Patterns of Birth Cohort–Specific Smoking Histories, 1965–2009


      Characterizing the smoking patterns for different birth cohorts is essential for evaluating the impact of tobacco control interventions and predicting smoking-related mortality, but the process of estimating birth cohort smoking histories has received limited attention.


      Smoking history summaries were estimated beginning with the 1890 birth cohort in order to provide fundamental parameters that can be used in studies of cigarette smoking intervention strategies.


      U.S. National Health Interview Surveys conducted from 1965 to 2009 were used to obtain cross-sectional information on current smoking behavior. Surveys that provided additional detail on history for smokers including age at initiation and cessation and smoking intensity were used to construct smoking histories for participants up to the date of survey. After incorporating survival differences by smoking status, age-period-cohort models with constrained natural splines were used to estimate the prevalence of current, former, and never smokers in cohorts beginning in 1890. This approach was then used to obtain yearly estimates of initiation, cessation, and smoking intensity for the age-specific distribution for each birth cohort. These rates were projected forward through 2050 based on recent trends.


      This summary of smoking history shows clear trends by gender, cohort, and age over time. If current patterns persist, a slow decline in smoking prevalence is projected from 2010 through 2040.


      A novel method of generating smoking histories has been applied to develop smoking histories that can be used in micro-simulation models, and has been incorporated in the National Cancer Institute’s Smoking History Generator. These aggregate estimates developed by age, gender, and cohort will provide a complete source of smoking data over time.
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      1. Surgeon General’s Advisory Committee on Smoking and Health. Smoking and health: report of the Advisory Committee to the Surgeon General of the Public Health Service. 1964: U.S. Department of Health, Education, and Welfare, Public Health Service, Office of the Surgeon General, 1964.

        • Warner K.E.
        Effects of the antismoking campaign: an update.
        Am J Public Health. 1989; 79: 144-151
        • Moolgavkar S.H.
        • Holford T.R.
        • Levy D.T.
        • et al.
        Impact of the reduction in tobacco smoking on lung cancer mortality in the U.S. during the period 1975–2000.
        J Natl Cancer Inst. 2012; 104: 541-548
        • Jeon J.
        • Meza R.
        • Krapcho M.
        • Clarke L.D.
        • Byrne J.
        • Levy D.T.
        Actual and counterfactual smoking prevalence rates in the U.S. population via microsimulation.
        Risk Anal. 2012; 32: S51-S68
        • Harris J.E.
        Cigarette smoking among successive birth cohorts of men and women in the U.S. during 1900–80.
        J Natl Cancer Inst. 1983; 71: 473-479
      2. U.S. Public Health Service, Office of the Surgeon General U.S. The health consequences of smoking for women: A report of the Surgeon General. Rockville MD: Department of Health and Human Services, Public Health Service, Office of the Assistant Secretary of Health, Office on Smoking and Health, 1980.

      3. U.S. Public Health Service. Office of the Surgeon General, U.S. Office on Smoking and Health. The health consequences of smoking: Cancer and chronic lung disease in the workplace, a report of the Surgeon General. Rockville MD: USDHHS, Public Health Service, Office on Smoking and Health, 1985.

        • Burns D.M.
        • Lee L.L.
        • Gilpin B.
        • Tolley H.D.
        • Vaughn J.W.
        • Shanks T.
        Cigarette smoking behavior in the U.S.
        in: Burns D.M. Garfinkel L. Samet J.H. Changes in cigarette related disease risks and their implications for prevention and control. National Cancer Institute, Bethesda1997
      4. National Cancer Institute. Strategies to control tobacco use in the U.S.: a blueprint for public health action in the 1990s. Rockville MD: USDHHS, Public Health Service, National Cancer Institute, 1991.

        • Anderson C.M.
        • Burns D.M.
        • Dodd K.W.
        • Feuer E.J.
        Birth-cohort-specific estimates of smoking behaviors for the U.S. population.
        Risk Anal. 2012; 32: S14-S24
        • Rogot E.
        • Murray J.L.
        Smoking and causes of death among U.S. veterans: 16 years of observation.
        Public Health Rep. 1980; 95: 213-222
        • Hammond E.C.
        Smoking in relation to the death rates of one million men and women.
        J Natl Cancer Inst Monogr. 1980; 19: 127-204
        • Chiang C.L.
        The life table and its applications.
        Krieger Publishing Co, Malabar FL1984
        • Fienberg S.E.
        • Mason W.M.
        Identification and estimation of age-period-cohort models in the analysis of discrete archival data.
        in: Schuessler K.F. Sociological methodology 1979. Jossey-Bass, San Francisco1978: 1-67
        • Holford T.R.
        The estimation of age, period and cohort effects for vital rates.
        Biometrics. 1983; 39: 311-324
        • Holford T.R.
        An alternative approach to statistical age-period-cohort analysis.
        J Clin Epidemiol. 1985; 38: 831-836
        • Holford T.R.
        Understanding the effects of age, period and cohort on incidence and mortality rates.
        Annu Rev Public Health. 1991; 12: 425-457
        • Durrleman S.
        • Simon R.
        Flexible regression models with cubic splines.
        Stat Med. 1989; 8: 551-561
      5. SEER*Stat Database: Populations—Total U.S. (1969–2011) <Single Ages to 85+, Katrina/Rita Adjustment> - Linked To County Attributes—Total U.S., 1969–2011 Counties, National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, released October 2012. National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, 2012.

        • Hyland A.
        • Cummings K.M.
        • Lynn W.R.
        • Corle D.
        • Giffen C.A.E.
        Effect of proxy-reported smoking status on population estimates of smoking prevalence.
        Am J Epidemiol. 1997; 145: 746-751
        • Gilpin E.A.
        • Pierce J.P.
        • Cavin S.W.
        • et al.
        Estimates of population smoking prevalence: self-vs proxy reports of smoking status.
        Am J Public Health. 1994; 84: 1576-1579
      6. Human Mortality Database, 2013;

      7. Office of the Actuary. Life tables for the U.S. Social Security area 1900–2080. USDHHS, 1992.

      8. National Center for Health Statistics. Statistics 2013;

        • Rosenberg M.A.
        • Feuer E.J.
        • Yu B.
        • et al.
        Cohort life tables by smoking status, removing lung cancer as a cause of death.
        Risk Anal. 2012; 32: S25-S38
        • Levy D.T.
        • Nikolayev L.
        • Mumford E.
        Recent trends in smoking and the role of public policies: results from the SimSmoke and tobacco control policy simulation model.
        Addiction. 2005; 100: 1526-1536
        • Fichtenberg C.M.
        • Glantz S.A.
        Association of the California tobacco control program with declines in cigarette consumption and mortality from heart disease.
        N Engl J Med. 2000; 343: 1772-1777
        • Fichtenberg C.M.
        • Glantz S.A.
        Effect of smoke-free workplaces on smoking behaviour: systematic review.
        BMJ. 2002; 325: 188-191
        • Levy D.T.
        • Chaloupka F.
        • Gitchell J.
        The effects of tobacco control policies on smoking rates: a tobacco control scorecard.
        J Public Health Manag Pract. 2004; 10: 338-353
        • Levy D.T.
        • Bauer J.E.
        • Lee H.-R.
        Simulation modeling and tobacco control: creating more robust public health policies.
        Am J Public Health. 2006; 96: 494-498
        • Levy D.T.
        • Ross H.
        • Powell L.
        • Bauer J.E.
        • Lee H.-R.
        The role of public policies in reducing smoking prevalence and deaths caused by smoking in Arizona: results from the Arizona tobacco policy simulation model.
        J Public Health Manag Pract. 2007; 13: 59-67