Trends in Smoking, Alcohol Consumption, 

and Other Health Practices 

Among U.S. Adults, 1977 and 1983 

by Charlotte A. Schoenborn, M. P. H., Division of Health Interview Statistics, and 

Bernice H. Cohen, Ph. D., M. P. H., Johns Hopkins University 

Introduction comparable data for 1977 and 1983 provides a unique opportuThe past decade has seen increasing recognition of the nity to assess changes in behavior during a period of rapid 

importance of personal health behaviors for the prevention growth in health promotion and disease prevention activities, 

of illness and disability, A pioneer work in this field was including increases in media promotions of exercise and good 

a study conducted in Alameda County, Calif., in the mid- eating habits and warnings of the dangers of cigarette smoking 

1!?60’s. 1 A decade later, longitudinal follow-up of the original and excessive alcohol consumption.


1965 cohort indicated that seven health habits were associated This report presents 1983 prevalence estimates for seven


with subsequent favorable health status and reduced mortal- health practices—hours of sleep, breakfast eating, snacking,


ity,~s These habits were: never smoking, drinking fewer than physical activity level relative to contemporaries, smoking,


five alcoholic beverages at one sitting, maintaining desirable alcohol consumption, and desirable body weight—for the non-


weight for height, sleeping 7–8 hours a night, exercising, institutionalized population aged 20 years arid over. by sex.


euting breakfast regularly, and avoiding snacks. In light of race, Hispanic origin, age, income, and education. It also


such evidence of the importance of personal practices for provides estimates of changes in the prevalence of selected


hcalth,4s5 ti national health promotion and disease prevention unfavorable practices between 1977 and 1983. Detailed 1977


initititive was launched in the late 1970’s.6 As an outgrowth prevalence estimates for all seven practices were presented


of this initiative. broad national goals for reducing death and in an earlier report.’ 1


disability through health promotion activities were outlined,7’8 One purpose of the 1983 AHPS was to provide data


tind specific qwmtified objectives for the year 1990 were to help clarify the interrelationships of health practices among


delineated in 15 priority areas.g Included among the prevention U.S. adults and to further investigate their relationships to


objectives were goals to reduce smoking and the misuse of health status. Public use data tapes are available at nominal


alcohol, tind to improve nutrition and physicial fitness. cost from the National Center for Health Statistics. Analyses


In 1977, at the outset of the prevention initiative, data of these data are encouraged. 

were collected in the National Health Interview Survey (NHIS) Some sex differences were observed in the relationship 

on the prevalence of the seven health practices found to be between selected health behaviors and various sociodemoassociated with health status and mortality in the Alameda graphic characteristics. A detailed consideration of these differCounty study. In 1983, when implementation plans were well ences is beyond the scope of this report. Tables showing 

undcnvay, ‘c’data on a variety of personal health practices were sex-specific prevalence for each of the seven health practices 

collected by means of the Alcohol and Health Practices survey are available on request from the Division of Health Interview 

Statistics. (AHPS), a component of NHIS. With the exception of those 

questions concerning alcohol (discussed below), the 1977 quesThe statistics presented and discussed in this report are 

tions were repeated in the 1983 AHPS. The availability of simple prevalence estimates, unadjusted for age or other 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Publlc Health Service 
sociodemographic characteristics. Relationships between 

health practices and selected characteristics (education, for 

example) may be attributable, at least in part, to differences 

in the age composition of particular population subgroups. 

Terms such as “similar” and’’the same” are used to indicate 

that no statistical significance exists between the statistics 

being compared. Terms that relate to differences (such as 

“greater” or’’less”) indicate that differences are statistically 

significant. The t-test with acritical value of 1.96 (0.051evel 

of significance) was used to test all comparisons that are 

discussed. Lack ofcomment regarding the difference between 

any two statistics does not mean that the difference was tested 

and found to be not significant. 

Sleep 

Data on sleeping practices of U.S. adults are shown in 

table 1. Approximately two-thirds of persons 20 years and 

over reported getting 7 or 8 hours of sleep cm the average, 

and about one-fourth reported sleeping 6hours orless anight. 

Black persons were more likely to be at the extremes of 

the sleep range than white persons. Among black respondents, 

34 percent reported sleeping 6 hours or less, compared with 

23 percent of white respondents; and 13 percent of bltick 

respondents reported sleeping 9 hours or more, compared 

with 10 percent of white respondents. People aged 45–64 

appear to get the least sleep, with approximately 28 percent 

reporting 6 hours or less. By contrast, 21 percent of adults 

under 35 years of age reported sleeping 6 hours or less. 

Sleeping habits also were related to income and educaticm. 

Thirty percent of persons with family incomes of less than 

$7,000 reported sleeping 6 hours or less, and 21 percent 

of persons with family incomes of $40,000 or more reported 

this behavior. Similarly, 29 percent of adults with less than 

12 years of education slept 6 hours or less. in contrast to 

21 percent of persons with more than a high school education. 

Table 1. Totsl population 20 years of age and over and percent distribution by average number of hours of sleep a night, socording to selected 

characteristics: United State% 1983 

Population 

20 years of 

Characteristic a.qe and over’ 

Allpersons 20years of age and over . . . . . . . . . . . . . . . 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Race3 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Another . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Hispanic origin3 

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age 

20-34years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

35-44yeafs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

55-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . 

Income 

Lessthan$7,000 . . . . . . . . . . . . . . . . . . . . . . . . . . 

$7,00C-$14,999 . . . . . . . . . . . . . . . . . . . . . . . . . . 

$15,000-$24,999 . . . . . . . . . . . . . . . . . . . . . . . . . . 

$25,000-$39,999 . . . . . . . . . . . . . . . . . . . . . . . . . . 

$40,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . 

Education of individual 

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 

12years. . . . . . . . . . . . . . . . . . . . 

Morethan 12years . . . . . . . . . . . . . . . . . . . . . . . . . 

Numberin 

thousands 

158,867 

74,600 

84,266 

138,695 

20,172 

16,716 

3,456 

9,598 

148,501 

59,868 

28,933 

22,169 

22,004 

16,377


9,516 

18,355 

29,272 

36,146 

36,373 

21,466 

41,916 

60,122 

55,799 

Hours of sleep 

Tota/2 6 or less 7 8 9 or more 

Percent distribution 

100.0 24.3 27.9 38.2 100 

100.0 24.9 29.2 37.2 8.7 

100.0 23.8 25.9 39.1 11,2 

100.0 23.1 28.2 39.0 9.7 

100.0 33.0 22.2 32.6 12’0 

100.0 34.3 20.3 32.6 12.7 

100.0 26.4 31.3 33.5 8.9 

100.0 21.2 24.8 42.0 12.0 

100.0 24.5 27.6 38.0 9.9 

100.0 20.8 28.2 40.7 10,3 

100.0 24.5 30.9 38.3 6.3 

100.0 27.5 29.5 35.7 7.2 

100.0 28.0 27.0 36.5 8.5 

100.0 26.5 22.6 36.7 14.2 

100.0 28.4 16.6 34.4 22.7 

100.0 30.0 19.6 35.3 15.1 ‘ 

100.0 25.8 23.7 38.4 12.1 

100.0 23.6 28.3 38.2 9.9 

100.0 22.5 31.8 38.3 7.4 

100.0 21.3 32.2 39.5 6,9 

100.0 26.9 20.7 36.4 14.0 

100.0 24.1 27.5 38.9 9.6 -

100.0 21.1 32.6 36.8 7.4 

‘Includes unknowns.


