At the same time, Secretary of Health, Education, and Welfare John
W. Gardner urged the Congress to require “tar” and nicotine levels on
packages and advertisements, with provision for adding to the label
any ingredients subsequently identified as hazardous (42).

The PHS then began transmitting this information to the public.
The PHS policy formulated on the evidence available was that there is
no safe cigarette; the single best way to avoid the health hazards of
smoking is to quit smoking, but for those unable to quit, a lower “tar”
and nicotine cigarette would probably pose lower risks.

In 1972, the PHS classified some of the known chemical constituents
of cigarette smoke into different risk categories. The compounds
classified as “most likely” contributors to health hazards—“tar,”
nicotine, and carbon monoxide—were recommended as primary targets
for reduction (34).

In 1974 and again in 1975, Secretary of Health, Education, and
Welfare Caspar W. Weinberger formally requested legislation author-
izing the regulation of cigarettes by formulation of maximum
permissible levels of hazardous ingredients (38, 39).

During this time, a number of health professional societies, volun-
tary health agencies, and concerned citizens’ groups also conducted
public education activities on the health hazards of cigarette smoking.

The cigarette industry’s activities during this period probably also
influenced changes in cigarette choice. In 1952 only 1.4 percent of
cigarettes sold in the United States were filter tipped; by 1956, 29.9
percent of all cigarettes were filtered (27). In 1979, filtered cigarettes
represented 89.2 percent of all brands marketed (24), and were used by
91.7 percent of regular smokers, according to data from the 1979
Smoking Supplement of the National Health Interview Survey.
Advertising probably contributed to this rapid growth of filter-tipped
cigarettes. As early as 1954, one brand’s advertising slogan read, “...
filter gives greater protection against nicotine and tars than any other
cigarette on the market today. It is the greatest health protection in
cigarette history” (27). Another brand advertised the “Miracle of the
Modern Miracle Tip” (even while the “tar” yield of that product
increased 40 percent and the nicotine increased 70 percent over the 2-
year period after the filter had been introduced) (27).

During the last decade, when systematic data on “‘tar” and nicotine
yields of marketed cigarettes have been available, lower “tar” brands
have been marketed in increasing proportions. Federal Trade Commis-
sion data show that cigarettes yielding 15 mg or less of “tar”
constituted 15 percent of all brands in 1968, 20.4 percent in 1972, 30
percent in 1976, and 58.5 percent in 1979 (1, 2, 3, 5). Over the same time
period, the proportion of all marketed brands that yielded 10 mg or less
of “tar” increased from 4.7 percent in 1968, 9.9 percent in 1972, 12.4
percent in 1976, to 33.0 percent in 1979.

201
MILLIONS OF DOLLARS

 

 

FIGURE 1.—Market share of dollars expended in the U.S. on
advertising and promotion of cigarettes yielding <15 mg “tar”
compared with total domestic cigarette advertising and
promotional expenditures for years 1970, 1975, 1976, 1977, and
1978

NOTE: Percentages (shaded areas) refer to percent of each individual her.
SOURCE: Derived from Federal Trade Commission (6).

Further, the marked increase in the last 5 years in the proportion of
all cigarette sales accounted for by brands yielding <15 mg “tar”
coincides with an increased percentage of total dollars spent for
advertising and promotion of cigarettes yielding 15 mg or less of “tar”
per cigarette. Figure 1 shows this increasing promotional effort. Since
1970, the absolute amount as well as the percent of all advertising
dollars spent that went to advertising of “low tar” cigarettes has
increased from approximately $37,900,000, or 10.5 percent, in 1970 to
$421,300,000, or 48.1 percent, in 1978 (4). This increase occurred over
the same period as the greatest increase in the lower “tar” brands’
proportion of market sales.

Public Attitudes

Several surveys have examined the opinions of the general public
about cigarette smoking.

202
Public surveys conducted by the National Clearinghouse on Smoking
and Health examined the beliefs and attitudes of the U.S. public
relative to cigarette smoking (28, 29, 36, 39, 41). These surveys
indicated that the belief that cigarette smoking poses health hazards
was increasing, not only among the general public but also among
persons who continued to smoke. For example, in response to the
statement “Smoking cigarettes is harmful to health,” in 1964, 81.3
percent of the persons interviewed agreed and 13.1 disagreed, but in
1975, 84.9 percent agreed and 11.3 percent disagreed, with intermedi-
ate figures occurring in 1970 (29, 35, 39). Substantial differences were
apparent when smoking history was considered. In 1964, former
smokers believed smoking to be harmful in 90.5 percent of interviews,
while only 69.5 percent of the current smokers believed smoking
harmful; only 7.4 percent of former smokers did not agree that
smoking is harmful, but 21.9 percent of smokers did not agree (29).
This difference by smoking status in the percentage of interview
subjects who believed smoking to be harmful persisted in 1975, but the
difference narrowed (78 percent of current smokers agreed and 91.6
percent of former smokers agreed) (39). Very similar results were
reported in a large survey in 1978, which found that 90 percent of all
persons and 88 percent of smokers believed smoking to be harmful to
health (7).

The percentage of smokers who agreed that “cigarette smoking
frequently causes disease and death” increased from 52.2 percent in
1966 to 70.7 percent in 1975; the proportion of smokers who disagreed
declined from 37.6 percent in 1966 to 22.3 percent in 1975. The
percentage of the total population who had no opinion on this question
and the preceding question declined from 9.1 percent to 5.3 percent and
from 4.7 percent to 3.4 percent, respectively. This suggests that
educational efforts may have reduced the size of the “undecided”
population.

