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Cigarette smoking prevalence among Delaware adults has declined to 13.6 percent in 2021, according to the Delaware Behavioral Risk Factor Survey (BRFS). While this was not a statistically significant decrease, there has been a declining trend over the past eight years.
However, when considering all the other forms of tobacco currently being used, total tobacco use prevalence in 2019 was 19.2 percent of adult Delawareans. The 2020 and 2021 total tobacco use prevalence cannot be compared to other years. In 2020 and 2021, the survey did not ask about cigar or hookah use. As a result, the dip in prevalence from previous years may be a result of not including these tobacco products in the calculations.
More than half (60.7 percent) of Delaware adults now say they have never smoked. Another 25.9 percent of respondents were former smokers. The BRFS defines "current smoker" as anyone who smokes every day or some days during the week. Only 9.0 percent of respondents say they smoke cigarettes every day; while 4.4 percent call themselves "some-day smokers." The "some-day smokers" group includes younger adults who are just starting to smoke, but also includes smokers who are cutting back or trying to quit.
A majority of smokers (49.8 percent) said they had tried to quit smoking during the past year.
There were no statistically significant differences in smoking prevalence by county.
|Statewide||New Castle County||Kent Co.||Sussex County|
In 2021, men have a slightly higher smoking prevalence (15.9 percent) than women (11.1 percent). This difference is statistically different, There are also no statistically significant differences by race or ethnicity.
Smoking has significantly decreased over the past decade among 18-24 year old adults, at least partly because smoking had decreased among high school students who have now entered the adult sample. The age group with the highest cigarette smoking prevalence (21.2 percent) is now adults between the ages of 25-34. Only 8.5 percent of adults ages 65 and older are smokers.
Although the BRFS does not ask at what age adults initiated smoking, the Division of Public Health conducts a companion survey called the Adult Tobacco Survey (ATS). According to the 2022 ATS, among adults who currently smoke, 72.7 percent first tried smoking before age 18, and 21.5 percent first tried smoking after they turned 18 but before age 21.
Some groups of adults have a significantly greater risk of becoming smokers, including people with disabilities and with depression or other mental health conditions.
Among adults reporting a significant number of "poor mental health days" each month, 22.5 percent are smokers, compared to only 12 percent of adults who reported no or few poor mental health days. Likewise, 22.4 percent of adults who reported depressive disorders smoke cigarettes, compared to 11.4 percent of adults without depression.
Among adults reporting any kind of disability, 20.4 percent were smokers, compared to 13.9 percent of adults without disabilities.
By income, the highest smoking prevalence (25.6 percent) is among adults with an income of less than $24,999 per year, according to the BRFS. Like income, as education increases, the prevalence of currently smoking cigarettes decrease. While 22.2 percent of adults with less than a high school education smoke cigarettes, only 5.4 percent of adults with a college degree are smokers.
Source: Delaware Health & Social Services, Division of Public Health, Behavioral Risk Factor Survey (BRFS), 2021
The tobacco industry has introduced and heavily marketed a number of new tobacco products during the past decade, most of which have the same health risks as cigarettes. Measuring the use of these other tobacco products is, therefore, as important as measuring prevalence of cigarette smoking. Other tobacco products include cigars, little cigars or cigarillos, smokeless tobacco, hookahs, pipes, bidis, kreteks, orbs, and strips. These products are more popular among men and young adults.
Little cigars have become more popular, with 4.5 percent of Delaware adults saying they were current cigar or little cigar smokers during 2019.
Smokeless tobacco includes traditional products such as chewing tobacco and snuff, but more recently also includes snus (pronounced snooce). Snus is flavored tobacco powder in teabag-like packets that are held between the lips and gums and do not require spitting. Smokeless tobacco is not popular — only about 1.9 percent of Delaware adults use these products.
Among teenagers, experimentation with electronic or e-cigarettes became very popular, starting about 2015. According to the 2021 Youth Risk Behavior Survey of public high school students, 17.9 percent of students had used e-cigarettes in the past month, and 3.9 percent were smoking or "vaping" e-cigarettes daily.
Experimentation with e-cigarettes is also catching on with adults. According to the 2021 BRFS, about 6.1 percent of Delaware adults currently use e-cigarettes, which is an increase from 3.7% in 2019.
In 2019, almost half of the adults who "vaped" e-cigarettes (47.6 percent) also were current smokers, thereby increasing potential harm.
While 13.6 percent of Delaware adults smoke cigarettes, the total percent of adults who use any tobacco products is significantly higher. The Delaware BRFS has calculated "total tobacco use" based on reported use of cigarettes, cigars, little cigars, e-cigarettes, smokeless tobacco, hookahs, and other tobacco products. The formula takes into account the fact that many adults use multiple types of tobacco products.
The total tobacco use prevalence for 2021 is 18.9 percent — about one-fifth of the state's adult population. the 2020 total tobacco used prevalence cannot be compared to other years. In 2020 and in 2021, the survey did not ask about cigar or hookah use. As a result, the dip in prevalence from previous years may be a result of not including these tobacco products in the calculations.
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