2Excludes unknown hours of sleep.


3Basedon self-reported identification,

dwl@C&l 3 

Table2. Percent datnbution ofpersona 20years ofageand over by frequency ofeatingbreaHas& according to selected characteristics: 

United Statea, 1983 

Frequency of eating breakfast 

Characteristic Total’ Everyday Sometimes Never 

Percent distribution 

Allpwsons 20y6wsofageandover . . . . . . . . . . . . . . . . . . . . . . .


Mal e........


Female . . . . . .


White . . . . . . .


Allolher . . . . . .


Black . . . . . . . 

Other . . . . . . 

Hispanic. . . 

Non-Hiswmlc 

20-34 years . . . 

35-44 years 

45-54 years . 

55-64 yews . . 

65-74 years . 

75 years and over 

Less than $7,000 . 

$7,000-$14,999 

$15,000-$24,999 

$25,000-$39,999. 

$40,0000 rmore 

Less than 12 years 

12 years . . . . . . 

More lhan 12 years 

1Excludm unknown breakfast-eating habits 

‘Based m SOlf-rOQOrted ldsmtificatlon. 

NOTE: Slmtoblol forpopulatlon. 

Eating breakfast 

TAle 2 shows that more than one-half of U.S. adults 

w hrwdditst every day, and more than one-fourth never eat 

Imxtkfust. White respondents were more likely (55 percent) 

to cut breuktkt every day than black respondents (46 percent). 

Breakfwt euting habits were strongly related to age. The percent of persons who reported eating breakfast every day rose 

stetidily from less than 40 percent of persons 20-34 years 

of age to more than 90 percent of persons 75 years and 

older. 

Snacking 

D~ti.t on snacking behavior are shown in table 3. Slightly 

more thtin one-third of respondents reported snacking every 

100.0 , 53.9 19.0 27.1 

100.0 52.9 19.3 27.8 

100.0 54.9 18.8 28.4 

100.0 55.1 17.6 27.3 

100.0 46.1 28.4 25.5 

100.0 46.0 28.6 25.2 

100.0 46.8 26.2 27.1 

100.0 53.5 22.8 23.7 

100.0 54.0 16.8 27.2 

100.0 36.4 25.9 35.6 

100.0 45.3 22.7 32.1 

100.0 55.0 17.8 27.2 

100.0 69.3 11.6 19.1 

100.0 82.0 7.5 10.5 

100.0 91.6 4.0 4.4 

100.0 55.7 19.4 24.9 

100.0 56.6 18.3 24.9 

100.0 52.8 19.4 27.8 

100.0 50.7 19.7 29.7 

100.0 53.2 16.1 28.7 

100.0 58.8 17.1 24.1 

100.0 50.1 20.4 29.5 

100.0 54.4 18.9 26.7 

day. The remaining respondents were evenly divided among 

those reporting snacking sometimes and those never snacking. 

Persons of Hispanic origin were less likely to snack every 

day (30 percent) than were non-Hispanic persons (38 percent). 

Snacking is clearly related to age, with about 40 percent 

of the youngest age groups reporting daily snacking, and 

27 percent of the elderly, aged 75 years and over, reporting 

this practice. Concomitantly, only 25 percent of persons in 

the youngest age group indicated that they never eat snacks 

compared with more than 50 percent of those 75 years and 

over. 
4 dKmedm3 

Table 3. Percent distribution of persons 20 years of age and over by frequency of eating snacks, according to selected characteristic: 

United States, 1983 

Frequency of eatino snacks 

Characteristic Total’ Everyday Sometimes Never 

Allpersons 20years of age and over . . . . . . . . . . . . . . . . . . . . . . . . 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Femsle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Race2 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Another . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Hispanic originz 

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age 

20-34years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

45-54yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

55-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75yearsandover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Income 

Lessthan $7,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$7!000-$14,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$15,000-$24,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$25,000-$39,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

$40,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Education of individual 

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Morethan 12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

100.0 

Percent distribution 

37.0 30.6 

38.9 28.1 

35.4 32.8 

37.4 29.9 

34.8 35.0 

35.8 35.0 

29.8 34.9 

29.8 34.4 

37.5 30.3 

40.2 35.4 

37.9 31.5 

37.8 28.5 

34.4 26.6 

32.8 24.0 

26.6 22.8 

34.5 31.2 

36.7 30.7 

37.6 31.0 

38.5 31.0 

39.0 29.2 

34.8 28.8 

38.4 31.5 

37.3 30.9 

32.4 

33.1 

31.8 

32.7 

30.2 

29.1 

35.4 

36.0 

32.2 

24.5 

30.6 

33.7 

39.0 

43.3 

50.7 

34.3 

32.7 

31.4 

30.5 

31.8 

36.5 

30.1 

31.7 

IExcludss unknown snacking habits. 

2Baaedon self-reported identification. 

NOTE Seetabfel for fmpulation. 

Physical activity 

Table 4 shows that about 40 percent of adults considered 

themselves “more active” than others their own age, and 14 

percent perceived their activity level to be lower than that 

of their contemporaries. Almost one-half of the persons in 

the population indicated that they were “about as active” as 

people the same age. Men more often reported being ’’more 

active” (44 percent) than women did (35 percent). Black persons more often reported being “less active” (18 percent) 

than white persons did (13 percent). 

Perceivedphysical activity levels varied with age, income, 

and education. Thirty-six percent of persons 20-34 years of 

age reported being more active in contrast to 41 percent of 

persons 65–74 years and49 percentof the 75 and overage 

group. Interestingly, reports of being less active were also 

more prevalent in the older age groups; 16 percent of the 

oldest group, compared with 13 percent ofthe youngest group 

said they were less active. Thus, persons in the older age 

groups were more likely to place themselves at the extremes 

of the physical activity spectrum. Young people aged 20-34 

years were most likely to report their activity level to be 

about the same as their contemporaries (52 percent), and 

the elderly aged 75 years and over were least likely to classify 

themselves this way (35 percent). 

