45.7. in. 38.3 percent in. Conover. Seattle, and 34.0 percent in San Jose.. percent. 35.6. Omaha,. in. (see. (11),. citing. "trade journal" surveys in the three or four years prior. to. reported smoking prevalence rates of 65 to 70 percent. 1950,. among men and 40 to 45 percent among women.. Although the differential growth of cigarette use among various socio-economic groups is not. documented,. well. the. data during this period suggest that male smoking. available. rates declined with increasing income, while the relation of. women's smoking to income was Journal. in. 1945. noted. (40). $30. proportions and Porter's. per. Among. month.. were 1947. 32. Milwaukee. The. clear.. 58 percent male smokers with. 75 percent male smokers with rent. monthly rent over $50 and under. less. women,. the. corresponding. and 37 percent respectively.. survey. of. Columbus,. Ohio. In Mills. (38),. 28.3. percent of white females and 64,9 percent white males smoked. J.HARRIS. '. DRAFT.

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(35) -15-. whereas. cigarettes,. percent. 36.4. black. percent black males smoked cigarettes. females and 68,9. (estimates calculated. from the age distribution data provided in Table. Kirchoff and patients,. Rigdon. visitors,. (32),. and. and Galveston, noted that. percent. white. females,. in. a. survey. 6. of. over. of. (38)).. 21,000. employees of hospitals in Houston percent. 63.2. white. male,. 33.4. 66.3 percent black males, and 32.2. percent black females smoked cigarettes. All of the above findings reinforce the conclusion that. the onset of widespread cigarette. use. among. women. lagged. that of men by 25 to 30 years.. This historical delay in the. growth. among. of. cigarette. smoking. women. has. also been. documented for the United Kingdom (10,48,51).. J.HARRIS. ' •. DRAFT.

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(37) -16-. The Emergence of Filtertip Cigarettes: 1951-1963 As shown in Figure 1, total per capita. cigarettes. declined. 1953-54,. during. coincident with the. appearance. in. reports. suggesting. a. seriously. smoking and. lung. consumption. of. cancer. (Figure 1),. In 1953,. percent. cigarette. of. of. was. the. popular. press. link. between. cigarette. Thereafter,. cigarettes. the. constituted. By 1958,. of. rapidly. increased. filtertip cigarettes production.. decline. This. (12,35,36,42).. filtertip. consumption. 2,9. their share of. production had increased to 45,3 percent, and by 1963 it was 58,0 percent. (52). .. •. The transient decline during 1953-54 in the number. cigarettes consumed was not clearly matched by the proportion of cigarette smokers. areas,. proportion. the. (29). women. of. a. of. decrease in. At least in urban. ,. smokers. continued. to. From 1953 to 1958, the prevalence of adult female. increase.. smoking increased from 42,9 to. 45.4. percent. Milwaukee. in. (Figure 2), from 38.4 to 42.6 percent in Omaha, from 47.0 to. 50.2. in. San Jose. Washington, D.C, and from 39.6 to 44.4 percent in (39). converted. At the same time, both women and men rapidly to. filtertip. cigarettes.. By. 1958,. filter cigarette use. prevailed among 61 percent of women smokers and of men smokers in Milwaukee, 43. percent. of. men. smokers. 54. percent. percent of women smokers and in Omaha,. smokers and 47 percent of men smokers in. J.HARRIS. 42. 53. percent of women. Washington,. D,C.,. DRAFT.

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(39) -17-. and. percent. 59. of. women. smokers in San Jose (39) reported Health. by. (62),. the 79. In. .. National. percent. smokers. of. a. and. nation-wide. Clearinghouse adult. 42 percent of men. female. for. 1964. survey. Smoking and. smokers. and. 54. percent of adult male smokers used filter cigarettes.. J.HARRIS. DRAFT.

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(41) -18-. Increasina Public Health Awareness. 1964 - 1979_. Per capita consumption reached a peak value of 4,336 in. 1963. (Figure. appearance. 1).. in. It. January. declined. transiently. 1964. the. of. first. after. report of the. Advisory Committee to the Surgeon General (54). consumption. continued. during. decline. to. smoking. (26,29),. the. subsequent. recent. 1979. hazards. Since 1975, per capita consumption has. declined at an average rate of 1.4 most. capita. Per. period of increased publicity concerning the health of. the. percent. annually.. The. of 3,900 cigarettes per capita. estimate. closely approximates that observed in 1952. Table. 1. summarizes the results of selected,. representative period 1935 to (14). 1955 of. surveys 1979.. of. adult. nationally. cigarette use during the. Except for the Fortune survey of. 1935. and the supplement to the Current Population Survey in (18). the. the. sponsorship. National Center for Health Statistics,. The results. ,. these data were collected under. of other recent national. surveys. (3,4,55,57,58,62,63,65),. revealing. the prevalence. of. smoking,. were. adult. of. very. cigarette. use. similar trends in. described. in. 1979. the. Surgeon General's Report (26). [INSERT TABLE. 1. ABOUT HERE,]. Among adult males, the prevalence of regular use. has. decreases absolute. J.HARRIS. cigarette. declined continuously since 1965, with more marked in. the. intervals. 1965-70. and. 1976-78.. (The. standard errors for National Center for Health. DRAFT.

