Cigarette Smoking and Secondhand
Smoke Exposure Among Adult Minnesotans
continues to decline
S moking prevalence in Minnesota
has declined
Minnesota Adult Tobacco Survey
25
Data from the 2010 Minnesota Adult Tobacco Survey
20
(MATS)
show that the percentage of adult Minnesotans
who
smoke has dropped from 17.0 percent in 2007 to
15
16.1 percent in 2010. Since 1999, cigarette smoking has
10
decreased
6 percentage points from 22.1 percent to 16.1
percent.
This
decrease represents a 27.1 percent change
5
over 11 years.
0
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Although the drop from 17.0 to 16.1 percent is not
statistically significant, Minnesota’s prevalence rate
has been consistently below the national average
since 1999. National rates of cigarette smoking have
remained at around 20 percent since 2004 (Figure A).
Figure A: smoking prevalence 1999-2010
MATS (MN)
30
25
20
15
10
Percent of Adults who Smoke
5
23.3% 23.1% 22.6%
22.3%
21.5% 20.8% 20.8% 20.8%
22.1%
20.6% 19.9%
19.7% 20.4%
The 2010 Minnesota Adult Tobacco Survey
(MATS) is a collaborative effort between ClearWay MinnesotaSM and the Minnesota Department
of Health. MATS is the most thorough source of
information about tobacco prevalence, behaviors,
attitudes and beliefs in the adult Minnesota
population and serves as a tool for measuring the
progress of Minnesota’s comprehensive tobacco
control program. Data for the most recent MATS
were collected in 2010. Other survey years were
1999, 2003 and 2007. Key findings for the most
recent MATS and the trend analyses from all
four MATS are discussed in the complete report,
Tobacco Use in Minnesota: 2010 Update, and
in this fact sheet, both of which are available at
www.mnadulttobaccosurvey.org.
1999
2003
2007
2010
NHIS (U.S.)
0
19.1%
17.0%
16.1%
Figure B: smoking prevalence by
education levels 1999-2010
NHIS (U.S.)
MATS (MN)
Note: The 2010 NHIS finding is based on early release data (January - June 2010)
Adult smokers in Minnesota tend to be male, younger,
have lower incomes, and have completed fewer years
of education. Similar to previous MATS findings,
young adults (18-24 year-olds) in 2010 continue to
have the highest smoking rate (21.8 percent) of all
age categories. Smoking rates decline as education
increases, with individuals with college degrees
significantly less likely to be smokers than those in
other education categories (Figure B).
Percent of Adult Minnesotans who Smoke
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
27.0%
24.8%
24.7%
21.6%
24.8%
20.5%
17.7%
10.4%
9.4%
5.9%
1999
Less than HS or
HS graduate
20%
2003
Some college or
technical school
2007
4.8%
2010
College graduate
or beyond
College g
Some co
Less than
Cigarette Smoking and Secondhand Smoke Exposure
Among Adult Minnesotans continues to decline
In 2007, Minnesota passed and implemented a
comprehensive smoke-free law (the Freedom to
Breathe Act) that covers indoor public places and
workplaces, including bars and restaurants. The
2010 MATS provides the first assessment since
the Freedom to Breathe Act went into effect of
Minnesotans’ attitudes, beliefs, and behaviors
towards tobacco use and secondhand smoke. The
Freedom to Breathe Act contributed to a large
positive change in the percentage of all Minnesotans
who report having a smoke-free policy at work. This
percentage rose from 76.1 percent in 2007 to 80.7
percent in 2010.
In addition to the increase in smoke-free workplaces,
Minnesotans are also implementing voluntary
smoke-free rules in their homes. 87.2 percent of all
100Minnesotans and 58.1 percent of Minnesota smokers
2010
have smoke-free rules at home. Both of these rates
80
2007
have increased significantly since 2007 (Figure C).
60
The high rates of home rules, which have increased
substantially since it was first assessed at 64.5
percent in 1999, reflect the widespread awareness
20
of the harms of secondhand smoke to health.
0Currently, 92.3 percent of all Minnesotans believe
Workplace
Home
that breathing smoke from other people’s cigarettes
is harmful to one’s health.
Exposure to secondhand smoke continues
to decline in Minnesota
80
70
With
the increase in smoke-free policies in work60
places
and homes, it follows that exposure to second50
hand smoke continues to decline. Reported exposure
40
to
secondhand smoke in any location, including the
30
community, workplace, car and home, declined 11
20
percentage points for the third consecutive MATS,
10
to0 a new low of 45.6 percent in 2010. There have
Any location
In the community at large In a car
In own work area
At home
also been large declines in reported exposure in the
home, at work and in a car (Figure D).
Figure D: Exposure to secondhand
smoke 2003-2010
67.2%
Percent Exposed in the Last 7 Days
More Minnesotans are protected by
smoke-free policies and voluntary
home rules
56.7%
45.6%
58.0%
46.0%
34.1%
21.7% 20.6%
17.6%
Any location
In the community
at large
In a car
19.0%
14.6%
9.4%
In own work area
16.9%
12.0%
9.5%
At home
Settings of Exposure to Secondhand Smoke
2003
2007
2010
40
Figure C: Existence of smoke-free
workplace and home
80.7%
83.2%
Percent Reporting Smoke-Free
76.1%
Workplace (indoor and outdoor)
2007
Home
2010
87.2%
S mokers are smoking fewer
cigarettes per day
Adult smokers in Minnesota are smoking fewer
cigarettes per day. The average number of cigarettes
smoked per day dropped 11.6 percent from 13.8
cigarettes in 2007 to 12.2 in 2010. In addition, the
percentage of heavy smokers (defined as those who
smoke 25 or more cigarettes per day) decreased from
10.3 percent in 2007 to 6.3 percent in 2010.