More active physical activity levels were associated with 

both income and education. Among persons with incomes 

of less than $7,000, 33 percent reported being more active 

in contrast to 46 percent of people in the highest income 

group. Similarly, about one-third of those persons who had 

not completed high school indicated that they were more 

active than their contemporaries, compared with 44 percent 

of people with post-high school education. The proportion 

of persons reporting themselves less active than their contemporaries declined correspondingly with both increasing income 

andeducation. 
acklncedata 5 

Table4. Percent dstfibution ofpersons 20years ofagesnd over byphysical activ~level relative topersons ofsameage, accordngtoselectd 

characteristics: United States, 1983 

Physical activity level 

Characteristic Total’ More active Same Less active 

Percent distribution 

Allpersons 20years ofage ancl over . . . . . . . . . . . . . . . . . . . . . . . 100.0 38.8 47.4 13.8 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 43.5 44.6 11.9 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 34.7 49.8 15.4 

Race2 

While . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 39.3 47.5 13.2 

Another . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 35.5 46.9 17.6 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 35.5 46.2 18.3 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 35.4 50.6 14.1 

Hispanic originz 

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 38.1 47.9 14.0 

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 38.9 47.4 13.7 

Age 

20-34years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 35.5 51.6 12.9 

35-44years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 40.4 48.3 11.3 

45-54years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 39.9 46.9 13.3 

55-64years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 39.6 43.3 17.1 

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 40.5 43.4 16.1 

75years Andover . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 48.6 35.4 16.0 

Income 

Lessthan$7,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 32.7 45.2 22.0 

$7,000-$14,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 35.5 48.3 16.2 

$15,000-$24,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 38.3 48.5 13.2 

$25,000-$39,999 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 40.0 49.4 10.6 

$40,0000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 45.8 44.6 9.6 

Education of individual 

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 33.3 48.0 18.8 

12years . . . . . . . . . . . . . . . . . . . 100.0 38.1 49.7 12.2 

Morethan 12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1Excludes unknown physical activity level. 

2Bmed on self-reported identification. 

NOTE: Seetablel for population. 

Alcohol consumption 

Alcohol consumption classifications shown intable5 were 

developed by the National Institute on Alcohol Abuse and 

Alcoholism and were based on the number and frequency 

ofdrinks reported for the most recent 2-week period in which 

alcohol wasconsumed.12 Quantity and frequency of alcohol 

consumed was converted into average number of ounces of 

ethanol consumed daily, and three categories of drinker— 

lighter, moderate, and heavier—were derived. About one-third 

of respondents reported never drinking more than 12 drinks 

in any single year and were therefore classified as lifetime 

abstainers. Only 7 percent of respondents said they had been 

drinkersat sometime in their lives but had not had a drink 

in the past year. These persons were classified as former 

drinkers. Thirty percent ofAHPS respondents reported consumption patterns that were indicative of “lighter drinking, ” 

defined as between O.01 ounces andO.21 ounces of ethanol 

u day. Ten percent of the people in the population were 

100.0 43.9 44.5 11.6 

classified as “heavier drinkers,” indicating that they consumed 

one ounce or more of ethanol per day on the average (two 

or more drinks). Men and women differed markedly in their 

drinking habits, with 19 percent of men reporting lifetime 

abstention in contrast to 45 percent of women. Men were 

aboutfourtimes morelikelythan womentobeheavier drinkers 

(16 percent of men versus 4 percent of women). Among 

drinkers, men were twice as likely as women to have had 

five drinks or more on at least 1 day in the past year (50 

percentofmencornpared with23percentof women). 

Drinking habits also variedaccording to race andHispanic 

origin. Black persons and members of other racial groups 

were significantly more likely to be lifetime abstainers (48 

percent and 56 percent, respectively) than were white persons 

(31 percent). Among drinkers, black persons were less likely 

than white persons to report having had five drinksor more 

on at least 1 day in the past year (30 percent of black persons 

in contrast to38 percentof white persons). Although Hispanic 
6 achancedata 

persons were more likely to be lifetime abstainers (46 percent) to 13 percent of adults aged 65–74 years and only 5 percent 

than were non-Hispanic persons (32 percent), Hispanic of respondents 75 years and older. These findings are consistent 

drinkers were more likely than non-Hispanic drinkers to have with other research showing an apparent trend toward increased 

consumed five drinks or more in 1 day at some time during alcohol consumption in the younger age groups. ]3 Heavier 

the past year (43 percent versus 37 percent, respectively). drinking among young adults could indicate that young people 

Alcohol consumption was also strongly associated with drink more but reduce their alcohol consumption as they get 

age, education, and income. Younger people were more likely olden however, lower lifetime abstention rates found for 

to drink, and they tended to drink more heavily than older younger persons in the current analysis, combined with evipeople. About 26 percent of persons 20-34 years of age dence from other studies that indicate alcohol consumption 

were lifetime abstainers, in comparison with 45 percent of levels do not tend to decrease as people age, ‘J suggest that 

persons 65–74 years and 61 percent of those 75 years and younger people are now drinking more than did earlier generaolder. Among drinkers, 52 percent of the youngest group tions, In light of current knowledge about the harmful health 

reported having had five drinks or more in 1 day, in contrast and social consequences of heavy drinking, the findings of 

Table 5. Percent distribution of persons 20 years of age and over by alcohol consumption, according to selected characteristics, and percent of persons 

who consumed 5 or more drinks in 1 day in past yeafi United States, 1983 

Alcohol consumption’ 

Percent of 

drinkers who 

consumed 5 

Lifetime Former Lighter Moderate Heavier or more drinks 

Characteristic Tota12 abstainer drinker drinker drinker drinker m 1 day 

All persons 20 years of age and over . . . . . . . 100.0 33.0 6.7 29.5 21.0 9.9 37.7 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 18.5 9.0 28.5 27.7 16.2 49.9 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 45.4 4.6 30.4 15.1 4.3 23.4 

Race3 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 30.6 6.6 30.5 22.0 10.3 38.4 

Al[ other . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 49.6 7.2 22.8 13.8 6.6 30.9 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 48.3 7.5 22.6 14.4 7.2 29,6 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 55.8 6.0 23.8 10.6 3.9 37.6 

Hispanic origin3 

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 46.1 4.1 23.3 18.0 8.5 42.6 

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . 100.0 32.1 6.8 29.9 21.1 10.0 37.4 

Age 

20-34 years . . . . . . . . . . . . . . . . . . . . . . . 100.0 26.3 3.5 33.7 26.1 10.4 51.8 

35-44 years . . . . . . . . . . . . . . . . . . . . . . . 100.0 28.2 6.3 31.9 23.1 10,4 360 

45–54 years . . . . . . . . . . . . . . . . . . . . . . . 100.0 32.8 8.1 28.7 19.1 11.3 30.2 

55-64 years . . . . . . . . . . . . . . . . . . . . . . . 100.0 36.3 9.4 27.3 17.3 9.8 21.2 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . 100.0 45.3 12.2 22.8 11.7 6.0 13.2 

75 years And over . . . . . . . . . . . . . . . . . . . . 100.0 61.1 8.9 14.5 10.9 4.7 5,0 

