State-Specific Prevalence of Tobacco Product Use Among Adults — United States, 2014–2015

Despite recent declines in cigarette smoking prevalence, the tobacco product landscape has shifted to include emerging tobacco products* (1,2).Previous research has documented adult use of smokeless tobacco and cigarettes by state (3); however, state-specific data on other tobacco products are limited.To assess tobacco product use in the 50 U.S. states and the District of Columbia (DC), CDC and the National Cancer Institute analyzed self-reported use of six tobacco product types: cigarettes, cigars, regular pipes, water pipes, electronic cigarettes (e-cigarettes), and smokeless tobacco products among adults aged ≥18 years using data from the 2014-2015 Tobacco Use Supplement to the Current Population Survey (TUS-CPS).Prevalence of ever-use of any tobacco product ranged from 27.0% (Utah) to 55.4% (Wyoming).Current (every day or some days) use of any tobacco product ranged from 10.2% (California) to 27.7% (Wyoming).Cigarettes were the most common currently used tobacco product in all states and DC.Among current cigarette smokers, the proportion who currently used one or more other tobacco products ranged from 11.5% (Delaware) to 32.3% (Oregon).Differences in tobacco product use across states underscore the importance of implementing proven population-level strategies to reduce tobacco use and expanding these strategies to cover all forms of tobacco marketed in the United States.Such strategies could include comprehensive smoke-free policies, tobacco product price increases, anti-tobacco mass media campaigns, and barrier-free access to clinical smoking cessation resources (1,4).The 2014-15 TUS-CPS was a household-based survey of adults aged ≥18 years in the 50 U.S. states and DC (5).A total of 163,920 respondents participated (response rate = 54.2%).† * Emerging tobacco products are noncigarette tobacco products that have gained increasing popularity and use within the U.S. market over the past decade.† Tobacco Use Supplement to the Current Population Survey (TUS-CPS) is conducted in person or by proxy.The 2014-2015 survey was co-sponsored by the National Cancer Institute and the Food and Drug Administration Center for Tobacco Products and was administered as part of the U.S. Census Bureau's Current Population Survey of the civilian, noninstitutionalized U.S. population.For the 2014-2015 iteration of the survey, 163,920 responses were self-reported (54,125 from July 2014, 56,652 from January 2015, and 53,143 from May 2015), and 67,476 were proxy-reported.Sensitivity analyses showed systematic differences between self-and proxy-responses in relation to key demographic characteristics, especially for younger adults.To reduce likelihood of misclassification bias, proxy responses were excluded from these analyses.The TUS-CPS self-response weights derived by the Census Bureau count proxy respondents as "nonrespondents" when an analysis is conducted only with self-respondents.