Cigarette Use Down, Yet Tobacco Consumption on the Rise

Through education and high taxation, the government has managed to influence a decrease in cigarette sales from 21.1 billion packs in 2000 to 17.4 billion in 2007, but the sale of other tobacco products has increased by the equivalent of more than a billion packs of cigarettes based on tobacco and nicotine content. The overall decrease in cigarette sales calculates to 18 percent, but about 30 percent has been offset by the use of tobacco in other forms. The alternative products, moist snuff, roll-your-own tobacco, and small cigars rose by 714 million, 256 million, and 130 million cigarette pack equivalents, respectively, and large cigar sales increased by 37 percent. Dry snuff and chewing and pipe tobacco were not included in the research due to their declining use.

While the shift in tobacco consumption patterns is not clear, study authors, Gregory Connolly, D.M.D., M.P.H., and Hillel Alpert, Sc.M., of the Harvard School of Public Health, cautions that non-combustible tobaccos may be safer but any kind of tobacco use is likely to pose certain health risks.

Since the drafting of the Tobacco Master Settlement Agreement in 1998, educational campaigns have focused primarily on the use of cigarettes, giving people a false sense of security with other forms of tobacco, according to Dr. Connolly. Cost and indoor clean air acts have probably influenced what type of tobacco products people are choosing, especially among teens. On top of state cigarette taxation, there is a 39-cent federal tax per pack and an additional 42 cents per pack stemming from the 1998 settlement with tobacco companies. Smokeless and roll-your-own tobaccos are generally taxed at only 5 percent to 10 percent the rate of cigarettes, with only a 4 cent tax on a package of small cigars. A typical user of premium moist snuff will spend 55 percent less per week than the average cigarette smoker.

Dr. Connelly said national campaigns should emphasize the deadly risks people are exposed to no matter what kind of tobacco products they use and all forms of tobacco should be taxed equally to help lower the risk of smoke related disease and death.

The American Heart Association reports that about 25.9 million men and 20.7 million women in the United States smoke, and smoke-related deaths will kill nearly 450,000 people annually.

The study's research was funded by the American Legacy Foundation, which is dedicated to tobacco prevention and cessation and appeared in the June issue of the Journal of the America Medical Association.