Income 

Lessthan $7,000 . . . . . . . . . . . . . . . . . . . . . 100.0 47.6 9.4 20.1 15.2 7.7 42.5 

$7,000-$ 14,999 . . . . . . . . . . . . . . . . . . . . . 100.0 38.8 9.0 25.6 18.3 8.3 40.4 

$15,000-$24,999 . . . . . . . . . . . . . . . . . . . . . 100.0 32.8 7.0 29.6 21.1 9.5 39.9 

$25,000-$39,999 . . . . . . . . . . . . . . . . . . . . . 100.0 25.3 5.2 34.8 23.6 11.0 37.3 

$40,0000 r more . . . . . . . . . . . . . . . . . . . . . 100.0 78.3 3.3 35.9 26.5 14.0 36.3 

Education of individual 

Lessthan 12 years . . . . . . . . . . . . . . . . . . . . 100.0 47.3 10.9 21.0 13.1 7.8 35.3 

12 years . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 32.1 6.1 31.8 20.6 9.5 38.0 

Morethan 12 years . . . . . . . . . . . . . . . . . . . . 100.0 23.0 4.1 33.6 27.4 11.9 365 

‘Measure developed by the National institute on Alcohol Abuse and AlcohoKsm.Categories based onounces ofethanol consumed dutinga 2-week reference per(odwllhtn the past 12mon[hs 

Zero forabstainers: O.01-O.21ounceaper day forlghter drinker% 0.22+.990unces perdayfor mderate drlnkera: andl,Oounces ormoreper day forheav!erdr!nkers Theconvers!on factors 

were .040uncesof ethanol per ounce of beer, .150unces per ounce of wine, and .45 ounces per ounce of bquor. 

2Excludes unknown alcohol consumption level, and for last column also excludes drinkers for whom it is unknown whether or not they have 5or more drinks in 1 day 

3Basedon self-repotted identification. 

NOTE: Seetablel for population, 
more prevalent and heavier alcohol consumption among the 

young should be a matter of considerable public health concern. 

Drinking was also associated with education, with adults 

in the higher educational attainment groups being more likely 

to drink and to drink more heavily. The relationship between 

drinking and income was somewhat different. Persons at the 

lower income levels were less likely to drink than persons 

with higher incomes (48 percent of persons with incomes 

under $7,000 were abstainers compared with 18 percent of 

persons with incomes of $40,000 or more). They were also 

less likely to drink heavily on a regular basis (8 percent 

of the lowest income group, compared with 14 percent of 

the highest income group, being classified as heavier drinkers). 

However, the lowest income group was somewhat more likely 

to have had five drinks or more on at least 1 day in the 

achncedata 7 

past year (43 percent) than persons in the $40,000 or more 

income category were (36 percent). 

Smoking 

Data on smoking status and number of cigarettes smoked 

are shown in table 6. In 1983, about 32 percent of U.S. 

adults currently smoked cigarettes, 45 percent had never 

smoked, and 23 percent had smoked but quit. A larger proportion of men (36 percent) currently smoked than women (29 

percent). Men were more likely than women to have ever 

smoked cigarettes (65 percent of men had ever smoked compared to 46 percent of women), but they were also more 

likely than women to be former smokers. About 30 percent 

of all men were classified as former smokers (45 percent 

Table 6. Percent distribution of persona 20 yeara of age and over by smoking status and percent distribution of current smokers by number of cigarettes 

smoked daily, according to selected characteristics: United States, 1983 

Smoking status Number of c@areftes smoked daily 

All Less 

Never Former Current current than 35 or 

Characteristic Total’ smoked smoker smoker smoker@ 15 15-24 25-34 more 

Allpersons 20 years 

ofage and over . . . . . . . . . . . . . . . . 100.0 45.2 22.5 32.4 100.0 28.4 44.6 13.4 13.4 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . 100.0 34.7 29.5 35.7 100.0 23.1 43.8 15.6 17.5 

Female . . . . . . . . . . . . . . . . . . . . . 100.0 54.4 18.2 29.4 100.0 34.1 45.9 11.0 9.0 

Race3 

White . . . . . . . . . . . . . . . . . . . . . . 100.0 44.5 23.5 32.0 100.0 24.4 46.1 14.7 14.4 

Another . . . . . . . . . . . . . . . . . . . . . 100.0 50.0 15.1 34.9 100.0 53.6 36.8 4.9 4.7 

Black . . . . . . . . . . . . . . . . . . . . . . 100.0 48.2 14.7 37.1 100.0 54.7 36.0 4.8 4.5 

Other . . . . . . . . . . . . . . . . . . . 100.0 58.6 16.9 24.5 100.0 45.0 42.6 �5.9 �6.4 

Hispanic origin3 

Hispanic . . . . . . . . . . . . . . . . . . 100.0 57.2 16.5 26.4 100.0 56.4 34.1 4.8 4.6 

Non-Hispanic . . . . . . . . . . . . . . . . 100.0 44.4 22.9 32.7 100.0 27.0 45.4 13.6 13.8 

Age 

20-34 years . . . . . . . . . . . . . . . . . . 100.0 49.6 14.4 36.1 100.0 32.0 47.3 11.6 8.9 

35-44 years . . . . . . . . . . . . . . . . . . 100.0 40.6 22.1 37.3 100.0 23.0 42.5 17.1 17.4 

45-54 years . . . . . . . . . . . . . . 100.0 37.6 25.9 36.5 100.0 22.7 41.0 15.0 21.3 

55-84 years . . . . . . . . . . . . . . 100.0 38.2 31.7 30.2 100.0 25.7 45.7 12.8 15.8 

65-74 years . . . . . . . . . . . . . . . . . . 100.0 45.5 33.0 21.5 100.0 37.0 43.7 10.5 8.9 

75years andover . . . . . . . . . . . . 100.0 64.7 26.8 8.5 100.0 46.0 45.4 “5.9 “2.5 

Income 

Lessthan $7,000 . . . . . . . . . . . . . 100.0 48.2 18.4 35.4 100.0 34.4 42.5 11.7 11.3 

$7,000-$14,999 . . . . . . . . . . . . . . . . 100.0 43.2 21.8 35.0 100.0 30.5 48.0 10.7 10.6 

$15,000-524,999 . . . . . . . . . . . . . . 100.0 44.3 21.9 33.8 100.0 27.7 45.0 14.0 13.3 

$25,000-$39,999 . . . . . . . . . . . . . . . . 100.0 45.2 23.8 31.0 100.0 23.7 44.3 15.5 16.5 

$40,0000r more . . . . . . . . . . . . . . . . 100.0 45.4 27.7 26.9 100.0 25.6 42.3 17.4 14.5 

Education of individual 

Lessthan 12 years . . . . . . . . . . . . . . . 100.0 41.2 22.1 36.7 100.0 28.1 44.7 12.0 15.3 

12 years . . . . . . . . . . . . . . . . . . . . . 100.0 42.1 21.8 38.2 100.0 27.9 45.8 13.6 12.7 

Morethan 12 years . . . . . . . . . . . . . . . 100.0 51.5 23.4 25.1 100.0 29.5 43.6 14.4 12.5 

‘Excludes unknown smoking status. 