Other questions assessed the personal impact of beliefs about the
health hazards of cigarette smoking. Although the percentage of
smokers who reported being “slightly” concerned about the possible
effects of smoking on their own health remained fairly constant from
1966 (18.1 percent) to 1975 (18.9 percent), the proportion of smokers
who were “fairly” or “very” concerned increased from 29.1 percent in
1966 to 47.6 percent in 1975. The number of smokers “not concerned”
declined from 52.5 percent in 1966 to 31.5 percent in 1975.

For the entire population, the proportion of interviewees who agreed
that “smoking (is) enough of a hazard for something to be done about
it” increased from 76.3 percent in 1966 to 84.0 percent in 1975.

Additionally, one question asked of current smokers in 1966, 1970,
and 1975 provides information on smokers’ perceptions of varying
hazards by cigarette type (29, 36, 40). The number of smokers who felt
that “all cigarettes (are) probably equally hazardous” declined from

203
57.8 percent in 1966 to 40.6 percent in 1975, while the number of
smokers who believed that “some cigarettes (are) more hazardous than
others” increased from 29.9 percent in 1966 to 49.1 percent in 1975.
Among smokers who believed there was a difference among cigarette
brands in health hazard, current smokers who believed their own
cigarette brand was less hazardous than other kinds declined from 59.9
percent in 1966 to 49.7 percent in 1975, and smokers who believed their
cigarette brand was more hazardous increased from 12.6 percent. to
20.4 percent. Thus in the period from 1966 to 1975, there was an
increasing proportion of smokers who believed different cigarettes
posed varying health risks, but among these smokers the proportion
who felt their cigarette was more dangerous to health than other
cigarettes also increased. Unfortunately, identical large surveys to
assess subsequent trends either in smokers’ beliefs about differences in
health risks or about the role of such beliefs in affecting cigarette
product choice have not been published since 1975.

The Tobacco Institute, which represents the cigarette manufactur-
ers, has also supported periodic surveys of attitudes. Their most recent
survey is publicly available. Conducted in 1978 (18), this survey found
that more than 90 percent of the U.S. population believed cigarette
smoking is hazardous to the health of the smoker. Fully 61 percent
believed that any amount of smoking is hazardous, up from 47 percent
in 1970. This is in close agreement with surveys performed by the PHS
in 1970. Further, in 1970 and 1978, 42 percent and 50 percent,
respectively, of the population surveyed believed that smoking “makes
a great deal of difference in longevity,” a higher percentage than those
believing the same thing about fatty diets (48 percent), alcohol
consumption (39 percent), lack of exercise (34 percent), and overweight
(24 percent).

The proportion of all persons who believe smokers “have” or
“probably have” more of “certain illnesses” has increased from 56
percent in 1970 to 62 percent in 1978, when only 11 percent believed
that smokers do not suffer more illness. Only 3 percent of people
surveyed did not believe that cigarette smoking is a cause of disease, a
figure that has not changed appreciably since 1970.

The 1978 Roper Survey found that the proportion of the population
who believed others’ smoking is hazardous to the nonsmoker’s health
had increased from 46 percent in 1974 to 58 percent in 1978. In 1978,
the number who believed passive or involuntary smoking to be harmful
was 69 percent among nonsmokers; while among smokers it was 40
percent. For the first time, the health effect of involuntary smoking
was cited most frequently as a reason for legislation to ban cigarette
smoking in public places.

204
The Cigarette Profile

The definition of cigarettes as “lower ‘tar’” at <15 mg is arbitrary.
Nonetheless, this breakpoint has gained general acceptance. The
separation of <15 mg “tar” was meaningful when the vast majority of
cigarettes were of higher “tar” yields; now, however, more than half of
all the cigarettes sold in this country are at or below the level of 15 mg
“tar” per cigarette. Many of the following measures use this break-
point (<15 mg). Special note should be taken, however, of the fact that
both “tar” and nicotine yields vary continuously, and groupings by
relative yield measurements do not automatically imply differences
either in the type or in the magnitude of their biologic effects.

As discussed previously, the proportion of domestic commercially
marketed cigarette brands that yield 15 mg or less of “tar” has
increased over the last two decades to 58.5 percent in 1979 (1, 5). These
figures, however, reflect industry marketing decisions and do not
directly measure the smoking public’s selection of a cigarette product.
The market share of unit sales, however, reflects both the “tar” yield
of each brand marketed and the smoking population’s actual use of
that product. Figure 2 shows the percentage of all U.S. cigarette sales
(the “market share”) represented by cigarettes containing 15 mg or
less of “tar.” Over the last decade the market share of sales accounted
for by lower “tar” products has increased consistently since 1971.
Cigarettes yielding <15 mg “tar” accounted for only 2 percent of the
cigarette market sales in 1967, but the comparable figure is projected
to approach 50 percent in 1980 (24). This represents an almost 23-fold
increase over 13 years. There has been a threefold increase over the
last 5 years in the proportion of all cigarettes purchased and
presumably consumed that are lower in “tar.” Thus, cigarettes of 15
mg or less are not only available in the market, but they are also being
chosen by the smoking population.

A different measure of cigarette choice is the sales-weighted
average of “tar” or nicotine. The sales-weighted average is derived
from the “tar” or nicotine yield of each cigarette available in the
United States, weighted by the numbers of packages of each brand
sold annually. The sales-weighted average values for “tar” and
nicotine thus represent a hypothetical “average cigarette” smoked in
the United States. Figure 3 shows the trend over time of the sales-
weighted average cigarette’s “tar” or nicotine content (43).

