# Presentation: 042287

## Tobacco Progress Review
May 14, 2003

**Tobacco Progress Review**
**May 14, 2003**

## Tobacco Impact and Public Health Challenges

**Tobacco Impact and Public Health Challenges**

**28% of High School Students **
** ****11% of Middle School Students**

**22% of Adults**
**(46 million adults)**

**Current Smokers**

**Environmental**
** ****Tobacco Smoke**

**54% of Nonsmokers Exposed**

**Annual Impact**

**~440,000**
** ****Premature**
**Deaths**

**Lung / Other Cancers**
**Chronic Respiratory Disease**
**Cardiovascular Disease**

**14% of Medicaid Expenditures**
**Direct and Indirect Costs:**
**	****$157 Billion **

## Smoking-Attributable Mortality, 1995-1999

**Number of average annual deaths **

- Sources: CDC. Annual Smoking –Attributable Mortality, Years of Potential Life Lost, and Economic Costs—United States, 1995-1999.  MMWR 2002 51;300-3.  Burn deaths from: Hall JR.  The U.S. smoking-material fire problem.  Quincy, Massachusetts: National Fire Protection Association, Fire Analysis and Research Division, 2001.  Environmental tobacco smoke deaths from: National Cancer Institute. Health effects of exposure to environmental tobacco smoke: the report of the California Environmental Protection Agency. Smoking and tobacco control monograph 10. Bethesda, Maryland: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 1999..  Total does not equal sum due to rounding.

**Neoplasms**

**Cardiovascular diseases**

**Respiratory disease **

**Total**

**Perinatal conditions**

**Burn**
** ****deaths **

**Total**

**Lung**
**cancer**

**Ischemic**
** ****heart disease**

**    ****Environmental Tobacco **
**   ****Smoke**

## 3-2. Lung Cancer Death Rates

**Age-adjusted death rate per 100,000 standard population**

**Black male**

**Total population**

**White male**

**White female **

**Black female **

**Notes: Data are age adjusted to the 2000 standard population. The race groups white and black may be of Hispanic or non-Hispanic origin.**
**Source: National Vital Statistics System-Mortality (NVSS-M), NCHS, CDC.**

**2010 Target**

**Total male**

**Total female**

## 27-1a. Current Cigarette Smoking: Adults 18 Years and Older

**Age-adjusted percent**

**2010 Target**

**Black male**

**1975**

**1965**

**1975**

**1995**

**2001**

**1985**

**White male**

**White female**

**Black  female**

- Notes: Data are age adjusted to the 2000 standard population.  Survey redesigned in 1997 and data for 1998 and subsequent years may not be directly comparable to earlier years.  Source: National Health Interview Survey (NHIS), NCHS, CDC.

## 27-1a. Current Cigarette Smoking for Adults 

**American Indian/**
**Alaska Native only**

**Asian only**

**Hispanic ***

**Black, not **
**Hispanic only***

**White, not **
**Hispanic only***

**2010 Target**

**1998 Baseline**

**Current Level**

- *Preliminary data: January-September 2002, current data year for other groups is 2001.
- Notes: Current smokers report smoking everyday/some days and have smoked at least 100 cigarettes.  Data are age adjusted to the 2000 standard population.  American Indians/Alaska Natives or Asians/Pacific Islanders may be of Hispanic origin.  Hispanics may be of any race.  For 1998 and 2002, persons reported only one race or reported more than one race and identified one race as best representing their race.  Adults: 18 years and older.

**Total***

- Source: National Health Interview Survey (NHIS), NCHS, CDC.

**Males***

**9-11 years**

**High school**
**graduate**

**13-15 years**

**16 years **
**or more**

**Females***

**Age-adjusted percent**

**Education level**

- test

## 27-5. Percent of Current Adult Smokers Who Attempted to Quit in the Past Year, 2001

**American Indian/**
**Alaska Native only**

**Asian only **

**Hispanic **

**Black, not **
**Hispanic only**

**White, not **
**Hispanic only**

**2010 Target**

- I 95% confidence interval
- *Current smokers (everyday/some days and have smoked at least 100 cigarettes) who have quit smoking one day or longer in the year prior to interview.
- Notes:  American Indians/Alaska Natives or Asians may be of Hispanic origin.  Hispanics may be of any race.  Data are age adjusted to the
- 2000 standard population.  Adults: 18 years and older.