‘Excludes unknown amount smoked. 

‘Based cmself-reported identification. 

NOTE: Seetablel forpopulaticm. 
of men who had ever smoked) compared with 16 percent 

of all women (36 percent of women who had ever smoked). 

Among current smokers, women appeared to smoke fewer 

cigarettes than men. Thirty-four percent of women smoked 

less than 15 cigarettes a day compared with 23 percent of 

men, and 18 percent of men smoked 35 cigarettes or more 

in contrast to 9 percent of women. 

Smoking practices differed for black and white persons 

and for Hispanic and non-Hispanic persons. A higher proportion of black persons (37 percent) currently smoked cigarettes 

than white persons did (32 percent), but black smokers reported 

smoking fewer cigarettes per day than white smokers did— 

about one-fourth of white smokers (24 percent) smoked less 

than 15 cigarettes daily, and over one-half of black smokers 

(55 percent) smoked this amount. A smaller proportion of 

Hispanic persons reported currently smoking cigarettes (26 

percent) than non-Hispanic respondents did (33 percent). 

Among smokers, Hispanic persons were twice as likely (56 

percent) as non-Hispanic persons (27 percent) to smoke less 

than 15 cigarettes per day. (See Technical notes for further 

discussion of Hispanic smoking practices. ) 

Smoking practices were also related to age. Prevalence 

of cigarette smoking was fairly similar in all age groups under 

age 55, but smoking prevalence in the older age groups was 

sharply lower. Among persons aged 55–74, this lower prevalence of current smoking was associated with much larger 

proportions of former smokers; approximately one-third of 

persons in this age group were former smokers. In contrast, 

the low smoking prevalence in the oldest group (9 percent) 

is attributable to the fact that they never started smoking 

(65 percent). 

Smoking prevalence was associated with education and 

to some extent with income. Persons with more than 12 years 

of education were the least likely to smoke (25 percent) and 

the most likely to have never started (52 percent) of any 

education group. Smoking was inversely related to income 

level, declining from 35 percent of persons with incomes 

of less than $7,000 to 27 percent of persons with incomes 

of $40,000 a year or more. 

Desirable weight 

Desirable weight is presented using the 1960 Metropolitan 

Life Insurance Company (MLIC) stan~ards of desirable body 

weight for height. 14 The MLIC desirable weight standards 

are based on the mortality experience of a group of life insurance policy holders. Because persons who obtain life insurance 

are not representative of the general population, the appropriateness of these standards for some population subgroups is 

unknown. 15The 1960 MLIC standards are slightly lower than 

the more recent MLIC standards, published in 1983. Thus, 

data presented in this report somewhat overestimate the proportion of the population that is overweight according to 1983 

standards. Both MLIC and NHIS data are based on self-reported height and weight (see Technical notes for a discussion 

of adjustments made for reporting differences). Self-reported 

height and weight data produce conservative estimates of the 

extent of overweight in the population because heavier people 

tend to report lighter body weights than are obtained by actual 

physical measurements. 16 

A variety of measures of overweight status are used both 

within NCHS and by outside researchers. ]5 A major source 

of data on the prevalence of overweight in the U.S. popultition 

is the Second National Health and Nutrition Examination Survey (NHANES H). Data released from the NHANES H on 

overweight status are computed using measured height and 

weight and are expressed in terms of body mass index (BMI ), 

calculated as weight divided by height squared. Although 

not identical, the proportions of the population defined m 

“20 percent or more overweight” using the BMI NHANES II 

cut-off points and the 1960 and 1983 MLIC standards we 

not substantially different. ‘5 The 196(I MLIC standards were 

selected for the present analysis to maintain comparability 

with measures of overweight used in previously published 

research. 11 

Overall, about 23 percent of U.S. adults reported height 

and weight measurements that placed them within 5 percent 

of their desirable body weight, whereas 16 percent of the 

population was 30 percent or more above desirable weight 

(see table 7). The proportion of Hispanic persons and non-Hispanic persons reporting desirable weight did not differ significantly. Young people were more likely to be of desirable 

weight than were older people. Almost 28 percent of persons 

in the youngest group were within 5 percent of dcsiruhle 

weight in contrast to 23 percent of persons 35-44 yews of 

age and even lower proportions in the older age groups. 

Women were more likely than men to be at the extremes 

of the desirable weight range. Twelve percent of women in 

contrast to 5 percent of men were in the most underweight 

category, and 18 percent of women compared with 13 percent 

of men were in the most overweight category. The proportion 

of persons 30 percent or more overweight differed signifiwmtly 

for black and white persons. About 26 percent of black perstms 

reported weights in this range compared with 15 percent of 

white persons. 

Extreme overweight was also associated with both income 

and education. People in the lowest income and educatitm 

groups were about twice as likely to be 30 percent or m(wc 

overweight compared with people at the high ends of the 

income and education ranges. 
aduancedata 9 

Table 7. Percent distribution of persons 20 years of age and over by body weight, according to selected characteristics United Ststea, 1983 

Body we@ht’ 

Plus or 30 

10percent 5-9.9 minus 5-9.9 10-19.9 2S29.9 percent 

or more percent 4.9 percent percent percent or more 

below below percent of above above above above 

desirable desirable desirable desirable desirable desirable desirable 

Characteristic Total’ weight weight weight waight weight weight weight 

All persons 20 years 

of age And over . . . . . . . . . . . . . . . . . . . 100.0 9.0 6.4 22.8 12.9 20.1 10.8 16.0 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 5.2 6.3 21.7 16.1 24.0 13.2 13.4 

Female, . . . . . . . . . . . . . . . . . . . . . . . 100.0 12.4 10.2 23.6 10.1 16.6 8.6 18.3 

Race3 

White . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 9.2 8.4 23.0 13.2 20.4 10.6 15.0 

Another . . . . . . . . . . . . . . . . . . . . . . . . 100.0 8.0 8.3 21.5 10.6 17.6 11.0 22.8 

Black . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 7.1 7.4 19.6 10.6 17.8 11.6 25.7 

Other . . . . . . . . . . . . . . . . . . . . . . . . 100.0 12.4 12.3 30.7 10.6 16.9 8.2 6.7 

Hispanic origin3 

l+spanic . . . . . . . . . . . . . . . . . . . . . . . . 100.0 6.4 6.7 23.6 10.6 20.6 13.8 18.1 

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . 100.0 9.2 8.5 22.7 13.0 20.0 10.6 15.9 

Age 

20–34years . . . . . . . . . . . . . . . . . . . . . 100.0 13.3 11.5 27.6 12.6 16.5 7.8 10.7 