The yield of “tar” declined from 38 mg in 1954 to 19 mg in 1975,
while that of nicotine declined from 2.3 to 1.3 mg per cigarette. The
decline in both “tar” and nicotine approximated 50 percent over this
20-year period. Data provided from a single source of continuous
measurement as shown in Figure 4 indicate that the decline in “tar”
has continued in recent years, although at a slower rate than that
observed from 1954 to 1965. It is projected that the sales-weighted

205
1973 1974 1975 1976 1977 1978

YEAR

1972

           
 

t N

- pad

2 o wv Nn Qo

28
26
20
18
16

°o
-

24
22

PERCENT

FIGURE 2.—Domestic market share of cigarettes yielding <15
mg “tar,” 1967-1978

NOTE: 1979 data unavailable.
SOURCE: Derived from Federal Trade Commiasion (6).

average “tar” and nicotine in 1980 will be less than 14 mg and 1 mg,
respectively.

Examination of the ratio of “tar” yield to nicotine yield per cigarette
is interesting in light of the hypothesis that nicotine, perhaps in
combination with organoleptic compounds, exhibits a threshold value
for acceptability to the consumer. This threshold may have been

206
mg NICOTINE

 

   

 

 

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mg TAR"

 

70 71 72 #73 74 75

69

58 59 60 61 62 63 64 65 66 67

57

56

YEAR

FIGURE 3.—Sales-weighted averages of “tar” and nicotine per

cigarette consumed in the U.S., 1954-1975

SOURCE: Wakeham (43).

207
21-

rs

- 1.3

1.2

mg “TAR”
&
I

mg NICOTINE

 

 

 

 

0 T T T T T 7 T T T T T 0
1968 1969 1970 1971 1972 1973 1974 1 975 1976 1977 14 978
YEAR

FIGURE 4.—Sales-weighted averages of “tar” and nicotine per

cigarette consumed in the U.S., 1968-1978
SOURCE: Derived from Federal Trade Commission (6).

reached (at 1.4 mg nicotine) in certain countries (e.g., England) (19). In
the United States, the sales-weighted average nicotine yield per
cigarette has continued to decline below the level of 1.4 mg (Figures 3
and 4). Figure 5 presents the “tar” to nicotine ratio of the sales-
weighted “average cigarette” annually from 1968 to 1978. The “tar” to
nicotine ratio has ranged from 16 to 14.3, with a maximum variation of
less than 10 percent of the ratio’s absolute value. There has been no
systematic difference observed between the declines of “tar” and
nicotine of the average cigarette product over the last decade.

The previous discussion has focused on “tar” yields and, to a lesser
extent, on nicotine yields. The relationship between “tar” and nicotine
is a direct one, as is shown in Figure 6 (5). The correlation coefficient
for these two variables is 0.967, based on data from the Federal Trade
Commission report (5). Similarly, the correlation coefficient reported
by the Oak Ridge National Laboratory was 0.917 (12). The description

208
T:N RATIO

15

 

 

: T T l T T T T T I |
1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978

YEAR

FIGURE 5.—Ratio of “tar” to nicotine based on sales-weighted
averages of cigarettes consumed in the U.S., 1968-1978

SOURCE: Derived from Federal Trade Commission (6).

of cigarette products by “tar” yield can thus be assumed to approxi-
mate closely the pattern that would result from a similar analysis by
nicotine yield. There appears to be a similar relationship between “tar”
and carbon monoxide yields, as Figure 7 shows. There is, however, a
systematic difference between the “tar” and carbon monoxide yields of
filtered and nonfiltered cigarettes (12). Filtered cigarettes tend to have
a higher carbon monoxide yield than do nonfiltered cigarettes of the
same “tar” yield. Nonetheless, there appears to be a strong association
between “tar” and carbon monoxide yield by cigarette variety, with a
correlation coefficient for “tar” and carbon monoxide of 0.803.

Data from the Department of Agriculture describe tobacco weight
per cigarette over time (24). Figure 8 shows tobacco weight per
cigarette in relation to “tar” yield, with both values shown as a percent
of its value in calendar year 1967. While “tar” content per cigarette
declined by 32.2 percent and nicotine declined by 25.6 percent since
1968, the weight of tobacco per cigarette declined by 23.8 percent over
the same period (24). This suggests that a significant portion of the

209
2.5

 

 

 

 

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we O
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4 Oo oO
os 7 0080 © Filter cigarette brand
4 a°° @ Nonfilter cigarette brand
+0
OO
0 5 10 16 20 25 30
“TAR”
(mg/cigarette)

FIGURE 6.—Delivery of nicotine as a function of “tar” of

commercial cigarettes, U.S.
SOURCE: Federal Trade Commission (5).

decline in the “tar” and nicotine yield in recent decades may have
resulted directly from a decrease in the amount of organic material
(tobacco) available to be burned in the cigarette.

Data available from Canada suggest that the observed decline in
that country’s officially measured “tar” and nicotine yields per
cigarette at least in part results from a decline in the total number of
puffs taken per cigarette during machine measurements of smoke
yield (18). Although detailed information on the number of puffs taken
per cigarette is not available for U.S. cigarettes, the FTC reports on
“tar” and nicotine yields of U.S. cigarette brands suggest a similar
factor may be operating in the decline of “tar” and nicotine yield
measurements. The FTC testing method specifies that cigarette “tar”
and nicotine yields be determined by smoking the cigarette to a
minimum butt length of 23 mm, or to the filter and overwrap length
plus 3 mm if in excess of 23 mm, while holding constant the puff
volume, duration, and interval. Since 1967, the filter and overwrap
length of U.S. cigarettes appears to have increased. In 1967, the
proportion of cigarette brands that were smoked down to a butt length

210
404

368
36 4

32

30 —
28
26 Oo 0
24

CARBON MONOXIDE (CO)
(mg/cigarette)

 

 

 

it rrr rrr yT yt
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28

8s~
8
go
g 4
g 4
&

“TAR"
(mg/ cigarette)

FIGURE 7.—Delivery of carbon monoxide as a function of

“tar” of selected U.S. commercial cigarettes
SOURCE: Derived from Jenkins (12).

of 23 mm was 26 percent, but in 1979 the comparable figure was only
10 percent. Conversely, the number of all brands tested that were
smoked to a butt length 30 mm or longer increased from 21 percent in
1967 to 77 percent in 1979. Thus, the butt and overwrap lengths of U.S.
brands appear to have increased. The absolute contribution of this
factor in the total decline in “tar” and nicotine yields over recent years,
however, is undetermined.

