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Multicenter Study
. 2017 Feb;26(2):228-239.
doi: 10.1158/1055-9965.EPI-16-0028. Epub 2016 Oct 19.

Determinants of Light and Intermittent Smoking in the United States: Results from Three Pooled National Health Surveys

Carolyn M Reyes-Guzman  1   2 , Ruth M Pfeiffer  3 , Jay Lubin  3 , Neal D Freedman  3 , Sean D Cleary  2 , Paul H Levine  4 , Neil E Caporaso  3
Affiliations
Multicenter Study

Determinants of Light and Intermittent Smoking in the United States: Results from Three Pooled National Health Surveys

Carolyn M Reyes-Guzman et al. Cancer Epidemiol Biomarkers Prev. 2017 Feb.

Abstract

Background: Light and/or intermittent smokers have been the fastest growing segment of cigarette smokers in the United States over the past two decades. Defining their behavioral characteristics is a critical public health priority.

Methods: Our sample included 78,229 U.S. adults from three pooled contemporary population-based surveys: the 2012 NHIS, 2012 NSDUH, and 2011-2012 NHANES. We classified current smokers into four categories (light and intermittent [LITS], light-daily, heavier-intermittent, and heavier-daily) and assessed smoking behaviors, illicit drug use, and mental health indicators using weighted analyses.

Results: Analyses associated smoking categories with nicotine dependence, age of smoking initiation, race/ethnicity, and other demographic and behavioral factors. Compared with heavier-daily smokers, smokers who were LITS were most likely to have mild or no nicotine dependence (weighted odds ratio [OR], 16.92; 95% confidence interval [CI], 13.10-21.85), to start smoking cigarettes regularly after age 21 (OR, 3.42; 95% CI, 2.84-4.12), and to be Hispanic (OR, 5.38; 95% CI, 4.38-6.61). Additional significant results were found for other categories of smokers.

Conclusions: Based on pooled data from three large national surveys, light and/or intermittent smokers differed in smoking, drug use, and mental health behaviors from heavier-daily, former, and never smokers. Notable differences by level of smoking frequency and intensity were observed for nicotine dependence, age of smoking initiation, and race/ethnicity.

Impact: Our results may help focus preventive measures and policies for the growing number of light and/or intermittent smokers in the United States because smoking patterns vary by behavioral and socioeconomic factors. Cancer Epidemiol Biomarkers Prev; 26(2); 228-39. ©2016 AACR.

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Figures

Figure 1
Figure 1
Definition of Light and/or Intermittent Current Smoking This diagram represents the questions used in the 2012 National Health Interview Survey, 2011-2012 National Health and Nutrition Examination Survey, and 2012 National Survey on Drug Use and Health to define light and intermittent current smoking. CPD = Cigarettes per day. Intermittent = non-daily. LITS = smokers who are both light and intermittent.
Figure 2
Figure 2
Distribution of Light and/or Intermittent Smokers, United States, 2012 Percentages of current, former and never smokers in the United States. Current smokers are presented as light and intermittent (LITS), light-daily, heavier-intermittent, and heavier-daily smokers. Pooled data from the 2012 National Health Interview Survey, 2011-2012 National Health and Nutrition Examination Survey, and 2012 National Survey on Drug Use and Health. Intermittent = non-daily. LITS = smokers who are both light and intermittent.
Figure 3a
Figure 3a
Weighted Percentages of Smoking Characteristics for Current Light/Heavier and Intermittent/Daily, Former and Never Cigarette Smokers. Pooled Data from the 2012 National Health Interview Survey (NHIS), 2012 National Survey on Drug Use and Health (NSDUH) and 2011–2012 National Health and Nutrition Examination Survey (NHANES) Note: LITS = light (=10 CPD ) and intermittent smoker, L-D = light-daily smoker, H-I = heavier (>10 CPD )−intermittent smoker, H-D = heavier-daily smoker. Percentages displayed are weighted. Percentages for categories within current smokers (LITS, L-D, H-I, H-D) sum to 100% and percentages for total current, former and never smokers sum to 100% (not shown). For each smoking behavior, differences among smoking groups were statistically significant at p <0.05 (Chi-sq test). a NHIS & NHANES data only. b NHIS & NSDUH data only. c NSDUH & NHANES data only. d Cigar, snuff, chew, smokeless tobacco.
Figure 3b
Figure 3b
Weighted Percentages of Behavioral Characteristics for Current Light/Heavier and Intermittent/Daily, Former and Never Cigarette Smokers. Pooled Data from the 2012 National Health Interview Survey (NHIS), 2012 National Survey on Drug Use and Health (NSDUH) and 2011–2012 National Health and Nutrition Examination Survey (NHANES) Note: LITS = light (=10 CPD ) and intermittent smoker, L-D = light-daily smoker, H-I = heavier (>10 CPD )−intermittent smoker, H-D = heavier-daily smoker. Percentages displayed are weighted. Percentages for categories within current smokers (LITS, L-D, H-I, H-D) sum to 100% and percentages for total current, former and never smokers sum to 100% (not shown). For each behavior, differences among smoking groups were statistically significant at p <0.05 (Chi-sq test). Heavy drinker, based on average number of alcoholic drinks/day, past 12 months. Current use refers to past 30 days. Former use refers to >30 days from survey. a NHIS & NHANES data only. b NHIS & NSDUH data only. c NSDUH & NHANES data only. d "Any other drug" in NSDUH includes use of crack cocaine, heroin, hallucinogens, d-lysergic acid diethylamide (LSD), phencyclidine (PCP), Ecstasy, inhalant, pain relievers, oxycontin, tranquilizers, stimulants, methamphetamines, or sedatives. "Any other drug" in NHANES includes heroin and methamphetamine.
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