**Age-adjusted percent**

**Total**

- Source: National Health Interview Survey (NHIS),  NCHS, CDC.

## 27-1a, 27-2b. Current Cigarette Smoking   

**Percent**

**2010 Target: Students**

**Students (grades 9-12)**

**Adults (18 and older)**

**2010 Target: Adults**

**1970**

**1975**

**1980**

**2000**

**1965**

**1985**

**1990**

**1995**

***Preliminary data, January-September 2002.**
**Notes: Adults, age adjusted to the 2000 standard population.  Current Smoking: Adults-every/some days (and have smoked at least 100 cigarettes), Students-1+ day/past month.**

**2002***

- Sources: Adults, National Health Interview Survey (NHIS), NCHS, CDC.  Students, Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC.

## Healthy People 2010 Objectives Past Month* Tobacco Users: Students (Grades 9-12), 2001

| Tobacco Product | Any 
Tobacco
Product | Cigarettes
 | Spit Tobacco | Cigars
 |
| --- | --- | --- | --- | --- |
| Current
Rate | 34% (total)

30% (females)
39% (males) | 28% (total)

28% (females)
29% (males) |    8% (total)

2% (females)
15% (males) | 15% (total)

9% (females)
22% (males) |
| 2010
Target | 
21% | 
16% | 
1% | 
8% |
| Objective Number | 27-2a. | 27-2b. | 27-2c. | 27-2d. |

- *Tobacco use on one or more days in the 30 days preceding the survey.
- Note: Tobacco users may have used more than one tobacco product.

- Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC.

## 27-2b. Cigarette Use in Past Month*:Students (grades 9-12)

**Males**

**Hispanic **

**Black, not Hispanic**

**White, not Hispanic**

**2010 Target**

**1999 Baseline**

**2001**

**Percent**

**Total**

**Females**

- Sources: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC and **National Youth Tobacco Survey, OSH, CDC and The American Legacy Foundation.

- I 95% confidence interval
- *Smoked cigarette(s) on one or more days of the 30 days preceding the survey.
- Note: Data for American Indians, Alaska Natives, and Pacific Islanders are unreliable.

**In 2000, 11% of students in grades 6-8 smoked****

## Current Cigarette Smoking, Price and Tax: Students (12th Grade)

**Dollars**

**Mean excise tax on a pack of cigarettes**

**Current smoking**

**Real price per pack**

**Current smoking **

**Percent**

- *Current cigarette smoking: Have smoked at least once in the past 30 days. ** Real price is Consumer Price Index-adjusted national average retail price.
- Real price and mean excise tax per pack of cigarettes adjusted for inflation.
- Sources:  Original analysis/slide prepared by the ImpacTeen Project.  Estimated prices for the period covered by the survey data are based on the 11/01 price
- for each year reported by Orzechowski and Walker, adjusted for changes in state and federal cigarette taxes and trends in the non-tax component of price.
- Price data from: Orzechowski W, Walker RC.  The tax burden on tobacco: historical compilation 2001. Arlington, Virginia: Orzechowski and Walker, 2002.
- Smoking prevalence data from:  Monitoring the Future Study, NIH, NIDA. Tax data from: The Tax Burden on Tobacco, The Tobacco Institute.

## Current Smoking* and Price: Students (12th Grade), 1975-2002

**Current Smoking* and Price: Students (12****th**** Grade), 1975-2002**

- *Current cigarette smoking: Have smoked at least once in the past 30 days.
- ** Real price is Consumer Price Index-adjusted national average retail price.
- Sources:  Original analysis/slide prepared by the ImpacTeen Project.
- Estimated prices for the period covered by the survey data are based on the
- 11/01 price for each year reported by Orzechowski and Walker, adjusted for
- changes in state and federal cigarette taxes and trends in the non-tax
- component of price.  Price data from: Orzechowski W, Walker RC.  The tax
- burden on tobacco: historical compilation 2001. Arlington, Virginia:
- Orzechowski and Walker, 2002.
- Smoking prevalence data from:  Monitoring the Future Study, NIH, NIDA.

