In the U.S., the crude prevalence of current smoking during 2015-2016 was lower among older adults (from 21% in those aged 20-39 years vs. 7% in those aged 70+ years), whereas the prevalence of past smoking was greater with increasing age (from 16% to 42%).
Males were more likely than females to be both current (21% vs. 16%) and past (30% vs. 20%) smokers; non-Hispanic whites were the most likely to be current or past smokers (47% vs. 40% and 34% in non-Hispanic blacks and Mexican-Americans, respectively); and in adults with a BMI <30 kg/m² and BMI 30+ kg/m², the prevalence for both past and current smoking were relatively the same.
Chart Explanation: In 2015-2016, the crude prevalence of current and past smoking in U.S. adults varied by age, gender, race/ethnicity, and BMI. The prevalence of current smoking was lowest in older adults (6.9% for 70+years) and highest in younger adults (21.0% in 20-39 years); whereas past smoking was lowest in younger adults (16.0% in 20-39 years) and highest in older adults (41.5% in 70+ years). Differential mortality likely explains the decreased prevalence of smoking in the oldest (70+) group. Males were more likely than females to be both current (21.2% vs. 16.0%) and past (30.2% vs. 20.5%) smokers. Non-Hispanic whites were the most likely to have any smoking history (47.3% vs. 40.1% and 34.2% in non-Hispanic blacks and Mexican-Americans, respectively) and had the highest prevalence of past smoking (29.3% vs.15.8% and 18.7% in non-Hispanic blacks and Mexican-Americans, respectively). The crude prevalence for current and past smokers was approximately the same when comparing adults with obesity (BMI 30+ kg/m²) and those without obesity (BMI <30 kg/m²); with both having a crude prevalence of 18% for current smoking, and greater than 20% for past 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 CKD, 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, 2015-2016, and 2017-2018 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 | 1999–2018 |
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| Pending Data | 2019-2020 |
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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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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