Down in smoke

  • By: JEFF HARGARTEN , Star Tribune
  • Updated: July 14, 2014 - 10:58 AM

A recent national smoking study reveals smokers in poorer Minnesota counties are quitting at slower rates.

Lighting up cigarettes has gradually become less common in Minnesota, yet a recent study reveals smoking's decline has been slower in poorer counties.

Smoking has decreased all across the country, according to a recent study by the Institute for Health Metrics and Evaluation , but at much slower rates in areas with lower average income. Data analyzed by IHME was broken down by county spanning the years 1996 to 2012, revealing trends in every state, including Minnesota.

Without drilling down into data on the county level, big metro areas can dominate state-level research, said Dr. Ali Mokdad, a University of Washington Professor and researcher on the study.

"You will miss the real issues," he said.

Counties with the highest incomes experienced faster declines in smoking than those with the lowest, according to the study. For instance, among Minnesotans in Mahnomen and Pine counties, about 28 percent and 26 percent respectively still smoked in 2012, while U.S. Census Bureau data showed their median household incomes hovered around $39,000 and $44,000. By contrast, about 15 percent smoked in Carver and Scott counties where the median income is above $80,000.

The Minnesota Department of Health and ClearWay Minnesota -- two organizations at the forefront of collecting state tobacco use data -- had not tracked smoking prevalence according to income, but did as related to education. Pete Rode, a researcher with the Minnesota Center of Health Statistics , said the two metrics are closely correlated.

Adult smokers in Minnesota tend to be younger with lower incomes and fewer years of education, according to the 2010 Minnesota Tobacco Survey, and smoking rates decline as education increases. Smoking prevalence is "almost nil" among those with a college education, said Dr. Raymond Boyle, a researcher with ClearWay Minnesota.

While the data shows lower income counties have greater percentages of smokers, cigarette prices have steadily increased to an average of $5.62 per pack nationally in 2011, according to the Centers for Disease Control -- a big change from 38 cents in 1970. The price of tobacco helped spur the more than 43 percent reduction in Minnesota smoking rates from 1993 to 2011, according to data from ClearWay.

As for how low-income earners manage to maintain smoking habits in the face of rising prices, Boyle said some find ways to minimize the cost. Whereas smokers most commonly quit when cigarette taxes were raised, others may have a "reasonably high" nicotine addiction and may resort to other methods of obtaining it, including rolling their own cigarettes. He said tobacco industry marketing in low-income areas may also have an effect on smoking prevalence in those places.

Disparities in Minnesota don't only cut along economic and educational lines. About 59 percent of Native Americans smoke, according to the Minnesota Department of Health. The IHME study also found states with high Native American populations were among those areas with the highest prevalence of smoking.

According to the CDC, about 18 percent of Americans were smokers in 2012. Minnesota's smoking prevalence rate has been consistently below the national average for more than a decade, according to the Minnesota Adult Tobacco Survey.

Since some counties had less data than others, the IMHE researchers used a method to help paint more accurate pictures of places with insufficient information, which included averaging out information from neighboring counties and trends over time.

Mokdad said he hopes the smoking data will help empower counties and the communities within to better understand and manage health risk factors like smoking.

The last statewide tobacco survey for Minnesota was released in 2010 and another is slated for year's end.

Consuming tobacco is a leading cause of preventable death in the United States and contributes to morbidity. More than 480,000 people -- or one in five deaths -- die from complications connected to cigarette smoking each year, according to the CDC, while over 16 million Americans suffer from a smoking-caused disease.

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