Determinants of Light and Intermittent Smoking in the United States: Results from Three Pooled National Health Surveys

Cancer Epidemiol Biomarkers Prev. 2017 Feb;26(2):228-239. doi: 10.1158/1055-9965.EPI-16-0028. Epub 2016 Oct 19.

Abstract

Background: Light and/or intermittent smokers have been the fastest growing segment of cigarette smokers in the United States over the past two decades. Defining their behavioral characteristics is a critical public health priority.

Methods: Our sample included 78,229 U.S. adults from three pooled contemporary population-based surveys: the 2012 NHIS, 2012 NSDUH, and 2011-2012 NHANES. We classified current smokers into four categories (light and intermittent [LITS], light-daily, heavier-intermittent, and heavier-daily) and assessed smoking behaviors, illicit drug use, and mental health indicators using weighted analyses.

Results: Analyses associated smoking categories with nicotine dependence, age of smoking initiation, race/ethnicity, and other demographic and behavioral factors. Compared with heavier-daily smokers, smokers who were LITS were most likely to have mild or no nicotine dependence (weighted odds ratio [OR], 16.92; 95% confidence interval [CI], 13.10-21.85), to start smoking cigarettes regularly after age 21 (OR, 3.42; 95% CI, 2.84-4.12), and to be Hispanic (OR, 5.38; 95% CI, 4.38-6.61). Additional significant results were found for other categories of smokers.

Conclusions: Based on pooled data from three large national surveys, light and/or intermittent smokers differed in smoking, drug use, and mental health behaviors from heavier-daily, former, and never smokers. Notable differences by level of smoking frequency and intensity were observed for nicotine dependence, age of smoking initiation, and race/ethnicity.

Impact: Our results may help focus preventive measures and policies for the growing number of light and/or intermittent smokers in the United States because smoking patterns vary by behavioral and socioeconomic factors. Cancer Epidemiol Biomarkers Prev; 26(2); 228-39. ©2016 AACR.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Ethnicity*
  • Female
  • Health Surveys / methods*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Nutrition Surveys / methods*
  • Odds Ratio
  • Prevalence
  • Racial Groups*
  • Retrospective Studies
  • Smoking / adverse effects*
  • Smoking / ethnology
  • Socioeconomic Factors
  • Tobacco Use Disorder / ethnology*
  • United States / epidemiology
  • Young Adult