**Cigarette price**

**Current smoking**

## 27-10. Exposure to Environmental Tobacco Smoke: Nonsmokers* with Detectable Cotinine Levels**, Ages 4 and Older

**2010 Target**

**1988-94 Baseline**

** ****Percent with detectable serum cotinine**

**1999-2000**

**  ****Mexican American **

**Total**

** ****White, not Hispanic **

** ****Black, not Hispanic **

- Source: National Health and Nutrition Examination Survey (NHANES), NCHS, CDC.

- I 95% confidence interval
- * Nonsmokers defined by serum cotinine levels < 11 ng/mL.
- **Detectable serum cotinine levels: _>_ .05 ng/mL and _<_ 10 ng/mL.
- Notes: Age adjusted to the 2000 standard population.
- Data for other Hispanics, American Indians, Alaska Natives, Asians and Pacific Islanders are unreliable.

## 27-13.  Smoke-Free Indoor Air Laws*  

**2010 Target**

**Total number of States with laws (including D.C.)**

**Workplace    **

**Transportation**

- Source: State Tobacco Activities Tracking and Evaluation System (STATE System), OSH, NCCDPHP, CDC .

- *Indoor air laws: smoking bans or limited to separately ventilated areas.

**3**

**5**

**18**

**24**

**6**

**17**

**1998 Baseline**

**2002**

**1**

**13**

**3**

**16**

**22**

**4**

## 25

- <date/time>

**2010 Target: 51  (50 States + D.C.)**

**25**

**34 **

**35 **

- Source: Health Policy Tracking Service, National Conference of State Legislators.

**27-8b. States With Medicaid Coverage for Treatment of Nicotine Dependency**

**25**

**15 **

**16**

**Complete Coverage**

**Partial  Coverage**

** ****No Coverage**

**1998**

**1999**

**2000**

**1**

**1**

**1**

## Progress review data and slides

**Progress review data and slides**
**can be found on the web at:**

**http://www.cdc.gov/nchs/hphome.htm**

## Healthy People 2010 ObjectivesCurrent Regular* Tobacco Users: Adults

| Tobacco Product
(Year) | Cigarettes
(2002, Jan.-Sept., preliminary) | Spit Tobacco
(2000) | Cigars

(2000) | Pipes

(2000) | Bidis

(2000) |
| --- | --- | --- | --- | --- | --- |
| Number of Users | 46,155,000
persons | 4,444,000
persons | 4,386,000
persons | 973,000
persons | 167,000
persons |
| 
Current
Rate
 | 22% (total)

20% (females)
25% (males) | 2.3% (total)

0.3% (females)
4.4% (males) | 2.2% (total)

0.2% (females)
4.4% (males) | 0.5% (total)

0.06% (females)**
1.0% (males)
 | 0.09% (total)

0.08% (females)
0.09% (males) |
| 2010
Target | 12% | 0.4% | 1.2% | 
  Targets: to be determined |  |
| Objective Number | 27-1a | 27-1b | 27-1c |    27-1d               27-1e |  |

- Notes: Data are age adjusted to the 2000 standard population.  Estimated number of users are rounded to the nearest thousand.
- Users may regularly use more than one tobacco product.  Adults: 18 years and older. *Everyday or somedays.**Unreliable estimate,
- relative standard error >30%.

- Source: National Health Interview Survey (NHIS), NCHS, CDC.

**(2001)**

## 27-1a. Current Cigarette Smoking for Adults 18 years and older: 1998, 2001, and 2002

**American Indian/**
**Alaska Native only**

**Asian only**

**Hispanic **

**Black, not Hispanic only**

**White, not Hispanic only**

**2010 Target**

**1998 Baseline**

**2001**

- I 95% confidence interval
- *Preliminary data: January-September 2002.
- Notes: Current smokers report smoking everyday/some days and have smoked at least 100 cigarettes.  Data are age adjusted to the 2000 standard population.  American Indians/Alaska Natives or Asians/Pacific Islanders may be of Hispanic origin.  Hispanics may be of any race.  For 1998 and 2002, persons reported only one race or reported more than one race and identified one race as best representing their race.