Cigarette Choice and Smoking Behavior
Overview

Previous examinations of many parameters measuring the patterns
of cigarette smoking in the United States have been published (25, 26).
They documented the continuing decline over the last several decades

211
   
 

“Tar” yield

INDEX VALUE

70

 

o—t
| | | | I I | I | T { T I

1967, 1968 1969 1970 197: 1972 1973 1974 1975 1976 1977 1978 1979*
YEAR

FIGURE 8.—Index of average “tar” and tobacco per cigarette,
annually, 1967-1979

* Data estimated or unavailable.
NOTE: Base year 1967 = 100.
SOURCE: U.S. Department of Agriculture (24).

in the proportion of men who were regular cigarette smokers, from
52.6 percent in 1955 to 37.0 percent in 1978. These publications also
reported a similar but smaller decline since 1965 in the proportion of
women who were current regular smokers, varying between 32 and 38
percent from 1965 to 1976, but declining to less than 30 percent in 1978.
These trends continued through 1979, with a total prevalence of
smoking at 32.5 percent of all adults, or 36.1 percent for males and 29.4

212
percent for females, according to data from the 1979 Smoking
Supplement of the National Health Interview Survey. Interpretation
of these cross-sectional data is difficult since changes in prevalence
figures represent the net effect of several variables, including the
entry of new smokers, the removal of smokers who quit, the reentry of
“relapsing” smokers, and the removal of smokers by death or
emigration. The data show an increasing proportion of former smokers
among the population, suggesting a significant role of cessation of
smoking in the observed decline in the prevalence of adult smoking,
particularly among males (25). The 1979 prevalence of regular smoking
at 32.5 percent of all adults represents the lowest total figure in more
than four decades.

Accompanying this decline in the prevalence of smoking among
adults has been a decrease in the per capita consumption of cigarettes
in recent years (Figure 9) and in the per capita consumption of pounds
of tobacco in any form or as cigarettes (Figure 10). After peaking at
4,336 in 1963, the consumption of cigarettes per adult decreased
(Figure 11) and is estimated to be 3,880 in 1980, its lowest point since
1950 (24). The decrease in per capita consumption of pounds of tobacco
began in the 1940s and continues to the present. The relatively greater
decrease in total pounds of tobacco consumed per capita in the form of
cigarettes than in tobacco consumed per capita in any form since 1978
may result from an increasing use of tobacco in other forms, such as
snuff or chewing tobacco, in addition to the previously mentioned
decline in the estimated weight of tobacco per cigarette.

The preceding parameters are aggregate measurements. Other more
detailed sources of evidence, however, suggest that the average
number of cigarettes smoked daily by regular smokers may, in fact, be
increasing. These data include evidence suggesting that the propor-
tionate decrease in percentage of the adult population who smoke
exceeds the reported decrease in per capita cigarette consumption for
the total population (25). Further, when figures on total annual per
capita cigarette consumption are divided by the estimated number of
smokers in the United States as derived from reported prevalence
figures, the estimated average daily intake for regular adult smokers
was 11.5 cigarettes in 1935, 26.2 cigarettes in 1955, and 33.3 cigarettes
in 1979 (26). These data should be interpreted in light of a strong
tendency for smokers to round off their reported number of cigarettes
smoked to one pack per day. Of the approximately 24,000 persons
surveyed for the Smoking Supplement of the National Health
Insurance Survey, fully 35.2 percent of all regular smokers reported
smoking one pack, or exactly 20 cigarettes per day. Nonetheless, the
proportion of all current regular smokers who consume 25 or more
cigarettes per day has increased for both sexes (26). These findings
could result from a higher rate of quitting by light smokers, from an
actual increase in the number of cigarettes consumed by continuing

218
 

Total

ws a A |
p

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

<

Be

&
2S
E fem
my © 3000 ;
< > Fitter
Sz
es
Oo z
« z
w = 2000
oo
s WwW
32 |
=a

z

5 /

° 1000 7

1900 1910 1920 1930 1940 1950 1960 1970 = 1980

YEAR

FIGURE 9.—Annual per capita consumption of total cigarettes
and filter-tipped cigarettes in the U.S., for persons aged 18 and
older, 1900-1979

SOURCE: U.S. Department of Health, Education, and Welfare (26).

smokers, from the entry of new smokers who consume more cigarettes
per day, or from some combination of these factors. A number of
sources of information exist on the issue of the role of nicotine as the
major pharmacologic agent in maintenance of smoking, including
prospective studies (8, 9, 10) and short-term experimental studies (20,
21), A more detailed discussion of the possible role of lower nicotine
yields in increasing the daily number of cigarettes smoked can be
found in the Behavioral Aspects section of this Report. To summarize,
the available evidence is consistent with the conclusion that the
average daily number of cigarettes smoked by current regular smokers
has increased. Although a role for “tar” or nicotine yields in this
change has been postulated, whether the role is primary and by what
mode of action are not clearly understood.

Several surveys in the 1970s examined the percentages of recent
smokers who recently attempted to quit and of those who succeeded.
Data from the National Center for Health Statistics indicate that men
and women were not only similar in the probability of attempting to
quit but also indistinguishable in the probability of quitting successful-

ly (26).