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(43) 19-. TABLE 1 - ESTIMATES OF THE PREVALENCE OF SMOKING AMONG ADULTS, UNITED STATES, SURVEYS, 1935 - 1979.. Females. Year. REGULAR CIGARETTE SELECTED NATIONAL. Males. 1935. 18.1. 52.5. 1955. 24.5. 52.6. 1965. 33.3. 51.1. 1970. 31.1. 43.5. 1974. 31.9. 42.7. 1976. 32.0. 41.9. 1978. 29.9. 37.0. 1979. 28,2. 36.9. Source: (14,18,56,58-61). Data for 1978 are revisions of preliminary estimates reported in Data for 1979 are preliminary estimates (26) based on a sample of over 13,000 interviews conducted during January - June 1979, provided by Health Interview Survey, National Center for Health Statistics. 1955 data represent persons 18 yrs and over. 1976 data represent persons 20 years and over. Estimates for the years 1965, 1970, 1974, 1978 and 1979 represent persons 17 years and over. .. J.HARRIS. DRAFT.

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(45) 20-. Statistics estimates for 1970 to 1976 are less than 0.3 percent. The absolute standard errors for 1978 and 1979 are 0.6 percent.). Among adult women, the direction of change in smoking prevalence The estimates fOr the interval 1976-79, however,. is less clear.. suggest a recent downturn.. The preliminary 1979 estimate of 32.3. percent for the overall prevalence of adult cigarette smoking among both sexes represents the lowest recorded value in at least (The overall prevalence of cigarette smoking in the. 45 years.. 1935 Fortune Magazine survey was 37.3 percent among adults of. both sexes.. .. These patterns of change in smoking prevalence applied to both. white and black adults.. For white men, the prevalence of regu-. lar smoking declined from 51.5 percent in 1965 to 36.3 percent in 1979.. For black men, the prevalence of regular smoking de-. clined from 60.. 8. percent in 1965 to 42.0 percent in 1979.. For. white women, smoking prevalence declined from 34.2 percent in 1965 to 28.2 percent in 1979.. For black women smoking prevalence. declined from 34.4 percent in 1965 to 28.9 percent in 1979. Racial differences in cigarette use are discussed in greater detail in the chapter in this report entitled "Psychosocial and. Behavioral Aspects of Smoking in Women," Although the Milwaukee area data for 1964-79 do not closely. match these national estimates, figure decline in smoking rates. foir. 2. does show a marked. both sexes during 1964-1970,. a. deceleration in the decline of smoking prevalence during 1971-75,. J.. HARRIS. DRAFT.

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(47) -21-. and a resumption of the decline in prevalence among men in the last four years.. The cessation of cigarette smoking has been a significant. factor in explaining this overall decline in smoking prevalence (26). .. Column. (i). of Table. 2. presents estimates of the percen-. tage of recent smokers who made a "fairly serious attempt to quit" within one year of the interview date.. (Recent smokers. include all current smokers plus those former smokers reported to have stopped within one year of interview.). Column. (ii). shows what proportion of those attempting to quit regarded. themselves as former smokers. tion of all recent smokers. Column (iii) shows the propor-. (whether or not they attempted or succeeded.

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(49) -22-. -1. quitting) who reported themselves as recent former. ;<. smokers.. data necessarily reflect respondents' self assessment. These. of both the seriousness of of. ,. quit attempt and. a. degree. their. Nevertheless, they do provide an indication of. success.. the representative smoker's annual probability of attempting. the probability of. to quit,. successful. cessation. given. a. quit attempt, and the overall annual smoking cessation rate. (The. standard errors in Table. absolute. 1.5 percent, and 0.3-0.5. percent. columns. All three indicators of smoking cessation were. highest. (i),(ii), and. (iii),. respectively.). [INSERT TABLE. Although. men in 1970.. women smokers attempted to. 2. ABOUT HERE.]. relatively large proportion of. a. smoking. quit. probability. their. (i)),. success. of. significantly lower than that of men attempt but. are approximately for. 1.0 percent,. for. 4. rates for both sexes. have. increased. probability adult. to. With. was. Quit. (ii)).. respect. the. to. and the success rate,. quit. cigarette. women. and. (column. year. (column (i)) declined by 1975,. 1978-79.. attempting. of. men. in. that. in. (column. 1970. in. smokers. now. are. indistinguishable. Table. cigarette. 3. displays recent changes in the distribution. brands. according. to F.T.C.. proportion of adults smoking cigarettes. delivery. J.HARRIS. less. than. 15. milligrams. "tar" contents.. with. F.T.C.. of. The "tar". has increased from 9.5. DRAFT.

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(51) -23-. TABLE 2 - ESTIMATED RATES OF ATTEMPTED AND SUCCESSFUL UNITED RECENT CIGARETTE SMOKERS, QUITTING AMONG ADULT, 1979. STATES, 1970. (i). Percent of All Recent Smokers Who Attempted to Quit in Past Year. (ii). Percent of Smokers Attempting to Quit in Past Year Who Reported Successfully Quitting. (iii). Percent of All Recent Smokers Who. Reported Successfully Quitting in Past Year. Women 1970 1975 1978 1979. 40.8 30.2 32.7 32.4. 21.3 19.5 18.8 21.6. 8.7 5.9 6.2 7.0. 44.4 28.3 29.1 31.4. 26.4 20.1 21.5 21.3. 11.7 5.7 6.3 6.7. Men 1970 1975 1978 1979. 21 Source: 1970 and 1975 data from surveys of persons aged years and over, conducted by National Clearinghouse for from the Smoking and Health (63,65). 1978 and 1979 data Health Interview Survey of persons aged 17 years and over, conducted by the U. S. National Center for Health Statistics upon 1979 data are preliminary estimates based (61). interviews during January - June of that year. J.HARRIS. DRAFT.