35-44years . . . . . . . . . . . . . . . . . . . . . 100.0 7.2 6.0 22.5 13.1 21.5 11.0 16.7 

45–54years . . . . . . . . . . . . . . . . . . . . . 100.0 4.9 5.7 16.1 13.1 23.1 13.3 21.9 

55-64 years . . . . . . . . . . . . . . . . . . . . . 100.0 4.7 5.0 18.9 12.9 23.3 13.9 21.3 

65-74years . . . . . . . . . . . . . . . . . . . . . 100.0 6.6 6.2 16.1 12.3 22.0 13.3 21.5 

75 years Andover . . . . . . . . . . . . . . . . . . 100.0 12.0 8.4 21.5 15.2 20.1 11.2 11.6 

Income 

Lesslhan $7,000 . . . . . . . . . . . . . . . . . . . 100.0 10.4 8.8 20.6 11.1 18.0 10.5 20.7 

$7,000-$14,999 . . . . . . . . . . . . . . . . . . . 100.0 9.3 7.9 21.9 12.8 18.4 10.9 18.8 

$15,000-$24,999, . . . . . . . . . . . . . . . . . . 100.0 9.0 8.2 22.7 12.0 21.0 11.4 15.6 

$25,000-$39,999 . . . . . . . . . . . . . . . . . . . 100.0 6.1 8.5 23.5 14.1 20.8 10.4 14.6 

$40,0000rmore . . . . . . . . . . . . . . . . . . . 100.0 8.9 9.8 25.0 14.1 21.7 10.0 10.5 

Education of individual 

Lessthan 12yeara . . . . . . . . . . . . . . . . . . 100.0 7.6 6.2 18.8 11.1 20.7 13.0 22.5 

12years . . . . . . . . . . . . . . . . . . . . . . . . 100.0 9.0 8.2 23.0 12.8 20.3 10.9 15.8 

Morethan 12years . . . . . . . . . . . . . . . . . . 100.0 10.0 10.3 25.7 14.3 19.4 9.0 11.3 

‘Oesirable weiriht basedon 1960 Metropolitan Life Insurance Company standards. NHIS data are self-reported, and estimates may vary from those that would be obtainad if physical 

measurements-weretaken. 

‘“Excludesunknown height or weight. 

‘Basedcm self-repotied identification. 

NOTE: Seelablel forpopulation. 

Trends 

Table 8 shows changes between 1977 and 1983 in the 

proportion of persons reporting selected unfavorable health 

practices, expressed as a ratio of the proportion reporting 

a particular practice in 1983 to the proportion reporting the 

same practice in 1977. Thus, ratios greater than 1.00 represent 

increases in the prevalence of the (unfavorable) practice over 

the 6-year period, and ratios of less than 1.00 represent 

decreases. 

In general, between 1977 and 1983 there appears tohave 

been an increase in unfavorable health practices, except for 

a decline of approximately 10 percent in reported rates of 

current smoking and a slight decrease in rates of irregular 

eating habits represented by snacking (3 percent). Although 

most of the differences were not marked, there was an increase 

of 10 percent or more in the prevalence rates of 4 of the 

7 unfavorable practices—sleeping 6 hours or less ( 12 percent); 

being less physically active than contemporaries (12 percent); 

weighing 30 percent or more above desirable weight (10 percent); and drinking five or more drinks in any 1 day (28 

percent). The proportion of persons who never eat breakfast 

increased only slightly (4 percent). 

Declines insmoking prevalence between 1977 and 1983 

signify a public health accomplishment and demonstrate that 

progress in being made toward reaching the 1990 objective 

of reducing smoking prevalence in the U.S. population to 

below25percent. 

It should be noted that increases in the proportion of 

persons who reported that they are less physically active than 

their contemporaries could beatttibuted as much to changing 

perceptions of the norms of physical activity as to changes 

in individual physical activity levels. In both 1977 and 1983, 
10 advancedata 

the physical activity questions required that people assess 

their level ofactivity relative toothers the same age, thereby 

measuring their perceptions of relative activity rather than 

any objective, quantifiable activity level. These perceptions, 

by definition, incorporate both an evaluation of individuals’ 

own physical activity levels and those of their contemporaries. 

Withrecentincreased publicityencouraging exerciseandphysical fitness. U.S. adults may perceive higher activity levels 

in the general population than in earlier years, even though 

their own physical activity levels may have remained constant 

or even increased slightly. 

The substantial increase in the proportion of persons who 

reported drinking five or more drinks is difficult to interpret 

because of differences in question wording and context between 

the two survey years. In 1977, respondents were asked if 

they had had five or more drinks at one sitting in the past 

year, whereas in 1983 people were asked about having five 

or more drinks in any 1 day. Also, unlike the 1977 question, 

the 1983 question on consuming five or more drinks followed 

one that asked respondents whether they had had nine or 

more drinks in any 1 day. These and other changes in the 

1983 alcohol questions allow better estimates of the alcohol 

Table 8. Changes between 19?7 and 1963 in the proportion of U.S. adulta ages 20 years and over, reporting selected heafth practices Ratio of the 

proportion reporting the practice in 1983 to the proportion reporting the practice in 1977 

Health practices 

Less 30 percent or 

physically Had 5 or more more above 

Sleeps 6 hours Never eats Snacks active than drinks on any Current desirable 

Characteristic or less breakfast every day contemporaries 1 day’ smoker weight2 

Ratio of tha proportion reporting practice in 1983 

to the proportion reporling practice in 1977 

All persons 20 years of age and over . . . . . . . . . . . . 1.12 1.04 0.97 1.12 1.28 0.90 1.10 

Sex 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.07 1.03 0.97 1.02 1.15 0.87 1.15 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.17 1.04 0.98 1.21 1.26 0.92 1.10 

Race3 

White . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.10 1.05 0.98 1.11 1.28 0.90 1.12 

Another . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.21 0.96 0.93 1.15 i .21 0.86 0.99 

Black . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.23 0.91 0.98 1.18 1.12 0.88 1.04 

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.17 1.33 0.81 1.24 2.08 0.84 0.77 

Hispanic origin3 

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.87 1.10 0.87 0.92 1.33 0.79 0.96 

Non-Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . 1.14 1.03 0.98 1.14 1.26 0.90 1.12 

Age 

20-34 years . . . . . . . . . . . . . . . . . . . . . . . . . 1.03 0.99 0.93 1.29 1.20 0.90 1.07 

35-44 years . . . . . . . . . . . . . . . . . . . . . . . . . 1.12 0.99 0.94 1.11 1.07 0.86 1.11 

45-54 years . . . . . . . . . . . . . . . . . . . . . . . . . 1.20 1.12 f .03 1.11 1.13 0.92 1.25 

55-84years . . . . . . . . . . . . . . . . . . . . . . . . . 1.23 1.10 0.99 1.00 1.15 0.88 1.09 

65-74years . . . . . . . . . . . . . . . . . . . . . . . . . 1.16 1.13 1.12 1.10 1.42 1.00 7.14 