214
  
 
    

Ali tobacco products

es ae me ns cee a

   

4 i
g ° i \
2 84 i Nee
f ——
ge 77 i | ™s,
3 6 - I Cigarettes “\
2 /
2 4 7
$5 /
° =
aq 44 ¢
/
34

 

 

 

Qo TTT TOT
1925 30 35 40 45 50 55 60 65 70 71 72 #73 #%74 #%75 76 77 78 1979*

YEAR

FIGURE 10.—Annual per capita consumption of tobacco
products in the U.S. (including overseas forces) for persons aged
18 and older, 1925-1979

* 1979 data subject to revision.
SOURCE: U.S. Department of Agriculture (22, 23, 24).

Relationship of “Tar” and Nicotine Yields to Smoking Behavior

As indicated previously, this section focuses upon the currently
available “tar” and nicotine data for adults. The discussion presents (1)
a description by demographic characteristics of the current use of
cigarettes of different yields, as well as changes over time where
available; (2) data on the effect of varying “tar” or nicotine yields on
consumption patterns; and (8) data defining the role of varying yields
of “tar” and nicotine in cessation of smoking. The following data are
from the National Center for Health Statistics’ Smoking Supplement
to the Health Interview Survey and include discussion of the informa-
tion on “tar” and nicotine levels of the cigarettes smoked by
adolescents, as collected by the National Institute of Education (127).

As noted previously, the selection of categories of “tar” or nicotine
yields is arbitrary; in fact, both are continuous variables. The
categories of yield used in the following analysis do not imply that the
cigarettes within those categories differ either qualitatively or quanti-
tatively from the cigarettes in other categories. Rather, the groupings
permit convenient presentation of data on a cigarette’s yield of “tar”
and nicotine relative to other available cigarettes.

215
t T T T ' t t I ! l t |
1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978
YEAR

 

A,

 

38

q { j
- ° a
7 v oO

43-5
4244

CIGARETTE CONSUMPTION PER CAPITA
(thousands of cigarettes)

FIGURE 11.—Annual per capita consumption of cigarettes in
the U.S. (including overseas forces) for persons aged 18 and
older, 1963-1978

SOURCE: U.S. Department of Agriculture (24).

216
TABLE 1.—Estimated percentage distribution of current regular
smokers by “tar” yield of primary brand of cigarette,
by sex, race, age, and education, adults, U.S., 1979

 

 

<10 10-14 15-19 >a
mg mg mg mg
Total 13.0 20.3 57.3 9.4
Sex
Males 111 17.3 59.1 1225
Females 15.0 23.6 55.4 6.0
Sex and race
Males,
white 12.2 18.0 57.4 125
Males,
black 3.2 12.1 715 13.2
Females,
white 16.0 24.5 53.6 59
Females,
black 76 15.0 69.8 16
Age in years
17-24 9.6 22.6 66.9 10
25-44 13.5 20.8 58.9 69
45-64 18.9 18.2 50.0 178
>65 15.6 19.4 50.0 15.0
Years of education
08 10 16.0 61.0 16.0
911 8.6 16.3 65.4 9.6
12 126 21.2 57.8 8.4
” 18-15 18.3 24.8 49.4 74
>16 239 24.7 45.0 64

 

SOURCE: Based on data from the 1979 Smoking Supplement of the National Health Interview Survey.

The percentage distribution of current regular smokers by “tar”
level of their primary brand of cigarettes is presented in Table 1.
Although not shown, the same patterns are observed among five
arbitrary categories of nicotine yield (based on data from the 1979
Smoking Supplement of the National Health Interview Survey).

As noted previously, both 1978 and 1979 data on brands were coded
to 1978 FTC values for “tar” and nicotine yield. For this reason, and
because the cigarette samples tested in 1978 were obtained in 1977, the
data that follow probably report slightly higher values of “tar” and
nicotine yields than were actually being used during these periods. A
further discussion of the differences in “tar” and nicotine yields of
cigarette varieties reported by the FTC in 1978 and 1979 appears in the
addendum to this section. Overall, 33.3 percent of current smokers use
lower “tar” cigarettes (yielding less than 15 mg of “tar”) and 66.7
percent use higher “tar” cigarettes. Females smoke lower “tar”

217
cigarettes in higher proportions than do males. This difference in
choice of product by “tar” or nicotine level also persists when examined
by race. Whites smoke lower “tar” products in greater proportions
than do blacks, regardless of sex. For both sexes, white smokers choose
lower “tar” products approximately twice as frequently as do black
smokers of the same sex. While the percentage of all smokers using
cigarettes yielding <10 mg of “tar” increases within age cohorts, there
is no clear relationship of age cohort to those smoking cigarettes
yielding 10 to 14 mg of “tar.” Among smokers of the two highest “tar”
categories, there is a clear difference by age; the proportion of smokers
choosing cigarettes yielding 15 to 19 mg of “tar” decreases with age,
but the percentage using the highest “tar” (>20 mg) cigarettes
increases with age. The trend to increasing use of highest yield
products among older cohorts is clearer than the corresponding trend
to higher proportions using the lowest “tar” yield products. The
correlation of older ages and more frequent use of the highest “tar”
products could result from a cohort effect among older smokers who
continue to use the higher “tar” cigarettes that they used when they
first began to smoke.

Educational level, as measured in years of education completed, is
strongly associated with the percentage of smokers who use low “tar”
products. In considering products of 15 to 19 mg “tar” yield, an inverse
relationship with educational level in the proportion of smokers using
that product is observed, and a similar pattern is observed for the
extremely high “tar” products, yielding 20 mg or more of “tar” per
cigarette. (This inverse relationship persists even when age is con-
trolled, although the data are not shown in the table.) A similar though
less clear trend is observed with an increasing proportion of smokers
choosing lower “tar” products among higher income groups (data are
not shown).