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(53) -24-. percont of women and 2.9 percent of. percent. A. smokers. 1970. in. 38.5. to. women and 28.1 percent of men in the first half. of. of 1979.. men. corresponding. of. cigarettes. increase with. F.T.C.. proportion. the. in. of. nicotine delivery less. than 1.0 milligram was also observed.. [INSERT TABLE. same. the. At. consumption. consumption. daily. average. the. time,. ABOUT HERE.]. adult smokers has increased.. of. changes. recent. 3. the. in. among. distribution. current. of. Table. shows. 4. cigarette. daily. These. smokers.. cigarette. must be. data. interpreted in light of possible underreporting biases and,. particular,. in. a. round off their reported. Nevertheless,. (67). strong tendency for respondents to. daily. consumption. to. one. pack.. the percentage of women smoking less than one. pack per day has declined, while the proportion smoking more than one pack per day has increased.. similar. trend. is. observed for men.. Except. for. 1979,. a. (The absolute standard. errors of the 1978 and 1979 estimates are approximately. 1.0. percent.) [INSERT TABLE The data of Table of. an. apparently. long. cigarette. consumption. Milwaukee. men. per day an. (40).. average. J.HARRIS. 4. 4. ABOUT HERE.]. represent the more run. among. portion. recent. trend toward increasing daily. regular. smokers.. In. 1924,. smokers consumed an average of 10 cigarettes In. 1934, male smokers in. Milwaukee. consumed. of 13.4 cigarettes per day, while women smokers. DRAFT.

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(55) -25-. TABLE 3 - ESTIMATED PERCENTAGE DISTRIBUTION OF ADULT CURRENT REGULAR CIGARETTE SMOKERS ACCORDING TO F.T.C. "TAR" CONTENT OF PRIMARY BRAND, UNITED STATES 1970 - 1979,. Year. Less Than 5,0 mg. 5, 9, 9. to. mg. 10,0 to 14,9 mg. 15.0 to 19.9 mg. 20,0 mg or More. Women 1970 1975 1978 1979. 6.8 15,0 21,1 23.4. 67.1 75.1 59.2 55.4. 23.4 7.5. 5.3 5,6. 2,0 1.2 8.8 9.5. 0.2 0.6 3.3 2.6. 0.9 1.1 6,2 8,5. 1.. 11. 13. 17.. 61,3 68.1 63.5 60.1. 28.1 19.2 13.6 11.8. 0,7 1. 2. 5,7.. 6.1. Men 1970 1975 1978 1979. Health Source: National Clearinghouse for Smoking and National Center for Health Statistics (61). 1979 (63,65), data are preliminary estimates provided by the National 1970 and 1975 data represent Center for Health Statistics, 1978 and 1979 data represent adults aged 21 years and over, adults aged 17 years and over, Estimates exclude those with unknown primary cigarette brand. J.HARRIS. DRAFT.

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(57) -26-. TABLE 4 - ESTIMATED PERCENTAGE DISTRIBUTION OF ADULT CURRENT CIGARETTE SMOKERS ACCORDING TO REPORTED DAILY CONSUMPTION FREQUENCY, UNITED STATES, 1965 - 1979,. Percent Smoking Less Than 15 Cigarettes per Day. Year. Percent Smoking 25 Cigarettes or More per Day. Women 1965 1970 1974 1976 1978 1979. 44,5 39,1 38.7 36.5 36,0 34.6. 13.7 18.0 18.5 19,6 21,0 22.4. 29.6 27.8 26.3 24.2 23.4 26.4. 24,5 27.7 30.6 31,1 34.2 32.2. Males 1965 1970 1974 1976 1978 1979. ,. .. Source: (26,56,58-61). Data for 1976 represent persons aged 20 years and over. All other years represent persons aged 17 years and over. Data for 1979 are preliminary estimates based on interviews conducted during January - June of that year, provided by the Health Interview Survey, National Center for Health Statistics.. J.HARRIS. DRAFT.

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(59) -27-. consumed. 7. per day. (40).. 1,564 per adult. was. cigarette consumption. If. (Figure. and. 1. (52)), and. percentage of adult smokers was 37,3 percent. consumption per adult smoker was 11.5 If. consumption. adult. per. the overall. then mean. (14),. cigarettes. 3,597. was. if. per. day.. 1955 and if the. in. prevalence of regular smoking was 37.6. 1935. in. percent. then. (18),. mean consumption per adult in that year was 26.2 cigarettes.. corresponding. The. calculation. based. consumption data and adult prevalence Table. data. Moreover, numerous epidemiological. (Figure. and. 1. studies. other. and. performed during the period 1950-65 have shown that. surveys. for both sexes, especially. smokers. among. larger. was. daily. current. fewer cigarettes per day. (Table. 2),. is. known. the. in past decades consumed. rates. smoking. of. changes in F.T.C, "tar" and nicotine. consumption (Table. not. with. than contemporary smokers.. delivery of cigarettes (Table 3), cigarette. to. and lifetime maximum. The empirical relationships between. cessation. applied. findings. of. age groups. They are consistent. smokers. regular. proportion. younger. consumption. cigarette. that. the. the. These. daily cigarette consumption.. hypothesis. women,. for. (10,18,21,22,24,32,38,62,63),. It. per capita. yields 33.3 cigarettes per day.. 1). heavy. 1979. on. whether. 4). increases. and. in. are poorly understood. smokers. of. the. lowest. daily (27).. "tar". cigarettes are more or less likely to attempt to quit, or to succeed. J.HARRIS. in quitting,. than smokers of conventional filtertip. '. DRAFT.