**Age-adjusted percent**

**Total**

**2002***

- Source: National Health Interview Survey (NHIS), NCHS, CDC.

- test

## 27-1a. Current Cigarette Smoking for Adults18 years and older: 1998, 2001, and 2002

**Age-adjusted percent**

- I 95% confidence interval.  * Preliminary data: January-September 2002.
- Note: Data are age adjusted to the 2000 standard population.

**Education Level**

**1998 Baseline**

**9-11 yrs.**

**All adults**

**HS graduate**

**13-15 years**

**16 years or more**

**Females**

**Males**

**2001**

- Source: National Health Interview Survey (NHIS), NCHS, CDC.

**2002***

## 27-5. Percent of Current Adult Smokers Who Attempted to Quit in the Past Year

**American Indian/**
**Alaska Native only**

**Asian only **

**Hispanic **

**Black, not **
**Hispanic only**

**White, not **
**Hispanic only**

**2010 Target**

**1998 Baseline**

**2001**

- I 95% confidence interval
- *Current smokers (everyday/some days who have smoked at least 100 cigarettes) who have quit smoking one day or longer in the year prior to interview.  Notes:  American Indians/Alaska Natives or Asians may be of Hispanic origin.  Hispanics may be of any race.  For 1998, persons reported only one race or reported more than one race and identified one race as best representing their race.  Data are age adjusted to the 2000 standard population.
- Adults: 18 years and older.

**Age-adjusted percent**

**Total**

- Source: National Health Interview Survey (NHIS),  NCHS, CDC.

## Slide 21

## 27-2a. Tobacco Use in Past month*:Students (grades 9-12)

**Males**

**Hispanic **

**Black, not Hispanic**

**White, not Hispanic**

**2010 Target**

**1999 Baseline**

**2001**

- I 95% confidence interval
-  *Smoked cigarettes or cigars or used chewing tobacco, snuff, or dip on one or more of the 30 days preceding the survey.
- Note: Data for American Indians, Alaska Natives, and Pacific Islanders are unreliable.

**Percent**

**Total**

**Females**

- Source: Youth Risk Behavior Surveillance System (YRBSS),  NCCDPHP, CDC.

**19**

## Tobacco Use in the Past Month:

**Tobacco Use in the Past Month:**
** ****Students (Grades 9-12)**

**Direction of change desired**

**2010 Target**

**2001**

**21%**

**8%**

**1%**

**16%**

**34%**

**28%**

**8%**

**15%**

- Source: Youth Risk Behavior Surveillance System (YRBSS), NCCDPHP, CDC.

** ****(27-2a.)**

**(27-2c.)**

**(27-2d.)**

**(27-2b.)**

## 27-3a,b. Persons Who First Used Any Cigarettes During 1965 to 2000

**Age-specific rate per 1,000 person-years exposure**

**Targets: to be determined.**
- Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 1999-2001.

## Percent of Mothers Who Reported Smoking During Pregnancy*, 2001

**15-17 years**

**20-24 years**

- Notes: *Total of 49 reporting States and D.C., excludes data for California, which did not require reporting of tobacco use during pregnancy on birth certificates.   **14% quit during their first trimester (age adjusted to the 2000 standard population - objective 27-6).

**18-19 years**

**25-29 years**

**40-54 years**

**30-34 years**

**35-39 years**

**Age of Mother**

**In 1998,  20% of mothers 18-49 years**
** ****who smoked quit smoking **
**during their pregnancy****

**Percent**

- Sources: *National Vital Statistics System-Natality (NVSS-N), and **National Health Interview Survey (NHIS), NCHS, CDC.