The lack of correlated health endpoint information or detailed data
on knowledge and beliefs precludes interpretation of these data as
cause or effect, but the data do provide a description of the observed
differences in product choice by “tar” or nicotine yields.

The percentage of adults of both sexes who use lower “tar” products
has increased over time. These increases are observed in both races for
the time period shown. This is consistent with the previously cited
market data on the sales of lower “tar” products. The finding that only
33.3 percent of adult smokers in 1979 used cigarettes yielding less than
15 mg “tar,” although these products accounted for almost 40 percent
of the market, does not establish a greater daily number of cigarettes
smoked by users of the lower “tar” products, because gross sales
figures include purchases by smokers not included in this analysis (e.g.,
institutionalized persons including the military forces, adolescent
smokers, occasional smokers, and interviewees whose smoking status is
unknown).

218
Comparison of changes in the “tar” level of chosen brand is possible
for the years 1970 and 1979. The proportion of male smokers choosing
cigarettes yielding less than 10 mg “tar” increased from 1.1 to 11.1
percent and females choosing these brands increased from 2.7 to 15
percent. The use of high “tar” (>15 mg) declined from 1970 to 1979
from 89.4 to 71.6 percent for males and from 90.5 to 61.4 percent for
females (based on data from the 1979 Smoking Supplement of the
National Health Interview Survey and from U.S. Public Health
Service (37)).

Analysis of cigarette choice by nicotine yield shows the same
patterns by demographic variables, with the proportion of current
regular smokers who use lower nicotine products increasing with
increasing age and the proportion of smokers using products with
higher nicotine yields also increasing with increasing age. Whites use
lower nicotine products in greater proportions than do blacks.

A further measure of consumption suggests that the actual toxic
exposure of smokers by age, race, and sex may, however, differ
significantly from that implied by consideration only of cigarette “tar”
or nicotine yield. Table 2 shows the estimated mean daily “tar” or
nicotine dose derived from combining the reported yield per cigarette
and the number of cigarettes smoked daily by each individual in that
group. There is a consistent trend toward higher dose with increasing
age of smokers for race and sex groups. Although these figures do not
consider possible systematic differences in the style of smoking (e.g.,
butt length unsmoked, frequency and depth of inhalation, etc.), they do
illustrate marked differences in an estimate of mean dose of “tar” or
nicotine by age, sex, and race. It shows that if all smokers smoked in
the same manner, blacks would nonetheless experience a lower daily
dose of “tar” and nicotine than whites. Thus, although blacks smoke
higher “tar” products in higher proportions, the lower numbers of
cigarettes they smoke daily may result in a lower average daily dose of
smoke constituents.

More recent data on cigarette brand choice reveal changes. Table 3
presents data on the percentage distribution of smokers by “tar” and
nicotine yield of cigarettes in the period July through December 1978
versus 1979. These two surveys, each of which represents approximate-
ly 12,000 interviews, showed a shift in the percentage of persons using
lower “tar” (<15 mg) cigarettes from 28.8 percent in 1978 to 33.7
percent only a year later; a similar downward shift was observed at
nicotine yields below the highest category. Such a shift might be
caused by either an actual brand change or an involuntary downward
“creep” due to reduction in the “tar” or nicotine yield of the product by
the manufacturer. As noted previously, however, the cigarette brands
reported were coded in both 1978 and 1979 by the 1978 FTC “tar” and
nicotine yield values. Thus, the downward shift observed over this 1-

219
TABLE 2.—Mean daily dose* of “tar” or nicotine for current
regular smokers by race, sex, and age, U.S., 1979**

 

Mean daily dose (mg/day)

 

 

“Tar” Nicoti
Males 406 26.3
White All ages > 17 417 269
17-24 309 20.2
25-44 416 27.1
45-64 482 313
65+ 424 25.1
Black All ages > 17 308 211
17-2 234 174
25-44 294 20.7
45-64 387 26.5
65+ 299 141
Females 316 21.0
White All ages > 17 324 21.4
17-24 236 19.1
25-44 326 22.0
45-64 359 23.3
65+ 239 178
Black All ages > 17 244 16.9
17-24 204 146
25-44 243 17.0
45-64 262 175
65+ 392 28.0

 

“Number of cigarettes consumed multiplied by the level of “tar” or nicotine.
**Last two calendar quarters only.
SOURCE: Based on data from the 1979 Smoking Supplement of the National Health Interview Survey.

year interval in cigarette “tar” and nicotine yield represents an actual
change in the brand of cigarettes used by smokers.

Similar patterns have been observed in smoking among adolescents.
In a 1979 national telephone interview survey of 2,639 adolescents, the
percentage of all adolescent smokers who selected brands of lower
“tar” (<15 mg) had increased from 6.7 percent observed in 1974 for
both sexes (Table 4) to 33.5 percent in 1979. Direct comparison of the
percentage distribution of “tar” yield among adolescents with that
observed among adults is complicated by different groupings of “tar”
level and by different definitions of “regular” smokers in the two
surveys (after having smoked 100 cigarettes, “regular” smokers were
defined for adolescents as “smoking regularly each week”; for adults,
as any positive response to “when did you start smoking regularly?”).
Nonetheless, a similar trend toward increasing use of lower “tar”
products is observed among adolescents and adults.

