In 2015-2016, with adjustments for age, males were more likely than females to be both current (21% vs. 16%) and past (30% vs. 21%) smokers; non-Hispanic whites had the highest age-adjusted prevalence for any smoking history (47% vs. 41% and 35% in non-Hispanic blacks and Mexican-Americans, respectively); and those with and without obestity had similar age-adjusted prevalence for any smoking history (~40%).
Chart Explanation: With adjustment for age, males were more likely than females to be both current (21.2% vs. 16.4%) and past (29.9% vs. 19.9%) smokers. Non-Hispanic whites had the highest age-adjusted prevalence for any smoking history (46.7% vs. 41.0% and 35.4% in non-Hispanic blacks and Mexican-Americans, respectively) and had the highest age-adjusted prevalence of past smoking (27.8% vs.16.9% and 20.3% in non-Hispanic blacks and Mexican-Americans, respectively). Those with obesity (BMI 30+ kg/m²) and without obesity (BMI <30 kg/m²) had relatively the same age-adjusted prevalence for current (18.2% vs. 19.0%) and past (27.3% vs. 23.0%) smoking.
The NHANES (National Health and Nutrition Examination Survey) is a nationally representative, cross-sectional survey that is currently conducted every 2 years by the Centers for Disease Control and Prevention's National Center for Health Statistics to examine disease prevalence and trends over time in noninstitutionalized U.S. civilian residents.
Smoking is a putative risk factor for chronic kidney disease, and the risk may differ by race/ethnicity. Some cohort studies have shown that smoking is an independent risk factor for development (Fox et al., 2004) or progression (Hallan & Orth, 2011; Lash et al., 2009) of CKD, particularly related to decline in kidney function, in white and African-American populations. However, other studies, including a screening study (Jolly et al., 2009), found that smoking was not a risk factor for CKD among Alaskans and American Indians. Several mechanisms for increased risk of CKD have been proposed, including increased environmental exposure to cadmium among smokers (Mortensen et al., 2011). The survey consists of a standardized in-home interview and a physical examination and blood and urine collection at a mobile examination center (MEC). Here we examined data from the 1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016 NHANES. Smoking history (cigarette use) was determined by questionnaire as part of the home interview for those participants aged 20 years or older.
| Field | Data |
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| Description of Measure | Prevalence of smoking in the general population |
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| Data Source | NCHS |
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| Type of Data Source | Public |
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| Data Set | NHANES |
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| Health Care System Data | No |
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| Regional or National? | National |
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| Demographic Group | Non-institutionalized U.S. residents aged 20+ |
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| Numerator | Participants 20+ reporting smoking (past or current) |
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| Denominator | Participants 20+ responding to smoking survey |
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| Primary Data Source Indicator | smq*, smd*: questions related to smoking (past, current, amount) |
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| Primary Indicator Method of Measurement | Self-report (computer-assisted interview in home) ages 20+ |
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| Frequency of Measurement (Primary) | Once (cross-sectional) |
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| U.S. Region Covered by Primary Variable | All |
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| Period Currently Available | 1999–2016 |
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| Pending Data | 2017-2018 |
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| Additional Data Items of Interest | stratification variables of interest (age, gender, race/ethnicity, BMI) |
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| Limitations of Indicator | Smoking may be over- or under-reported by past and current smokers |
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| Analytic Considerations | Appropriate NHANES survey weights must be used for all analyses (interview for adults, unless MEC variables such as BMI used) |
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| Age Adjustment | Adjusted for the distribution of age within the sample. |
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References and Sources:
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Hallan SI, Orth SR. Smoking is a risk factor in the progression to kidney failure. Kidney Int. 2011;80(5):516-23.
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Mortensen ME, Wong LY, Osterloh JD. Smoking status and urine cadmium above levels associated with subclinical renal effects in U.S. adults without chronic kidney disease. Int J Hyg Environ Health. 2011;214(4):305-10.
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Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;18;291(7):844-50.
http://www.ncbi.nlm.nih.gov/pubmed/14970063
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Lash JP, Go AS, Appel LJ, et al. Chronic renal insufficiency cohort (CRIC) study: baseline characteristics and associations with kidney function. Clin J Am Soc Nephrol. 2009;4(8):1302-11.
http://www.ncbi.nlm.nih.gov/pubmed/19541818
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Jolly SE, Li S, Chen SC, et al. Risk factors for chronic kidney disease among American Indians and Alaska natives--findings from the Kidney Early Evaluation Program. Am J Nephrol. 2009;29(5):440-6.
http://www.ncbi.nlm.nih.gov/pubmed/19011277