**10-54 years**

## Percent of Mothers Who Reported Smoking During Pregnancy by Race/Ethnicity, 2001

**Total***

- Notes: Persons of Hispanic origin may be of any race.
- Total of 49 reporting States and D.C., excludes data for California, which did not require reporting of tobacco use during pregnancy on birth certificates.

**Hispanic**

**Black, not**
**Hispanic**

**White, not**
**Hispanic**

** ****Mother’s Age  15-19 **

**Total***

**Hispanic**

**White, not Hispanic**

**Black, not ****Hispanic**

**11.3**

**3.1**

**14.2**

**9.6**

**17.5**

**4.0**

**30.5**

**7.2**

**Percent**

**Mother’s Age 20-54 **

- Source: National Vital Statistics System-Natality (NVSS-N), NCHS, CDC.

- *Totals include origin not stated.

## 27-9. Reported Exposure to Tobacco Smoke at Home:Children ages 6 and under, 1998 

**Hispanic**

**Black,**
** ****not Hispanic**

**White,**
** ****not Hispanic**

**2010 Target**

- I 95% confidence interval. ** ##**Unreliable estimate, relative standard error >30%.
- Notes: Exposure is defined as anyone smoking inside the home at least 4 days a week.
- Hispanics may be of any race. American Indians, Alaska Natives, Asians, and Pacific Islanders may be of Hispanic origin.

**Percent**

**Total**

**Poor**

**Middle**
**/High**

- Source: National Health Interview Survey (NHIS), NCHS, CDC.

**Near**
** ****poor**

**American Indian **
**/Alaska Native**

**Asian/Pacific**
**Islander**

**##**

**##**

**6**

**Family Income Level**

## Rode in Car with Someone Who Was Smoking on at Least 
	One of the Preceding Seven  Days:
			Middle School Students: 34.3%**
			(range of 26 States: 21.7% in DC, to 45.5% in WV)

			High School Students: 29.2%**
			(range of 24 States: 19.9% in CO, to 43.3% in KY)

Were in Same Room with Someone Who Was Smoking on at Least One of the Preceding Seven Days:
			Middle School Students: 49.1%** 
			(range of 26 States: 36.4% in CA, to 63.7% in WV)
			High School Students: 56.5%**
			(range of 24 States: 39.7% in DC, to 71.5% in KY)

. 

***	******One of the Preceding Seven  Days:***
**	****	****	****Middle School Students: 34.3%****
**	****	****	**(range of 26 States: 21.7% in DC, to 45.5% in WV)
**	****	****	****High School Students: 29.2%****
**	****	****	**(range of 24 States: 19.9% in CO, to 43.3% in KY)
***Were in Same Room with Someone Who Was Smoking on at Least One of the Preceding Seven Days:***
**	****	****	****Middle School Students: 49.1%** **
**	****	****	**(range of 26 States: 36.4% in CA, to 63.7% in WV)
**	****	****	****High School Students: 56.5%****
**	****	****	**(range of 24 States: 39.7% in DC, to 71.5% in KY)
- .

- Reported Environmental Tobacco
-  Smoke Exposure in Nonsmokers*, 2000

- Source: National Youth Tobacco Survey (NYTS), OSH, NCCDPHP, CDC and American Legacy Foundation.

- *Never cigarette smokers.  ** Median of State rates.

## 27-10. Exposure to Environmental Tobacco Smoke (ETS):Nonsmokers* with Detectable Serum Cotinine Levels** 

**2010 Target**

**1988-94 Baseline**

- I 95% confidence interval
- * Nonsmokers defined by serum cotinine levels < 11 ng/mL.
- **Detectable serum cotinine levels: _>_ .05 ng/mL and _<_ 10 ng/mL.
- ***Age adjusted to the 2000 standard population.
- Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.

** ****Percent with detectable serum cotinine**

**1999-2000**

**Ages 4-17 **

**  ****Ages 4 and older*** **

**Ages 18+*****

- Source: National Health and Nutrition Examination Survey (NHANES), NCHS, CDC.