Table 5 presents data on brand choice by “tar” level among
adolescents of different ages from the largest recent smoking survey
of adolescents. The small numbers of smokers, and the relatively large
numbers of individuals who are unclassifiable, make interpretation of

220
TABLE 3.—Estimated percentage distribution of current regular
smokers by “tar” and nicotine yield of primary
cigarette used, U.S., 1978* and 1979*

 

 

 

 

Percentage Percentage
“Tar” yield in 1978 in 1979
<5 mg 42 4.0
5-9 mg 15 9.0
10-14 mg 71 20.7
15-19 mg 61.4 56.8
>a mg 9.8 9.6
Percentage Percentage
Nicotine yield in 1978 in 1979
<0.5 mg 43 42
0.5-0.9 mg 26.7 31.7
10-12 mg 41.1 37.7
13-16 mg 26.7 25.3
>17 mg 12 12

 

*Last 2 calendar quarters only.
SOURCE: Based on data from the 1979 Smoking Supplement of the National Health Interview Survey.

TABLE 4.—Estimated percentage distribution of regular smokers
by “tar” yield, adolescents aged 12-18, U.S., 1974 and

 

 

1979

Percentage Percentage Percentage

boys girls both sexes
“Tar” yield 1974 1979 1974 1979 1974 1979
<10 mg 06 25 0.5 123 05 7.8
11-14 mg 5.6 29.5 68 22.6 62 25.7
15-19 mg 3.70 0.8 74.4 59.5 74.0 60.1
>20 mg 20.3 TA 18.2 5.5 19.3 6.3

 

SOURCE: National Institute of Education (17).

product choice among adolescents by age group difficult. Thus, a clear
definition of the relationship of the adolescent smoker’s age to choice
of cigarette smoked is not possible from this series.

In Table 6, the mean age of onset of smoking cigarettes for all
current regular smokers is 18.2 years. Although most of the data in the
National Health Interview Survey Smoking Supplement involves
recall, the mean age at onset is perhaps the most subject to bias,
whether in remembrance or in reporting preference. Nonetheless, the
reported age at onset of smoking is higher among older age groups.
This might reflect (1) a real change in recent years in the age at which
younger cohorts start to smoke, (2) the addition of a few late-starting
smokers during the extra years ‘“‘at risk,” causing a higher reported
age at onset among older cohorts, or (8) an effect of different mortality
rates for early versus late beginning smokers. The demonstration that
the average age at onset of smoking among females has declined from
35 years among women born prior to 1900 to 16 years among women

221
TABLE 5.—Percent distribution of adolescent regular smokers by
“tar” yield of primary brand, by sex and age, US,

 

 

 

1979
“Tar” yield of pri brand
<15 mg >15 mg Unspecified Don’t know
Boys age group % n % n % n % o
12-14 111 2 55.6 10 27.8 5 5.6 1
15-16 29.4 15 62.7 82 78 4
17-18 26.4 19 58.3 42 15.3 11
19 23.6 13 63.6 35 12.7 q
Nicotine yield of pri brand
<15 mg >15 mg Unspecified Don’t know
Girls age group % n % a % n % a
12-14 25.0 6 70.8 vw 42 1
15-16 23.9 11 56.5 26 13.0 6 6.5 3
17-18 34.7 34 62.0 51 122 12 1.0 1
19 30.5 18 £0.8 30 18.6 il

 

SOURCE: National Institute of Education (17).

born between 1951 and 1960 (26) explains a portion of the observed
differences in age at onset by cohort. Older cohorts may not fit the
assumption that the survivors within that cohort are representative of
all individuals within the original cohort. The amount and direction of
the effects of (1), (2), and (3) remain to be defined. However, there is a
general trend that, for each age cohort, the higher the “tar” level of
the cigarette currently smoked, the younger the reported age of onset
of smoking. The same observation is also found in the relationship
between nicotine yield and age of onset, except that an older age of
onset is indicated for those smoking the highest nicotine yield (>17
mg) cigarettes, which value is based on a small sample size.

Consumption Patterns

In attempting to define the role of “tar” or nicotine yield on the
daily number of cigarettes smoked, adult regular smokers were divided
into three levels of daily consumption by approximate quintiles of
“tar” and nicotine yield of primary brand (Table 7). This Table shows
that the percentage distribution of smokers by number of cigarettes
per day does not exhibit an association with “tar” or nicotine level of
cigarette used. This Table provides evidence that there is not a
significantly greater proportion of “heavy” smokers among smokers of
the lowest “tar” and nicotine cigarettes than there is among smokers
of the highest “tar” and nicotine cigarettes. It does not, however,
disprove the theory that individual smokers may increase their daily
number of cigarettes smoked when they switch to a cigarette with
lower “tar” or nicotine yield. That is, the absolute number of cigarettes

222
TABLE 6.—Mean age at onset of regular smoking by “tar” or
nicotine yield of primary brand, by age at
interview, current regular smokers, U.S., 1979

 

Age at interview

 

“Tar” yield
Total 17-24 a4 35-44 5-4 55-64 654+
<5 mg 19.6 16.6 183 19.5 20.3 19.2 Bs
5-9 mg 188 163 178 18.8 19.6 20.7 21
10-14 mg 185 16.2 18.1 18.7 19.3 20.6 22.4
15-19 mg 18.0 15.6 173 18.3 19.0 19.8 23.9
>20 mg 17.0 15.7 171 17.0 17.1 18.1 21.3
Total 182 15.8 175 18.4 18.8 19.7 23.2
Nicotine yield
<05 mg 19.7 16.5 18.3 19.8 20.5 192 24.1
0.5-0.9 mg 18.7 16.3 18.1 18.9 19.5 20.7 23.3
10-12 mg 18.0 15.7 172 182 19.1 19,7 B.7
13-16 mg 117 15.2 17.0 178 17.6 18.7 22.6
>L7 mg 193 18.0 175 173 19.4 21.6 20.3
Total 182 15.8 175 18.4 18.8 19.7 232

 

SOURCE: Based on data from the 1979 Smoking Supplement of the National Health Interview Survey.

smoked by individuals at low “tar” and nicotine yields may, in fact, be
higher than the number of cigarettes the same individuals smoked at
high yield levels, even though there is no cross-sectional difference.
The relationship of “tar” or nicotine yield to the number of
cigarettes smoked daily can also be examined by the average number
of cigarettes smoked in various age groups, as presented in Table 8.
After grouping smokers by age at interview, it is still observed that
neither the level of “tar” nor that of nicotine demonstrates a definite
association with the mean number of cigarettes smoked daily.

