Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan.
Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, Georgia.
Am J Epidemiol. 2018 Jan 1;187(1):113-119. doi: 10.1093/aje/kwx196.
According to survey data, the prevalence of Americans' self-reported cigarette smoking is dropping steadily. However, the accuracy of national surveys has been questioned because of declining response rates and the increasing stigmatization of smoking. We used data from 2 repeated, cross-sectional, nationally representative health surveys (National Survey on Drug Use and Health (NSDUH), 1979-2014; and National Health Interview Survey (NHIS), 1965-2015) to determine whether self-reported cigarette consumption has changed over time as a proportion of federally taxed cigarette sales. From each survey, we calculated national equivalents of annual cigarette consumption. From 1979 to 1997, the amount of cigarettes that NSDUH and NHIS respondents reported corresponded to an average of 59.5% (standard deviation (SD), 2.3%) and 65.6% (SD, 3.2%), respectively, of taxed cigarette sales. After 1997, respondents' reported smoking data corresponded to the equivalent of an average of 64.2% (SD, 5.9%) and 63.3% (SD, 2.5%), respectively, of taxed cigarette sales. NHIS figures remained steady throughout the latter period, with a decline during 2013-2015 from 65.9% to 61.1%. NSDUH figures increased steadily, exceeding those of the NHIS after 2002. Given the consistent underreporting of cigarette consumption over time, these surveys are likely not less accurate than they were previously. The recent decrease in NHIS accuracy, however, gives pause about the magnitude of the reported decline in smoking prevalence in 2014 and 2015. Improvement in the accuracy of NSDUH data is encouraging.
根据调查数据，美国人自我报告的吸烟率正在稳步下降。然而，由于回应率下降和吸烟的污名化加剧，全国性调查的准确性受到了质疑。我们使用了来自两次重复的、横断面的、全国代表性的健康调查（全国药物使用和健康调查（NSDUH），1979-2014 年；和全国健康访谈调查（NHIS），1965-2015 年）的数据，以确定自我报告的吸烟量是否随着时间的推移，相对于联邦征税的香烟销售额而发生变化。从每个调查中，我们计算了全国每年的香烟消费量。从 1979 年到 1997 年，NSDUH 和 NHIS 受访者报告的香烟数量分别相当于平均 59.5%（标准差（SD），2.3%）和 65.6%（SD，3.2%）的征税香烟销售额。1997 年后，受访者报告的吸烟数据相当于平均 64.2%（SD，5.9%）和 63.3%（SD，2.5%）的征税香烟销售额。在后者期间，NHIS 数据保持稳定，2013-2015 年从 65.9%下降到 61.1%。NSDUH 数据稳步上升，2002 年后超过了 NHIS。考虑到吸烟量随着时间的推移一直被低估，这些调查可能并不比以前不准确。然而，NHIS 近期准确性的下降，让人对 2014 年和 2015 年报告的吸烟率下降幅度产生了怀疑。NSDUH 数据准确性的提高令人鼓舞。