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(61) -28-. or. nonfiltcr cigarettes.. switching. to. a. iower. The extent to. which. cigarette. "tar". may. the. serve. as. substitut"^ for quitting may differ among women and men.. observed current. increase. smokers. in. could. daily. represent:. the. cessation rates among lighter smokers;. daily. cigarette. consumption. cigarette. consumption. of. an. effect increase. smoking. (25),. population; or. a. a. Th^^. among. of higher in. the. continuing smokers; or an. increased daily cigarette consumption of new the. of. act. entrants. into. combination of these effects. The relationship of these possible mechanisms to the. observed increase in the proportion of. filtertip. cigarette. and low "tar" cigarette smokers is not well elucidated.. J.HARRIS. DRAFT.

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(63) -29-. Exposure to Cigarette Smoke Among Succe ssive Birth Cohorts Figures. and. 3. 4. prevalence. depict estimates of the. of. current cigarette smoking from 1900 to 1978 among successive. cohorts. birth time. corresponds. series. particular to 1940. Each continuously graphed. of men and women.. individuals. to. during. born. a. For example, among women born from 1931. decade.. (Figure 4), who are now 40. years. 49. to. the. old,. prevalence of smoking rose rapidly during the post World War II. period. reached. and. peak. a. of. 45. percent. by 1963.. Thereafter, their overall prevalence of smoking declined. to. 39 percent in 1978.. prevalence. These. lifetime. reported. data. were. smoking. constructed. histories. 1978.. methodology, survey. see. and. the. 13,000. of. this. accuracy. the. to. of. of age started smoking, age of smoking. duration. of. temporary. significant,. of abstinence is not known, no particular source of. recall bias. significantly as. Although. the. July. during. applications. related. (9,29,17).). recollection. cessation,. periods. (For. over. of. respondents to the Health Interview Survey December,. from. has. been. identified. However,. (17,18),. the. higher mortality rates of continuing smokers,. compared. to. nonsmokers. (1,13,19,20,43,47,48,54),. introduces. smokers. former. or a. selection bias that. may understate the prevalence of past smoking for the oldest cohorts.. tables. J.HARRIS. For example, on the basis of. recently. reported. the. insurance. by Cowell and Hirst. (13). ,. life a. male. DRAFT.

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(65) -30-. cigarette smoker at age. probability. surviving. surviving. of. percent for. a. age. probabilities. percent. 80. percent for nonsmokers, respectively.. for smokers and 93. Therefore,. from 1978 survey responses to be 46 precent in. actually have been as high as 65 percent. quit. smokers. peak. the. smoking. (1,19,47),. have. effect. Since individuals. higher survival than continuing. a. the actual point in time at which smoking. than. 1937.. less likely to be important among men born. is. after 1910, who are now approaching 70 years old.. calculation for. men. reveals. their. that. could. 1937,. rates peaked in this cohort may have been later This. born,. example,. for. smoking. peak. rat'='. may. 3. percentage points.. [INSERT FIGURES. 3. AND. 2. 4. A similar. 1911-20. between. or. understated by at most. have. been. ABOUT HERE.]. This source of bias is likely to be less important older. of. prevalence rate of men born before 1900, calculated. smoking. who. percent. 25. compared to 49. as. 80,. estimated. The are. 60. estimated. an. age. to. nonsmoker.. to. has. 32. women.. On. the basis of age-specific mortality data. reported by Hammond in 1966. continuing. smoke. to. for. Appendix Table. (19,. cigarettes. 2b),. women. from age 35 would have an. estimated 48 percent chance of surviving to age 80 years, as compared. to. probabilities. 54. percent. of survival. for. nonsmokers.. estimated. to age 60 would be 91 percent. smokers and 93 percent for nonsmokers.. J.HARRIS. The. If. these. for. survival. DRAFT.

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(67) -31-. 1921-30. 1941-50. 1951-60. 1900. 1910. 1920. 1930. 1940. 1950. 1960. 1970. 1980. YEAR. Figure 3. Changes in the prevalence of cigarette smoking among successive birth cohorts of men, 1900-1978. Calculated from the results of over 13,000 inSource: terviews conducted during the last two quarters of 1978, provided by Division of Health Interview Statistics, U.S. National Center for Health Statistics.. J.. HARRIS. DRAFT.

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(69) -32-. S31-40. WOMEN. 1951-60. 1-50. •eOO. 1910. 1920. 1930. 1940. 1950. 1960. 1970. 1980. YEAR. Figure 4. Changes in the prevalence of cigarette smoking among successive birth cohorts of women, 1900-1978. Source: Calculated from the results of over 13,000 interviews conducted during the last two quarters of 1978, provided by Division of Health Interview Statistics, U.S. National Center for Health Statistics.. J.. HARRIS. DRAFT.