**Annually, ETS causes about 3,000 lung cancer deaths and 35,000 deaths from ischemic heart disease **
**in adult nonsmokers**

## 27-10. Exposure to Environmental Tobacco Smoke: Nonsmokers* with Detectable Cotinine Levels**, Ages 4 to 17

**2010 Target**

**1988-94 Baseline**

** ****Percent with detectable serum cotinine**

**1999-2000**

**  ****Mexican American **

**Total**

** ****White, not Hispanic **

** ****Black, not Hispanic **

- Source: National Health and Nutrition Examination Survey (NHANES), NCHS, CDC.

- I 95% confidence interval
- * Nonsmokers defined by serum cotinine levels < 11 ng/mL.
- **Detectable serum cotinine levels: _>_ .05 ng/mL and _<_ 10 ng/mL. ),
-  Note: Data for other Hispanics, American Indians, Alaska Natives, Asians and Pacific Islanders are unreliable.

## 27-10. Exposure to Environmental Tobacco Smoke:  Nonsmokers* with Detectable Cotinine Levels**, Ages 18 and older

**2010 Target**

**1988-94 Baseline**

- Note: Age adjusted to the 2000 standard population.   Data for other Hispanics, American Indians, Alaska Natives, Asians and Pacific Islanders are unreliable.

** ****Percent with detectable serum cotinine**

**1999-2000**

**  ****Mexican American **

**Total**

** ****White, not Hispanic **

** ****Black, not Hispanic **

- Source: National Health and Nutrition Examination Survey (NHANES), NCHS, CDC.

- I 95% confidence interval
- *Nonsmokers defined by serum cotinine levels < 11 ng/mL.
-  **Detectable serum cotinine levels: _>_ .05 ng/mL and _<_ 10 ng/mL.

## 27-10. Exposure to Environmental Tobacco Smoke: Nonsmokers* with Detectable Cotinine Levels**

**2010 Target**

**1988-94 Baseline**

** ****Percent with detectable serum cotinine**

**1999-2000**

**  ****18-24 **

**25-44 **

**45-64 **

** ****Adults**
**Ages 18 and older*****
** **

** ****65+ **

**40.7**

- Source: National Health and Nutrition Examination Survey (NHANES), NCHS, CDC.

- I 95% confidence interval
- * Nonsmokers defined by serum cotinine levels < 11 ng/mL.
- **Detectable serum cotinine levels: _>_ .05 ng/mL and _<_ 10 ng/mL.
- Note: ***Age adjusted to the 2000 standard population.  ), CDC, NCHS.

## 27-13.  Smoke-Free Indoor Air Laws*: 2002  

**2010 Target**

**Number of States with laws (including D.C.)**

**Workplace    **

**Transportation**

- Source: State Tobacco Activities Tracking and Evaluation System (STATE System), OSH, NCCDPHP, CDC.

- *Indoor air laws: smoking bans or limited to separately ventilated areas.

## 24-2a,b,c. Hospitalizations for Asthma: 1998, 1999, and 2000

**2010 Target**

**1998 Baseline**

- I 95% confidence interval
- Note:  *Data are age adjusted to the 2000 standard population.

**Hospitalizations per 10,000 population**

**1999**

**Children under 5 years**

**Persons 5 to 64 years* **

**Adults 65 and older* **

**Total**

**Female**

**Male**

**Total**

**Female**

**Male**

**Male**

**Female**

**Total**

- Source: National Hospital Discharge Survey (NHDS), NCHS, CDC.

**13.6**

**2000**

**17.5**

## 24-2a,b,c. Hospitalizations for Asthma: 1998, 1999, and 2000

**2010 Target**

**1998 Baseline**

- I 95% confidence interval
- Notes:  *Data are age adjusted to the 2000 standard population.  Data for Hispanics, American Indians, Alaska Natives, Asians
- and Pacific Islanders are unreliable.

**Hospitalizations per 10,000 population**

**1999**

**Children under 5 years**

**Persons 5 to 64 years* **

**Adults 65 and older* **

**Total**

**Black**

**White**

**Total**

**Black**

**White**

**White**

**Black**

**Total**

**103.0**

**13.6**

**27.9**

**21.2**

**2000**

- Source: National Hospital Discharge Survey (NHDS), NCHS, CDC.

