MMWR Morb Mortal Wkly Rep. 2012 Aug 3;61(30):565-9.
Smoking cigarettes and other combustible tobacco products causes adverse health outcomes, particularly cancer and cardiovascular and pulmonary diseases. A priority of the U.S. Department of Health and Human Services is to develop innovative, rapid-response surveillance systems for assessing changes in tobacco use and related health outcomes. The two standard approaches for measuring smoking rates and behaviors are 1) surveying a representative sample of the public and asking questions about personal smoking behaviors and 2) estimating consumption based on tobacco excise tax data. Whereas CDC regularly publishes findings on national and state-specific smoking rates from public surveys, CDC has not reported consumption estimates. The U.S. Department of Agriculture (USDA), which previously provided such estimates, stopped reporting on consumption in 2007. To estimate consumption for the period 2000-2011, CDC examined excise tax data from the U.S. Department of Treasury's Alcohol and Tobacco Tax and Trade Bureau (TTB); consumption estimates were calculated for cigarettes, roll-your-own tobacco, pipe tobacco, and small and large cigars. From 2000 to 2011, total consumption of all combustible tobacco decreased from 450.7 billion cigarette equivalents to 326.6, a 27.5% decrease; per capita consumption of all combustible tobacco products declined from 2,148 to 1,374, a 36.0% decrease. However, while consumption of cigarettes decreased 32.8% from 2000 to 2011, consumption of loose tobacco and cigars increased 123.1% over the same period. As a result, the percentage of total combustible tobacco consumption composed of loose tobacco and cigars increased from 3.4% in 2000 to 10.4% in 2011. The data suggest that certain smokers have switched from cigarettes to other combustible tobacco products, most notably since a 2009 increase in the federal tobacco excise tax that created tax disparities between product types.
吸烟和使用其他可燃烟草制品会导致不良健康后果，尤其是癌症以及心血管和肺部疾病。美国卫生与公众服务部的一个优先事项是开发创新的、快速响应的监测系统，以评估烟草使用和相关健康结果的变化。衡量吸烟率和行为的两种标准方法是：1）对公众进行代表性抽样调查，并询问个人吸烟行为；2）根据烟草消费税数据估算消费。虽然疾病预防控制中心定期公布全国和各州的吸烟率调查结果，但疾病预防控制中心尚未报告消费估计数。美国农业部（USDA）此前提供了此类估计数，但在 2007 年停止了报告。为了估计 2000-2011 年的消费情况，疾病预防控制中心审查了美国财政部酒精和烟草税收贸易局（TTB）的消费税数据；计算了香烟、自卷烟、烟斗烟以及小雪茄和大雪茄的消费估计数。从 2000 年到 2011 年，所有可燃烟草制品的总消费量从 4507 亿支香烟当量下降到 3266 亿支，下降了 27.5%；所有可燃烟草制品的人均消费量从 2148 支下降到 1374 支，下降了 36.0%。然而，尽管 2000 年至 2011 年期间香烟消费量下降了 32.8%，但同期散装烟和雪茄烟的消费量却增长了 123.1%。因此，从 2000 年的 3.4%到 2011 年的 10.4%，散装烟和雪茄烟在可燃烟草总消费中所占的比例有所增加。这些数据表明，某些吸烟者已经从香烟转向其他可燃烟草制品，尤其是自 2009 年联邦烟草消费税增加以来，不同类型产品之间的税收差距导致了这种情况。