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(71) -33-. datc. currently. are. nonsmokers, then. applicable estimated. the. smokers. women. to. prevalence. peak. and. rate. of. smoking among women born before 1910 could be understated by only one to two percentage points.. Despite. percentages. biases,. smokers. current. of. consistent with past smoking. possible. these. Figures. in. predicted. the. and. 3. 4. are. survey and epidemiological data on the. habits. different. of. groups. age. (14,16-18,21-25,32,37,38,56).. Comparison of Figures conclusions.. and. 4. reveals. following. the. most marked differences in smoking. The. (a). 3. prevalence among men and women appeared in those individuals born before 1910, who are now approaching 70 years old.. (b). Women born between 1921 and 1940, who are now approaching 40 to. years. 59. prevalence. of. age,. experienced. These women have not yet reached the age. rates.. where the absolute excess deaths of smokers over are. expected. smoking. highest. the. to. become. substantial. (1).. nonsmokers Among. (c). successive cohorts of men and women, the age of peak smoking prevalence has declined. smoking is. Among younger. a. prevalence. 1921-30 reached. J.HARRIS. Men born between. prevalence. smoking. peak. 1946-48, while those. smoking. the. peak. prevalence rates are declining, although the effect. less marked for women.. reached. cohorts,. a. born of. 58. 1941. to. of. 1950. 1911 71. and. 1920. percent during. reached. percent in 1968-69.. peak prevalence of 44 percent in. a. peak. Women born 1958-60,. DRAFT.

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(73) -34-. while. born. those. prevalence. of. percent. 41. 1951-60, the rate of. slower. than. smoking. publicity. increased. reached 1970-73,. in. increase. previous. in. diffusion of. 1941-50. in. cohorts.. practices. peak. (d). Among men born. smoking. of. smoking. a. prevalence slowing. This. coincident. was. of the. with. late. the. 1960's.. A. similar. effect. approaching. now. are. 20-29,. ages. smoking has apparently peaked.. males. not clearly. is. discernible for young women in this cohort. who. the. concerning the health risks of smoking. and the relatively high rate of cessation among adult in. was. sexes,. In both. prevalence of. tY\f=. Smoking rates among men. and. women in this age group are now nearly indistinguishable.. Figure. smoking. depicts. 5. the. age. mean. regular. among successive birth cohorts, calculated from the. same data as for Figures. smoking. among. 3. and. that. continuously. women. men.. of. The. 4.. century, to the point where it is from. starting. of. As. a. of. age. onset. during. declined. of this. indistinguishable. nearly. result, each successive cohort of. lifelong continuing women smokers will. have. increasing. an. number of years of exposure to cigarette smoke. [INSERT FIGURE. Figure smoking. per. 6. 5. ABOUT HERE.]. depicts the accumulated capita,. up. to. 1978,. years. prevalence. individuals born. J.HARRIS. curve 1911-20. in. Figures. have. thus. cigarette. for each birth cohort.. These magnitudes correspond to the total. cohort. of. 3. areas and. far. 4.. under. each. Among women,. experienced. the. DRAFT.

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(75) -35-. -^1901-10 ^^^-^1921-30^^^-^1941-50^^5^-^. Birth. Cohort. Figure 5. Mean age of onset of regular smoking among successive birth cohorts of women and men. Source:. J.. HARRIS. See notes to Figures. 3. and. 4.. DRAFT.

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(77) -36-. largest. Figure. exposure. total. unless the smoking prevalence rat«^s of women. 4,. 1921-40. during. decline. lifetime exposure of exceed. However, as seen from. per capita.. that. of. rapidly. more. 1911-20. the. the future,. tho. is. likely. to. is. not clear,. cohorts. latter. those. in. cohort.. It. however, whether the lifetime exposure of men born now. generations.. 1921-40,. of age, will exceed that of previous. years. 69. to. 50. born. With each. successive. cohort,. ratio. the. of. female to male exposure approaches one. [INSERT FIGURE As. result. a. cigarettes. after. 1950. cohort was exposed to and. a. (Figure. 1),. different. nonfilter cigarettes.. diffusion. rapid. the. of. ABOUT HERE.]. 6. fjltertip. of. each successive birth. proportion. filtertip. of. Details of the respondent's past. history of cigarette brand use were not obtained in the 1978 Health Interview Survey. from. a. series of over 2,000 interviews of current and former. smokers. aged. 21. years and over, cc iducted by the National. Clearinghouse for Smoking and Health in 1975 depicts. the. cigarettes. proportion among. of. comparable. years. distinct,. monotonically. (65). smoking. birth cohorts.. birth cohorts necessarily differ.). increasing. Among men, relation. proportion of filtertip cigarette exposure and The. available. Such data, however, are. .. Figure. 7. filtertip (The youngest. there. between birth. is. a. the. date.. corresponding relationship among women born before 1930. reflects their lower smoking cessation rates and, therefore,. J.. HARRIS. DRAFT.

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(79) -37-. -1900. 1901-10. 1911-20. Birth. 1921-X 1931-40 1941-50 1951-60. Cohort. Figure 6. Accumulated years of cigarette smoking per person among successive birth cohorts of women and men, 1978. Source:. J.. HARRIS. See notes to Figures. 3. and. 4.. DRAFT.

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(81) 38-. their continued use of filter cigarettes in 1925,. (65). .. A woman born. for example, who began smoking at age 21. and who switched to filtertip cigarettes in 1957. (Figure 5), (Figure 1),. has now been smoking filtertip cigarettes for over two thirds of her smoking career and 40 percent of her entire life.. [INSERT FIGURE. 7. ABOUT HERE.]. The prevalence of cigarette smoking, age of initiation,. lifetime duration of smoking, and the extent of use of. various types of cigarettes are not the only measures of cigarette smoke exposure among a particular population.. Trends in depth of inhalation, fraction of cigarette actually smoked,. and other dimensions of the style of smoking also. affect smoke exposure.. As discussed in the 1979 Surgeon. General's Report (26), these are difficult to determine from survey data.. In view of the concern over the accuracy of. contemporaneous survey reports of smoking frequency. (67). past accounts of the time course of cigarette smoking frequency would be difficult to assess accurately.. Nevertheless,. the evidence presented in the previous section is consistent. with the conclusion that the average cigarette consumption. frequency among regular cigarette users has increased among feach. successive birth cohort.. '. J.. HARRIS. DRAFT.