20
20
20
Cigarette Smoking and Secondhand Smoke Exposure
Among Adult Minnesotans continues to decline
MATS Survey Methods
Use of smokeless tobacco has increased
Although cigarettes are the most commonly used
form of tobacco, MATS also tracks the use of
other tobacco products such as cigars, pipes and
smokeless tobacco. The only notable change in the
use of these products was an increase in smokeless
tobacco use between 2007 and 2010. The use of
smokeless tobacco products has increased among all
Minnesotans, from 3.1 percent in 2007 to 4.3 percent
in 2010. Smokeless tobacco is used almost exclusively
by men (97 percent). Also, smokeless tobacco users
tend to be younger and have completed fewer years
of education.
There has also been a dramatic increase in the use of
smokeless tobacco products among current cigarette
smokers. In 2007 4.4 percent of current smokers
reported using smokeless tobacco. By 2010, that rate
had more than doubled, to 9.6 percent.
It is important to note that in addition to traditional
smokeless products such as chewing tobacco,
the marketplace is changing to include other
non-smoked tobacco products such as snus (a
pouch of moist snuff that sits in the mouth and is
later discarded) and products that dissolve in the
mouth like strips, sticks and tablets. MATS will
continue to measure the use of these new products
in future years.
The 2010 Minnesota Adult Tobacco Survey is a
cross-sectional, random digit dial telephone survey
conducted from March to May 2010 among adults
aged 18 and older living in Minnesota. The sample of
7,057 responding adults consisted of 5,555 from a
statewide landline sample and 1,502 from a cell
phone sample. Statistical tests use overlapping
confidence intervals, chi-square, and t-tests, as
appropriate. Differences are statistically significant
at p<0.05 unless otherwise noted. A comprehensive
description of the statistical methods can be
found in the complete report, Tobacco Use in
Minnesota: 2010 Update, which is available at
www.mnadulttobaccosurvey.org
50
2010
40
type of medication to help them in their quit attempt
30 (Figure E). However, there is also some concern
among Minnesota smokers about the safety of
20
medications to quit smoking. MATS 2010 found
10 that there was a large and significant increase in the
perception that quit-smoking medications might
0 harm health. This belief increased from 30.5 percent
Any Assistance
Any Medications
Any Behavioral Counseling
in 2007 to 51.7 percent in 2010.
Figure E: Use of assistance when trying to
quit smoking
Minnesotans are trying to quit and are
receiving help with quitting
45.5% 46.3%
Percent of Smokers
A majority of smokers want to quit smoking. In
2010, 54.6 percent of current adult Minnesota
smokers stopped smoking for one day or longer
in the past year because they were trying to quit.
That’s about 340,000 current smokers in Minnesota
who actively tried to quit. The use of behavioral
counseling in a quit attempt increased significantly,
from 14.9 percent in 2007 to 20.1 percent in 2010.
Of those who tried to quit, 46.3 percent used some
48.5% 49.2%
20.1%
14.9%
Any Assistance
Any Medications
2007
Any Behavioral Counseling
2010
2007
Cigarette Smoking and Secondhand Smoke Exposure
Among Adult Minnesotans continues to decline
Health care providers play a key role in supporting
quit attempts. There was a large and significant
increase in the percentage of Minnesotans who
reported being asked if they smoke by a health care
provider between 2007 and 2010, with 80.2 percent
of Minnesotans currently reporting being asked if
they smoke. This is an increase from 69.4 percent
in 2007. This finding demonstrates that health care
providers are moving toward asking all patients if
they use tobacco.
Despite significant improvements in asking
about tobacco use, MATS identified areas for
improvement. Among smokers surveyed in 2010,
71.8 percent reported that health care providers
advised them to quit and 43.9 percent reported
receiving a referral for assistance in quitting
smoking. These lower rates for advising and referring
suggest that health care providers need to intervene
with all smokers more consistently.
Conclusion
MATS 2010 has identified several significant findings that suggest societal norms about smoking have changed in Minnesota.
In addition to fewer adults smoking cigarettes, and less exposure to secondhand smoke, more Minnesotans are implementing
voluntary smoke-free rules in their homes. These encouraging trends occurred during a decade of tobacco control policy
advances in Minnesota. These policies included local smoke-free ordinances, a comprehensive statewide smoke-free law,
cigarette price increases, mass media campaigns to promote cessation, and statewide provision of cessation services. However,
the data highlight ongoing areas of concern as well, including significant increases in smokeless tobacco use and higher
prevalence rates among young adults and those who have completed fewer years of education. Even with significant progress,
tobacco use remains the leading cause of preventable death and disease in Minnesota. The next decade will be measured a
success if tobacco use continues to decrease, exposure to secondhand smoke is a rare event and all continuing tobacco users
have access to the assistance they need to quit.
www.mnadulttobaccosurvey.org
Ann St. Claire, M.P.H.
Senior Research Program Manager
ClearWay MinnesotaSM
(952) 767-1416
[email protected]
© 2011 ClearWay MinnesotaSM
© 2011 Minnesota Department of Health
*The 2010 MATS was partially funded by a contribution by Blue Cross and Blue Shield of Minnesota.