Decades-Long U.S. Decrease in Smoking Rates Levels Off

The price of cigarettes increased after tobacco companies agreed in 1997 to pay billions to the states to settle a suit seeking compensation for Medicaid costs of smoking-related diseases. But statistics collected by the Federal Trade Commission show that tobacco companies then dramatically increased their advertising and marketing budgets, from $6.7 billion in 1998 to $15.1 billion in 2003 and $13 billion in 2005. From 2003 through 2005, price discounting accounted for more than 70 percent of the promotion expenditures.

David Sutton, a spokesman for Philip Morris USA, which supplies about half of the U.S. cigarette market, said the company agrees with the public health community that the "best way to reduce the health effects of cigarettes is to quit or not start in the first place." But he said that in the highly competitive domestic market for adult smokers, companies had to offer discounts to retailers to keep old customers and attract new ones.

Since 2000, there also has been a drop of 20 percent in state spending to keep children, in particular, from taking up smoking and to encourage and help smokers to stop, the CDC reported. That decline has been especially stark in several states that had had aggressive and effective programs, including Massachusetts, Florida and Minnesota.

Some of the spending decline has resulted from cuts in state appropriations, and some from a decrease in the amount of money available from the tobacco settlement. Under that landmark agreement, the amount paid by the tobacco companies declines if cigarette consumption falls off, or if more than 1 percent of the cigarette market is captured by small or foreign companies not covered by the settlement -- a threshold that was reached some time ago.

The rate of cigarette smoking began to fall steadily after the 1964 surgeon general's report on tobacco's health risks, although the decline leveled off for two years in the mid-1990s.

The new data, in the CDC's Morbidity and Mortality Weekly Report released yesterday, did not include specific information about youth smoking, but other reports have shown a similar leveling off among young people in the past several years.

The controversy over R.J. Reynolds's Camel No. 9 -- which came on the market in February -- has reached Congress, where Rep. Lois Capps (D-Calif.) has denounced the company's advertising for targeting women, especially young women. She and 40 other members of Congress twice wrote to 11 women's magazines asking them to stop running the ads, which generally feature slinky clothes in black and pink. One ad says the Camel No. 9s are now "available in stiletto" -- longer, thinner cigarettes. Capps has also accused the company of flavoring the cigarettes to taste like a chai latte.

The CDC report showed a small drop-off in adult smoking in the first three months of 2007, but Husten said that it is not considered significant and that rates often come in low at the beginning of a year.

Among the CDC findings was that in 2006, almost 37 percent of people with smoking-related chronic diseases were still smoking, a considerably higher percentage than the general population.