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(83) 39-. 100. P. 90. 080 Q.. i. ^60 12 50. CO. I. 30. 020. §10. D. -1900 1901-10. 1911-20. Birth. 1921-30 1931-40 1941-50 1951-54. Cohort. Figure 7. Proportion of years smoking filtertip cigarettes among successive birth cohorts of women and men, 1975. Source: Calculated from the results of over 2,000 smoking histories of men and women who had ever smoked, collected by National Clearinghouse for Smoking ahd Health (65). HARRIS. DRAFT.

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(85) -40-. Cigarette Smoking Among Young Women The more marked. among age,. reflected. smoking group.. slowing. a. that. smoking. peak. in. prevalence. 1951-60, now approaching 20 to 29 years of. born. men. decline. not. was. rate. the. in. observed. in. initiation. of. of. women of the same age. This trend appears to be continuing. next. the. into. birth cohort. Table. 5. teenage. reports the results. cigarette. recent. Education. during. smoking. conducted. survey,. during. late. by. 19 years of. were. age. also. of. represents the. telephone. interviews. of. In this recent survey, but. previous surveys reported in Table. in. of. The most. Institute. National. 1978 and early 1979,. individuals aged 12 to 18 years.. surveys. 1968 to 1979,. the. preliminary results of over 2,600. not. nation-wide. of. 5,. women and men. Otherwise,. interviewed.. the. survey sampling techniques and interview questions eliciting smoking. practices. remained. unchanged from previous years,. (See notes to Table 5.). ,. The findings in Table. 5. confirm the conclusion that the. rate of initiation of smoking among even the youngest men is women.. declining, an effect that is not present among young These. results. variability,. must. interpreted. be. (The absolute. standard. in. light of sampling. errors. estimates for ages 15-16 and 17-18 are about in. adult. considered.. J.HARRIS. surveys,. non-response. Nevertheless,. the. biases. findings. in. of 2. 1979. the. percent,). must Table. also 5. As be. are. DRAFT.

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(87) -41-. TABLE 5 - ESTIMATED PERCENTAGE OF CURRENT, REGULAR CIGARETTE SMOKERS, AGES 12 - 18, UNITED STATES, 1968 - 1979. Year. Ag es 12-14. Ages 17-18. Ages 15-16. Females 1968 1970 1972 1974 1979. 0.6 3.0 2.8 4.9 4.4. 9.6 14.4 16.3 20,2 11.8. 18.6 22.8 25.3 25.9 26.2. 2.9 5.7 4.6 4.2 3.2. 17.0 19.5 17.8 18.1 13.5. 30.2 37.3 30.2 31.0 19.3. Males 1968 1970 1972 1974 L979. '. National Source: performed by Nation-wide surveys 1968-1974 Clearinghouse for Smoking and Health, (64), and 1979, Current regular National Institute of Education, smoker surveys in all includes all those who smoke cigarettes at least weekly. In 1979 approximately 90 percent of current regular smokers used cigarettes on a daily basis. For 1979 only, 29.7 percent males and 31.9 percent females, aged 19, were reported as regular smokers. ,. J.HARRIS. DRAFT.

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(89) -42-. consistent with other nation-wide estimates of smoking rates among. women. young. and. The. men.. of current. prevalence. regular smoking among respondents 17 to 19 years of. survey. this. for males.. was. age. in. 28.1 percent for females and 22.8 percent. The comparable rates. for. women. men. and. aged. 17-19 from the Health Interview Survey were 29.2 percent and An analysis of the growth of. respectively.. percent,. 27,5. smoking prevalence among this group, performed in. manner. as. of Figures. that. 3. of. men. by. 1975,. same. and 4, suggested that smoking. rates among this group of women grew those. the. rapidly. and. exceeded. The future smoking habits of this. generation of young women cannot be accurately predicted. Smoking among teenage women detail. in the chapter entitled. is. taken. up. in. greater. "Psychosocial and Behavioral. Aspects of Smoking in Women" in this Report, [INSERT TABLE. J,. HARRIS. 5. ABOUT HERE,]. DRAFT.

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(91) -43-. Summary 1.. Women have differed from men in their. of. widespread. cigarette. use,. historical. in the rate of. smoking among each new birth cohort, in their. cigarette. smoking,. and. their. use. diffusion of intensity. various. of. onset. types. of. of. cigarettes. 2.. Men took up cigarette smoking rapidly at. of. the. twentieth. beginning. especially during World War. century,. Cigarettes rapidly replaced. the. other. forms. of. tobacco.. I.. By. 1925, approximately 50 percent of adult males were cigarette. smokers.. Smoking among men accelerated rapidly during World. War. By 1949, the prevalence of cigarette use among men. II.. approached 70 percent in some urban areas. 3.. The onset of widespread cigarette use among women lagged. behind that of men by 25 to 30 women. adult. smoking. years.. The. proportion. of. cigarettes did not exceed one-quarter. until the onset of World War II. 4.. Between 1951 and 1963, increasing proportions. and men smokers converted to filtertip cigarettes. 79. percent. of. of. women. By 1964,. adult women smokers and 54 percent of adult. men smokers used filter cigarettes, 5.. After reaching. a. peak value of 4,336 in 1963, annual per. capita consumption of cigarettes declined in 1964, and. in. the period since 1975.. The most recent estimate of. 3,900 cigarettes per capita in 1979 is to that observed. J,. HARRIS. 1968-70,. approximately. equal. in 1952,. DRAFT.