Cessation

The role played by cigarettes of varying “tar” and nicotine yields in
cessation has been widely discussed (25, 26). Present survey data have
not sufficed to define the role for varying “tar” and nicotine yields in
cessation, largely because of the lack of longitudinal surveys of
cigarette consumption prior to attempting to quit or after an
unsuccessful attempt. A longitudinal study of smoking patterns by
both cigarette product choice and number smoked daily to determine
their relationship to cessation is being conducted by the NCHS for the
Office on Smoking and Health during 1980 and 1981.

Table 9 examines by cigarette “tar” or nicotine yield the percent of
current smokers who report ever having seriously tried to quit
smoking. Overall, there is a clear inverse relationship between the
“tar” or nicotine yield of the cigarette and the percent of smokers who
have ever tried to quit. The group of lowest yield smokers shows a

223
TABLE 7.—Estimated percentage distribution of current regular
smokers by number of cigarettes smoked daily by
approximate quintiles of “tar” or nicotine yield,
adults, U.S., 1979

 

 

 

 

<10 11-15 16-17 17-18 >19
mg mg mng mg mg
Percent. of
total population 19.1 18.1 23.5 19.4 19.8
Daily number of
cigarettes
<15 29.9 20.5 31.2 27.6 239
15-24 42.7 45.5 42.4 Bs B39
>B5 275 269 26.3 292 30.2
Totals 100.1 99.9 99.9 100.1 100.0
<0.7 0.8-1.01 1.02-1.09 1.10-1.31 >182
mg mg mg mg mg
Percent of
total population 20.3 20.3 19.7 213 18.4
Daily number of
cigarettes
<15 29.2 29.0 B2 275 31.0
15-24 423 46.5 414 33 43.1
> 28.5 AS 30.4 29.2 259
Totals 100.0 100.0 100.0 100.0 100.0

 

SOURCE: Based on data from the 1979 Smoking Supplement of the National Health Interview Survey.

higher proportion of persons who have ever tried than those groups
smoking higher yield products. This relationship was found for both
“tar” and nicotine yields for all age groups except those 65 or more
years of age, where the sample size was considerably smaller and the
pattern was less clear.

The finding that greater proportions of current smokers of lower
“tar” or nicotine products report ever attempting to quit than do
smokers of higher “tar” products could result from (1) a higher rate of
attempting to quit (but with a similar failure rate) for more health-
conscious individuals who may also therefore choose lower yield
cigarettes; (2) a difference in the addictive qualities of lower “tar” or
nicotine products, causing a higher probability of relapsing after
attempting to quit; or (3) the choice of a lower “tar” and nicotine
cigarette product after failing to stop smoking. Selection between
these alternatives would require comprehensive data on brand choice
both prior to and following an attempt to quit smoking, as well as
health status measurements that might affect brand switching or quit
attempts. Such information is not available from this data set.

224
TABLE 8.—Mean number of cigarettes smoked daily by “tar” or
nicotine yield, by age groups, current regular
smokers, adults, U.S., 1979

 

Total 1k24 24 35-44 45-54 55-64 65+
<5 mg 215 16.0 19.5 2B3 26.8 218 18.9
5-9 mg 20.7 17.0 20.7 219 2.3 22.0 18.9
10-14 mg 20.2 16.2 22 2B 23.7 19.5 16.4
15-19 mg 20.6 175 21.0 22.7 23.8 22.1 16.4
>20 mg 225 152 23.0 29 239 21.6 16.9
Total 20.7 171 20.8 22.9 B4 215 17.2
Nicotine yield
<05 mg 214 16.9 19.8 22.9 25.6 21.5 18.7
05-0.9 mg 20.2 16.2 20.3 224 2.7 205 18.4
10-12 mg 21.0 12.7 219 2.1 35 22.0 15.9
13-16 mg 212 17.6 20.1 23.4 2.7 23 173
>17 mg 18.5 55 18.3 21.4 18.8 18.3 17.0
Total 20.7 11 28 29 24 215 17.2

 

SOURCE: Based on data from the 1979 Smoking Supplement of the National Health Interview Survey.

TABLE 9.—Estimated percent of current regular smokers who
have tried seriously at least once to quit, by “tar” or
nicotine level and age, U.S., 1979

 

“ ”

 

 

Age group <5 mg 5-9 mg 10-14 mg 15-19 mg >20 mg
17-24 62.9 57.1 57.6 623 B83
25-44 729 68.8 63.5 59.8 50.0
45-64 715 64.0 59.1 58.5 51.0
265 50.8 60.0 61.6 58.4 49.7
All ages 69.8 65.3 618 58.8 515
Nicotine level of pri .

<0.5 0.5-0.9 1.0-1.2 13-16 >t
Age group mg mg mg mg mg
11-% 60.7 58.0 53.6 47.1 50.4
25-44 3.3 665.1 612 55.1 492
45-64 70.7 60.6 58.4 55.0 483
>65 53.8 60.8 57.5 543 58.6
All ages 68.8 62.1 58.4 58.8 50.0

 

SOURCE: Based on data from the 1979 Smoking Supplement of the National Health Interview Survey.

Table 10 shows a comparison of the frequency distributions of recent
smokers by “tar” or nicotine level of the primary cigarette brand
smoked by those who either did not try to quit, those who tried but
failed to quit, and those who succeeded in quitting smoking within the

225