##  3-2. Lung Cancer Death Rates

**Age-adjusted death rate per 100,000 standard population**

**2010 Target**

**Female**

**Male**

**Total**

- Note: Data are age adjusted to the 2000 standard population.

- Source: National Vital Statistics System-Mortality (NVSS-M), NCHS, CDC.

## 3-2. Lung Cancer Death Rates

**Age-adjusted death rate per 100,000 standard population**

**Black male**

**Total population**

**White male**

**White female **

**Black female **

**Notes: Data are age adjusted to the 2000 standard population. The race groups white and black may be of Hispanic or non-Hispanic origin.**
**Source: National Vital Statistics System-Mortality (NVSS-M), NCHS, CDC.**

**2010 Target**

## 3-2. Lung Cancer Death Rates, 2000

**Age-adjusted death rate per 100,000 standard population**

- Notes: American Indians/Alaska Natives or Asians/Pacific Islanders may be of Hispanic origin.  Hispanics may be of any race.
- Malignant neoplasms of trachea, bronchus and lung: ICD-10 codes C33-C34.  Data are age adjusted to the 2000 standard population.
- Source: National Vital Statistics System-Mortality (NVSS-M), NCHS, CDC.

**2010 Target**

**American Indian/**
**Alaska Native**

**Asian/ Pacific Islander**

**Hispanic **

**Black, **
**not Hispanic**

**White, **
**not Hispanic**

**Total**

- Source: National Vital Statistics System-Mortality (NVSS-M), NCHS, CDC.

## Age-Adjusted Lung Cancer Incidence Rates

| 
Group | 
1990 | 
1999 | Estimated Annual
 Percent Change 
1990-99 |
| --- | --- | --- | --- |
|           Male | 95.4 | 76.3 | -2.4* |
|                  White | 94.7 | 74.4 | -2.5* |
|                  Black / African American | 134.6 | 109.8 | -2.4* |
|                  Asian or  Pacific Islander | 64.4 | 62.7 | -0.4 |
|                  Hispanic or Latino | 58.2 | 35.9 | -4.1* |
|          
           Female | 
47.4 | 
48.2 | 
+0.3 |
|                  White | 48.7 | 49.9 | +0.4 |
|                  Black / African American | 53.2 | 55.7 | +0.2 |
|                  Asian or Pacific Islander | 28.2 | 28.6 | +0.5 |
|                  Hispanic or Latino | 24.6 | 20.6 | -1.8* |

**Age-Adjusted Lung ****Cancer**** Incidence Rates**

**New Cases per 100,000 population**

- *Estimated annual percent change (EAPC) is significantly different from 0 (p<0.05).  EAPC has been calculated by fitting a linear regression model to the natural logarithm of the yearly rates from 1990-99.   Notes:  Estimates for American Indians or Alaska Natives are not shown because of the small number of cases.  The race groups, white, black and Asian or Pacific Islander include persons of Hispanic and non-Hispanic origin.  ICD-9-CM codes: 162.2-162.9.
- Source: National Institutes of Health, National Cancer Institute, Surveillance, Epidemiology, and End Results (SEER) Program.

## 27-21a. Average Federal and State Tax on Cigarettes:Mean Excise Tax on a Pack of Cigarettes

**Dollars**

-  Source: The Tax Burden on Tobacco, The Tobacco Institute.

## 12-1. Coronary Heart Disease Death Rates, 2000

**Total**

**12-1. Coronary Heart Disease Death Rates, 2000**

**Black, Not**
**Hispanic**

**Hispanic**

**Asian or**
** ****Pacific Islander**

**American Indian**
**or Alaska Native**

**White, Not**
**Hispanic**

**Male**

**Female**

- Source: National Vital Statistics System – Mortality (NVSS-M), NCHS, CDC.

- NOTE: Coronary heart disease: ICD-10 codes I11, I20-I25.  American Indian or Alaska Natives, Asian or Pacific Islanders may be of Hispanic origin.
- Hispanics may be of any race.

**Total**

**156**

**Age-adjusted death rate per 100,000 standard population**