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(93) -44-. 6.. From 1965 to 1978, the proportion of adult men cigarette. smokers declined from 51 to. 1965 to 1976, the proportion of adult women. From. smokers remained virtually unchanged at 32 Since. 1976,. to. percent.. 33. the proportion of women smokers has declined to. below 30 percent. adult. preliminary. The. adult men's smoking prevalence for 1979 is 36.9. estimate of percent.. percent.. 37. women's. preliminary. the. For 1979,. prevalence. smoking. of. percent.. 28.2. is. estimate. The. overall smoking prevalence of 32,3 percent for both sexes in 1979 represents the lowest recorded value. least. at. in. 45. years. 7.. The proportion. declined. smoking 1978-79.. women. adult. of. from. 1970. In contrast to. men. and. reported. now. quitting. attempting. smokers to. past. years,. attempting rates,. increased. in. proportions. of. but. 1975,. the. and their. to quit smoking,. indistinguishable.. are. Approximately one in three adult smokers now makes attempt. to. quit. smoking. Approximately one in five. during of. those. quit. to. the. who. course. a. of. attempt. serious a. year.. to. quit. subsequently succeed, 8.. The proportion of adult smokers using. nicotine. brands. has. lower. increased substantially.. percent of adult women smokers and 28 percent of smokers. reported. J.HARRIS. the. lowest. In. 1979,. adult. 39. men. primary brands with F.T.C. "tar" delivery. less than 15.0 milligrams. of. and. "tar". It is not known whether. smokers. "tar" cigarettes are more or less likely to. DRAFT.

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(95) -45-. attempt to quit smoking, or to succeed. quitting,. in. than. smokers of conventional filtertip or nonfilter cigarettes. 9.. of cigarettes smoked. The average number. recent declines in the average F.T.C.. to. and. The relationship of this. men current smokers has increased.. finding. women. by. "tar" and. nicotine deliveries of cigarettes is not well understood. With. 10.. characteristics similar. successive. each. smoking. the. and men have become increasingly. .. Among women,. 11.. women. of. generation,. smoking. average. the. age. onset. regular. of. with each successive birth. declined. progressively. of. cohort-- from 35 years of age for those born before 1900, to 16 years of age among those born 1951 to 1960.. age. of. onset. average. The. regular smoking among young women is now. of. virtually identical to that of young men. Maximum. 12.. prevalence. smoking. rates. substantially in recent birth cohorts of men. to. reached. 1940. a. peak. declined. have. Men born 1931. smoking proportion of 61 percent. during 1960-62, while men born 1941 to 1950 reached smoking. proportion of 58 percent in 1968-69.. to 1960 reached a peak smoking proportion of 40. 1976.. Among. recent. cohorts. prevalence rates have declined to Women born 1931 to 1940 reached 45 percent a. J.HARRIS. peak. in 1966-68,. a. of a. Men born 1951. percent. in. peak. smoking. smaller. extent.. women,. much. peak. a. peak smoking proportion of. while women born 1941 to 1950 reached. smoking proportion of 41 percent in 1970-73.. Women. DRAFT.

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(97) -46-. born 1951 to 1960 reached. percent. in. 1976.. a. peak smoking. of. proportion. 38. Among the generation born 1951 to 1960, now. are the proportions of women and men smoking cigarettes. virtually identical. 13.. The proportions of women and men smokers. have. group. declined.. Among. those born before 1951, this from. decline in smoking prevalence resulted mainly By. cessation.. the. contrast,. smoking. both. initiation.. cessation. smoking. observed decline in smoking. prevalence among younger men born 1951 to 1960 has from. age. each. in. and. a. resulted. lower rate of smoking. onset. This decline in the rate of. of. smoking. among young men has not been observed for young women. 14.. Recent survey data on ages 17 to 19,. by. that lence.. smoking. teenage. habits. reveal. women exceed men in smoking preva-. This finding supports the conclusion that the rate of. initiation. of. smoking. among. young women-- is declining.. young. men—. but not that of. The future cigarette use of the. youngest generations of women is uncertain. 15.. With each. successive. birth. cohort,. years of cigarette smoking per woman has. the. accumulated. progressively. approached the accumulated years of cigarette smoking per man. Each successive birth cohort has also experienced progressively. smaller sex differences in the fraction of lifetime years of smoking that represents filtertip cigarette use. 16.. J.HARRIS. Am.ong men born during this century,. each successive. ^^^^^.

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(99) -47-. birth cohort has thus far experienced fewer cumulative years of. cigarette. smoking,. higher. filtertip cigarettes, and lower This. relationship. between. experienced. smoking. birth. exposure does not hold for women. have. proportionate. substantially. rates than earlier generations.. exposure. prevalence. to. rates.. date and cigarette smoke. Women born 1921 higher. 1940. to. smoking prevalence. Unless they quit smoking in. substantial numbers, these women, currently aged 40 to 59, will surpass. older. women. in total. smoking per capita, the total. cigarette. smoking. cigarettes smoked.. years of cigarette years of nonfilter. per capita, and in the total number of. The health consequences of this enhanced. exposure to cigarette smoke among women. are. likely. to. be. more prominent in the coming decades.. J.HARRIS. •. DRAFT.

