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Current Cigarette Smoking Among Specific Populations—United StatesAmerican Indian/Alaska Native (Non-Hispanic) AdultsAmerican Indians/Alaska Natives (AI/ANs) have a higher prevalence of current smoking than most other racial/ethnic groups in the United States.5 Factors that may affect smoking prevalence include sacred tobacco’s ceremonial, religious, and medicinal roles in Native culture, which may affect attitudes, beliefs, and behaviors toward commercial tobacco use.6 Also, tobacco sold on tribal lands is typically not subject to state and national taxes, which reduces costs. Lower prices are connected with increased smoking rates.1
Asian (Non-Hispanic) AdultsAsian Americans represent a wide variety of languages, dialects, and cultures.7 While non-Hispanic Asian adults have the lowest current cigarette smoking prevalence of any racial/ethnic group in the United States, there are significant differences in smoking prevalence among subgroups in this population.7 Many Asian Americans emigrate from countries where smoking prevalence is high and smoking among men is the social norm. However, research also shows an association between cigarette smoking and acculturation among Asian Americans, with those having higher English-language proficiency and those living in the United States longer being less likely to smoke.6
Among Asian adult subpopulations in the U.S., current smoking prevalence is higher among Korean and Vietnamese respondents compared with Filipino, Japanese, Asian Indian, and Chinese respondents.7 Among women, smoking prevalence is highest among Koreans and lowest among Chinese. Among men, smoking prevalence is highest among Vietnamese and lowest among Asian Indians.7 Black (Non-Hispanic) AdultsAlthough prevalence of cigarette smoking is lower among non-Hispanic Black high school students than it is among U.S. high school students overall (6.4% compared with 11.2% in 20218, respectively), smoking prevalence among non-Hispanic Black adults is similar to that of the overall adult population.5,8
Hispanic AdultsThe prevalence of cigarette smoking among Hispanics is generally lower than the prevalence among other racial/ethnic groups in the United States, with the exception of non-Hispanic Asians. However, smoking prevalence among Hispanic men is significantly higher than among Hispanic women, and there are significant differences in smoking prevalence among subgroups in this population.5,7
Among Hispanic adult subpopulations in the U.S., current smoking prevalence is higher among Puerto Rican adults compared with Cuban, Mexican, and Central or South American adults.7 Among both men and women, smoking prevalence is highest among Puerto Ricans, and lowest among Central or South Americans.7 Lesbian, Gay, Bisexual, and Transgender (LGBT) AdultsSmoking prevalence among lesbian, gay, bisexual, and transgender (LGBT) individuals in the United States is higher than among heterosexual/straight individuals.5,10 This may be in part due to the aggressive marketing of tobacco products to this community. LGBT individuals also are likely to have risk factors for smoking that include daily stress related to prejudice and stigma that they can face.11
Military Service Members and VeteransIn the United States, cigarette smoking prevalence is higher among people currently serving in the military than among the civilian population.12,13 Cigarette smoking prevalence is even higher among military personnel who have been deployed.12
The high prevalence of tobacco use among military and veteran personnel has a significant financial impact. During 2010, the Veterans Health Administration (VHA) spent an estimated $2.7 billion on smoking-related ambulatory care, prescription drugs, hospitalization, and home health care.14 Women Who Are Pregnant or Planning to Become PregnantOverall, there have been slight decreases in cigarette smoking during pregnancy and after delivery between 2000 and 2010, but for the majority of states, smoking prevalence before, during, or after pregnancy did not change over time, according to a study using Pregnancy Risk Assessment and Monitoring Survey (PRAMS) data.15 In 2010, data from 27 PRAMS sites, representing 52% of live births, showed that among women with recent live births:15
Among racial and ethnic groups, smoking during pregnancy was highest among AI/ANs (26.0%) and lowest among Asians/Pacific Islanders (2.1%).15 The highest prevalence of smoking after delivery was reported in women aged 20–24 years (25.5%), AI/ANs (40.1%), those who had less than 12 years of education (24.5%), and those who had Medicaid coverage during pregnancy or delivery (24.3%).15 The cigarette smoking rates of women who smoked before, during and after pregnancy15 The cigarette smoking status of women with recent live births in 2010.
People Living With HIVCigarette smoking prevalence is estimated to be at least two times higher among adults living with HIV than in the general population.16,17,18 Advances in science mean that HIV is now a chronic, manageable disease. Many people with HIV lead healthy lives. However, smoking has serious health effects on people with HIV, including higher risks for cancer, chronic obstructive pulmonary disease (COPD), heart disease, stroke, and HIV-related infections, including bacterial pneumonia.16
Adults Who Have Mental Health ConditionsApproximately 1 in 4 (or 25%) of adults in the U.S. have some form of mental illness or substance use disorder, and these adults consume almost 40% of all cigarettes smoked by adults overall.20
The Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health (NSDUH) defines mental illness as any diagnosable mental, behavioral, or emotional disorder and defines substance use disorder as dependence or abuse of alcohol or illicit drugs.22 Adults Who Have DisabilitiesAdults who have disabilities have a higher prevalence of cigarette smoking than adults without disabilities. It is not known if the disability is a result of smoking or if the person began smoking after the onset of the disability.5
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