75yearsandover . . . . . . . . . . . . . . . . . . . . . . 1.18 0.77 1.00 1.00 1.39 0.85 0.97 

lncome4 

Lessthan$7,000 . . . . . . . . . . . . . . . . . . . . . . . 1.11 1.23 1.02 1.02 2.08 1.06 1.08 

$7,000-$14,999 . . . . . . . . . . . . . . . . . . . . . . . 1.21 0.99 0.99 1.oe 1.54 0.93 1.14 

$15,000-$24,999 . . . . . . . . . . . . . . . . . . . . . . . 1.10 1.04 0.95 1.28 1.24 0.88 1.06 

$25,000-$39,999 . . . . . . . . . . . . . . . . . . . . . . . 1.08 1.01 0.95 1.19 1.12 0.83 1,16 

$40,0000rmore . . . . . . . . . . . . . . . . . . . . . . . 1.10 1.02 1.01 1.25 0.99 0.79 1.11 

Education of individual 

Lessthan 12years . . . . . . . . . . . . . . . . . . . . . . 1.14 1.03 0.97 1.14 1.60 0.98 1.07


12years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.16 1.02 0.97 1.13 1.22 0.92 1,17


Morethan 12years . . . . . . . . . . . . . . . . . . . . . . 1.10 1.03 0.98 1.23 1.09 0.82 1.28


‘The 1977 question asksd about 5ormore drinkson anyone c-xasion in the past year, while the 1983 question asked abart 5 or more drinks on any 1 day in Ihe past year,


‘Desirable weight based on 1960 Metropolitan Life Insurance Company standards. NHIS data are self-reported, and estimates may vary from those that would be obtained if physical


measurements were taken,


3Baeedon self-reporled identification.


4The income categories for1983sh0wn here differ from the 1977 categories shown in Advsnce Data No.64. The 1963 income categories ccntain roughly thesame proporfionof the 1983


population as the 1977 categories contained of the 1977 population. The income categories for 1977
were leas than $5,000, $5,00G$9,999, $10,000-$14,999, $15,000-$24,999, and $25,000 or 

more. 
acklncedata 11 

consumption habits of the American people, but limit the 

ability to measure changes overtime. 

Overall, these findings, especially with regard to alcohol


use, body weight, and physical activity, suggest the need


for further assessment of the progress made toward the 1990


prevention objectives and of the public health education strate­


gies designed to accomplish those goals. Progress has been


made in the area of smoking reduction, but additional gains


are needed to reach the 1990 goal. The recently completed


1985 NHIS Health Promotion and Disease Prevention survey


will offer an opportunity to continue to monitor advances


toward the national goals.’ 7

12 adwl-


References 

‘N,B. Belloc and L. Breslow: Relationship of physical health status 

and health practices. Prev, Med. 1(3):409-421, 1972. 

2J.A. Wiley and T.C. Camacho: Life style and future health+vidence from the Alameda County study. Prev. Med. 9:1-21, 1980. 

‘L. Breslow and J.E. Enstrom: Persistence of health habits and 

their relationship to mortality. Prev. Med. 9:469-483, 1980. 

4Fogarty International Center and American College of Preventive 

Medicine: Preventive Medicine, U.S.A .—Proceedings of a National 

Conference on Prevention. New York. Prodist, 1976. 

SInstitute of Medicine: perspecti~?eson Health Promotion and Disease 

Prevention in the United States. Washington, D.C. National Academy 

of Sciences, 1978. 

60ffice of the Assistant Secretary for Health: Disease Prevention 

and Health Promotion: Federal Programs and Prospects. Report 

of the Departmental Task Force on Prevention. DHEW Pub. No. 

(PHS) 79-55071 b. Public Health Service. Washington. U.S. GovernmentPrinting Office, 1978. 

Toffice of the Assistant Secretary for Health and the Surgeon General: 

Healthy People: The Surgeon General’s Report on Health Promotion 

and Disease Prevention. DHEW Pub. No. (PHS) 79-55071. Public 

Health Service. Washington. U.S. Government Printing Office, 

1979a. 

80ffice of the Assistant Secretary for Health and the Surgeon General: 

Healthy People: The Surgeon General’s Report on Health Promotion 

and Disease Prevention—Background Papers. DHEW Pub. No. 

(PHS) 79-55071a. Public Health Service. Washington. U.S. GovernmentPrinting Office, 1979b. 

9Public Health Service: Promoting Health, Preventing Disease, Objectives for the Nation. DHHS. Washington. U.S. Government Printing Office, 1980. 

Iooffice of Disease prevention and Health promotion: promoting 

health/preventing disease. Public Health Service implementation 

plans for attaining the objectives for the Nation, Public Health Reports. Supplement to the September/October issue, 1983. 

“National Center for Health Statistics, C.A. Schoenborn and K.M. 

Danchik: Health practices among U.S. adults, United States, 1977. 

Advance Data From Vitul and Health Statistics. No. 64. DHHS 

Pub. No. (PHS) 81-1250. Public Health Service. Hyattsvillc, Md., 

NOV.4, 1980. 

IZW.B. Clark and L. Midanik: Alcohol use and alcohol problems 

among U.S. adults, results of the 1979 national survey, in Alcohol 

Consumption and Related Problems. Alcohol and Health Monograph. 

No. 1. National Institute on Alcohol Abuse and Alcoholism. 

Rockville, Md., 1982. 

]3R J G]ynn, G.R. Bouchard, J.S, LoCastro, and N.M. Laird: Aging . . 

and generational effects on drinking behaviors in men: Results from 

the Normative Aging Study. Am. J. Public Health 75( 12): 1413-1419, 

1985. 

lqMetropo]itan Life Insurance Company: overweight, its Prevention 

and significance. Stat. Bull. Metropol. L@e Ins. Co. New York. 

Metropolitan Life Insurance Company, 1960. 

IsNational Institutes of Health: Health implications of obesity. National Institutes of Health Consensus Conference Development State­


ment. Vol. 5, No. 9, Feb. 11–13, 1985.


16M Rowland and A. White: personal communication. HyattsviUe!


Md., 1986.


17Nationa] Center for Health Statistics: Provisional data from the


health promotion and disease prevention supplement to the National 

Health Interview Survey, United States, January-March 1985. Advance Data From Vital and Health Statistics. No. 113. DHHS Pub. 

No. (PHS) 86-1250. Public HeaIth Service. Hyattsville, Md., Nov. 

15, 1985. 

18s G Haynes, B. Cohen, C. Harvey, and M. McMillen: Cigarette . . 

smoking patterns among Mexican-Americans, HHANES, Southwest 

United States, 1982–84. Paper presented at the 113th Annual Meeting 

of the American Public Health Association. Washington, D.C., Nov. 