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(101) -48-. REFERENCES (1). ADAMS, E.E. Mortality.. of. Surgeon. the. In:. General.. Smoking and Health. A. Department. U.S.. Education, and Welfare. January 1979, pp. (2). ADVERTISING. &. 8:25, March 23, (3). Direct. a. Appeal.. 1927.. AMERICAN INSTITUTE. Gallup. Health,. of. 2-1 to 2-47.. Marlboro Makes. SELLING.. Report. OF. PUBLIC. OPINION. The. (GALLUP).. 1935-1971 Series, pp. 477-1501;. Poll Public Opinion,. 1972-1977 Series, pp. 274-1203. (4). AMERICAN INSTITUTE. Gallup. OF. PUBLIC. OPINION. (GALLUP). The. .. Opinion Index, September 1970, July 1971, July 1972,. June 1978. (5). Cigarettes in Fact. BAIN, J. Jr., WERNER, C.. Fancy,. and. Boston: H.M. Caldwell Co., 1906. (6). BONNER,. Women. Advertising. BORDEN,. (7). Chapter. Cigarette. Why. L.. &. N.H.. The. VII,. Selling. The. Makers 7:. Economic. Effect. 21,. Don't. ,. 1944, pp.. to. October 20, 1926.. Effects. Advertising.. of. of Advertising on the Demand for. Tobacco Products-- Cigarettes. Chicago: Inc.. Advertise. Richard. Irwin,. D.. 207-249.. (8). BURKE, H. Women Cigarette Fiends.. 39:. 19,. (9). BURBANK,. Ladies. Home. Journal.. June 1922. F.. U.S.. Proportionately Dose-Response. Lung Cancer Death Rates Begin. To. Rise. More Rapidly For Females Than for Males:. Effect?. Journal. of. Chronic. A. Diseases,. 25:473-479, 1972.. J.HARRIS. DRAFT.

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(103) -49 -. CAIRNS,. (10). 233(5):. J.. Scientific. Problem.. American,. 64-78, November 1975.. CONOVER,. (11). Cancer. The. Journal. of. Discussion. A.G,. Farm. Economics,. Jackson's. Elmo. of. 32 (4 , par t2). :. 923-924. Paper,. ,. November. Lung. Cancer,. 1950.. CONSUMERS UNION. Cigarette. (12). Smoking. and. Consumer Reports. 19:54-92, February 1954, COWELL, M,J., HIRST, B,L. Mortality Differences Between. (13). Smokers and Non-Smokers.. Massachusetts:. Worcester,. State. Mutual Life Assurance Company of America, October 22, 1979.. FORTUNE MAGAZINE.. (14). The Fortune Survey.. III.. Cigarettes.. 12(1) :68, 111-116, July 1935. (15). GOTTSEGEN, J.J, Tobacco, A Study of Its Consumption. the. United. New. States.. York:. in. Pitman Publishing Corp.,. 1940. (16). GRAHAM, E.A. Primary Cancer of the. Consideration. of. Its. Academy of Medicine. 27 (17). HAENSZEL,. Etiology. (5 ):. with. Bulletin of the New York. M.B.. Smoking. Patterns. Epidemiology. of Lung Cancer in the United States:. Compatible?. Journal. of. Special. 261-276, May 1951,. SHIMKIN,. W.. Lung. the. National. Cancer. and. Are They Institute.. 16(6) :1417-1441, June 1956. (18). HAENSZEL, W.. Smoking. Patterns. SHIMKIN, in. M.B.,. MILLER,. the United States. U.S.. H.P.. Tobacco. Department of. Health, Education, and Welfare, Public Health Monograph 45,. No.. 1956,. J.HARRIS. DRAFT.

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(105) -50-. (19). One. HAMMOND, E.G. Smoking in Relation to the Death Rates of. Million. Monographs, (20). Men. Expectancy. Life. E,C,. Journal. L,. Smoking Habits of Men. National. the. of. Men. in. 951-962, October 1969,. 43(4):. HAMMOND, E,C,, GARFINKEL,. Women,. American. of. Journal of the National. Their Smoking Habits,. to. Cancer Institute. (21). Institute. Cancer. 19:127-204, January 1966,. HAMMOND,. Relation. National. Women.. and. Cancer. and. Institute,. 27:419-442,1961, (22). HAMMOND,. E,C,,. Journal. Smoking,. GARFINKEL, the. of. Changes. L,. National. in. Cigarette. Cancer. Institute,. 33:49-64,1964. (23). HAMMOND,. Smoking. E.C, GARFINKEL, National. Habits,. Influence. L.. of. Institute. Cancer. Health. on. Monographs. 19:269-285, January 1966, (24). HAMMOND, E,C,, 1959-1965,. Smoking. GARFINKEL,. American. Changes. L,. Journal. of. in. Cigarette. Public. Health.. 58(l):30-45, January 1968. (25). HAMMOND,. Smoking. E.C, HORN,. Habits. and. Medical Association, (26). D.. Death. The Relationship Between. Rates,. Journal of the American. 155:1316-1328, 1954.. HARRIS, J,E, Cigarette Smoking in. 1950-1978.. General,. In:. U,S.. Human. the. United. States,. Smoking and Health, A Report of the Surgeon. Department of Health, Education, and Welfare.. January 1979, pp. A1-A29. (27). HARRIS, J.E. Public Policy Issues in the. J.HARRIS. Promotion. of. DRAFT.

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(117) -56-. 126(5) :3-6, 137-146, January 31, (69). WHITTEN,. Industry. and. I.T,. the. Brand. 1924.. Performance. in. the. Cigarette. Advantage of Early Entry, 1913-74. Staff. Report to the U.S. Federal Trade Commission, June 1979.. J.HARRIS. DRAFT.

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