1985. 

lsNational.Center for Hea]th Statistics: Current eStirOates. 1983. vital 

and Health Statistics. Series 10, No. 154. DHHS Pub. No. (PHS) 

86-1582. Public Health Service. Washington, U.S. Govcmmcnt 

Printing Office, 1986. 

. 
ackmdam 13


Technical notes 

Data presented in this report were obtained from household 

interviews of the National Health Interview Survey (NHIS). 

These interviews were conducted among a probability sample 

of the civilian ncrninstitutionalized population of the United 

States, During 1983 approximately 106,000 persons living 

in about 41,000 households were included in the sample. 

The total noninterview rate for the NHIS was about 3.3 percent, 

including 2.0 percent attributable to respondent refusal and 

1,3 percent attributable to failure to find an eligible respondent 

ot home after repeated calls. 

Questions about health practices were asked of a one-third 

subsample of all persons 18 years of age and over, or approximately 22,400 persons. This report is based on data for the 

approximately 21,450 subsample respondents who were 20 

years of age and over. Self-reporting was generally required 

for these questions, but proxy responses were accepted when 

subsample persons were physically or mentally incapable of 

answering the questions for themselves. Persons with unknown 

heidth practice characteristics are excluded only from the analysis for that particular health practice. Item nonresponse for 

the dtitti discussed in this report ranged from 0.2 percent 

for snacking to 3.1 percent for desirable weight. 

The measure of desirable weight used in this report was 

based on the 1960 Metropolitan Life Insurance Company 

(MLIC) standards of desirable weights for men and women 

that were derived from the 1959 Build and Blood Pressure 

Study conducted by the Society of Actuaries. These standards 

are published in a Metropolitan Life Insurance Company booklet entitled Overweight: Its Prevention and Signij2cance.’4 

Desirable weights were shown for small, medium, and large 

frames for men and women. For NHIS analyses, the midpoint 

of the desirable weight range for the medium frame category 

was used as the “desirable weight” for a particular height, 

with certain adjustments. The MLIC standards were developed 

based on weight in indoor clothing and height with l-inch 

heels for men and 2-inch heels for women. The NHIS asked 

respondents to report their height without shoes and their 

weight without shoes, To compensate for these differences, 

the MLIC standards were adjusted by subtracting 2 pounds 

from the midpoint of the medium frame category for both 

sexes, and subtracting 1 inch from the height for men and 

2 inches from the height for women. 

Estimates for the white, black, and other populations, 

shown in table 1 of the text, are based on self-reported racial 

identifications. The Hispanic classification is also based on 

self-reporting, For detailed definitions of other sociodemographic terms used here, see appendix II in most Series 10 

reports in the Vital and Health Statistics series. In accordance 

with new Government guidelines, the race and Hispanic origin 

designations shown in this report differ from those presented 

in the earlier Advance Data report on health practices of 

Standard errors, expressed in percentage points, of estimsted percents, 

NHIS Alcohol and Heslth Prsctices Survey, 1983 

Base of Estimated percent 

percent in 2 or 5 or 10 or 20 or 

thousands 98 95 90 80 50 

50 . . . . . . . . . . 5.5 8.5 11.7 15.6 19.5


70 . . . . . . . . . . 4.6 7.2 9.9 13.2 16.5


100 . . . . . . . . . 3.9 6.0 8.3 11.0 13.8


300 . . . . . . . . . 2.2 3.5 4.8 6.4 8.0


500 . . . . . . . . . 1.7 2.7 3.7 4.9 6.2


700 . . . . . . . . . 1.5 2.3 3.1 4.2 5.2


1,000 .,...... 1.2 1.9 2.6 3.5 4.4


5,000 . . . . . . . . 0.5 0.8 1.2 1.6 1.9


10,000 . . . . . . . 0.4 0.6 0.6 1.1 1.4


20,000 . . . . . . . 0.3 0.4 0.6 0.8 1.0


30,000 . . . . . . . 0.2 0.3 0.5 0.6 0.8


50,000 . . . . . . . 0.2 0.3 0.4 0.5 0.6


100,000 . . . . . . . 0.1 0.2 0.3 0.3 0.4


the U.S. population. 11 TO calculate the ratios shown in table 

8 of this report, the 1977 data were recomputed with race 

and Hispanic origin designations that resembled, as closely 

as possible, those shown here for the 1983 population. 

Findings presented in this report regarding the smoking 

practices of Hispanic persons differ somewhat from findings 

presented elsewhere 18 for Mexican-ArnericanS living in the 

Southwest United States, collected in the Hispanic Health 

and Nutrition Examination Survey (HHANES). HHANES data 

showed a higher prevalence of current smoking among Mexican-American men and a lower prevalence among MexicanAmerican women than did unpublished sex-specific data from 

the 1983 NHIS for persons of Hispanic origin. Possible explanations for these discrepancies could include differences in 

sample design or interviewing procedures, cultural differences 

between Mexican-Americans and other Hispanic groups (NHIS 

includes all Hispanic groups), regional differences in smoking 

behavior, or differences in the age or educational composition 

of the two Hispanic samples. Analysis of these methodological 

issues is beyond the scope of this report. 

Because the estimates shown in this report are based 

on a sample of the population rather than on the entire population, they are subject to sampling error. Standard errors appropriate for estimated percents of persons are shown in the 

table above. The statistics shown and discussed here are simple 

prevalence estimates, unadjusted for age or other sociodemographic characteristics. 

To better understand the limitations of the estimates presented in this report, data users are encouraged to familiarize 

themselves with the survey design, the methods used in estimation, and the general qualifications of the data, which are 

described in appendix I of the 1983 Current Estimates report.’9 

Definitions of certain terms used in this report, but not specifically addressed in this section, and the questionnaire and 

flashcards used during 1983 are presented in appendixes II 

and HI of that report. 

NOTE: SW list ofrekrcnccs at end of text. 
16 achmncedata 

Recent Issues of Advance Data From Vital and Health Statistics 

No. 117.Office Visits to Orthopedic Surgeons, National Ambulatory 

Medical Care Survey: United States, 1980-8 I (In preparation) 

No. 116. Aging in the Eighties: Age 65 and Older and Living 

Alone-Contacts with Family, Friends, and Neighbors: Preliminary 

Data From the Supplement on Aging to the National Health Interview 

Survey: United Sta~es, January-J&; 1984 (In preparation) 

No. 115. Aging in the Eighties: Preliminary Data From the Supplement on Aging to the National Health Interview Survey: United 

States, January-June 1984 (In preparation) 

Suggested citetiin 

National Center for Health Statiafics, C. A. Schoenborn 

and B. H. Cohen: Trends in smoking, alcohol 

consumption, and other health practices among U.S. 

adults,1977and 1983. Advance Data From V/fa/ am/ 

Hea/th .9atiatics, No. 118, DHHS Pub. No. (PHS) 

86-1250. Public Health SetVice, Hyaffsville, Md., 

June 30, 1986 

U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Public Health Service 

National Center for Health Statistics 

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