TOBACCO IS KILLING (AND COSTING) US

A Report on Tobacco Use Rates, Smoking-Related Deaths,
and Smoking-Related Health Care Costs in West Virginia

In 2003, West Virginia had the third highest current smoking rate among the 54 participants (50 states plus the District of Columbia and three U.S. territories) in the annual Behavioral Risk Factor Surveillance System (BRFSS) survey (3). The BRFSS allows a calculation of the state’s rate of smoking every year using statistics collected from approximately 3,600 randomly selected adults by means of a telephone survey. The state’s 2003 smoking prevalence was 27.3 percent, somewhat lower than the state’s 2002 rate of 28.4 percent but markedly higher than the U.S. average of 22.2 percent.

Among smokeless tobacco users, the difference was even more striking. The state’s 2003 prevalence of smokeless tobacco use among adult males was 15.9 percent, lower than the 2002 rate of 17.2 percent, but first among the 12 BRFSS participants in 2003 who included questions about smokeless tobacco use in their surveys.

The tobacco use data on the following pages reflect aggregated survey responses from the years 1999 through 2003. County rates were calculated from aggregated state data where possible. Aggregated sample sizes were large enough to allow the calculation of county smoking rates for 24 individual counties. Among those counties with sample sizes still too small to calculate individual (county-level) prevalences, samples were combined to provide multicounty smoking rates. That rate was then used as the prevalence for each county within that multicounty region. The U.S. average prevalence for 2001 as chosen for comparison purposes on the county map because it represents the midpoint of the five-year range.

• If everyone in the United States quit smoking today, there would [eventually] be 90 percent less lung cancer, 50 percent less bladder cancer, 33 percent less heart disease, 41 percent fewer childhood deaths and 22 percent fewer low-birthweight infants.
  
  -American Academy of Pediatrics
  
  
• Ninety percent of all smokers begin smoking before the age of 16 and more than 3,000 teens become regular smokers every day in the United States.
  
  -American Academy of Pediatrics

Table 1 Prevalence (%) of Current Smoking by County WVBRFSS, 1999-2003
County	%	Rank*	County	%	Rank*
Barbour	23.6	31	Monongalia	22.6	34
Berkeley	32.5	6	Monroe	24.6	28
Boone	39.0	1	Morgan	26.7	23
Braxton	21.8	35	Nicholas	21.8	35
Brooke	31.5	8	Ohio	26.4	25
Cabell	24.7	27	Pendleton	24.4	29
Calhoun	29.0	15	Pleasants	28.6	18
Clay	29.0	15	Pocahontas	24.4	29
Doddridge	29.3	14	Preston	23.7	30
Fayette	30.7	10	Putnam	22.9	33
Gilmer	29.0	15	Raleigh	30.4	11
Grant	25.6	26	Randolph	23.3	32
Greenbrier	24.6	28	Ritchie	29.3	14
Hampshire	26.7	23	Roane	29.0	15
Hancock	30.1	12	Summers	24.6	28
Hardy	24.4	29	Taylor	23.6	31
Harrison	27.8	20	Tucker	23.7	30
Jackson	28.3	19	Tyler	28.6	18
Jefferson	29.4	13	Upshur	32.2	7
Kanawha	27.4	22	Wayne	28.9	17
Lewis	29.3	14	Webster	21.8	35
Lincoln	39.0	1	Wetzel	28.6	18
Logan	35.5	2	Wirt	28.3	19
McDowell	32.9	4	Wood	26.7	24
Marion	21.1	36	Wyoming	32.6	5
Marshall	30.8	9	Total WV	27.4
Mason	28.9	16	Total US	22.7
Mercer	27.5	21
Mineral	25.6	26
Mingo	33.8	3
Note: The data from counties sharing the same rank were combined due to low sample sizes. Aggregated sample sizes were large enough for 24 of the 55 counties to stand alone. The data from the remaining 31 counties were combined into 12 groupings of counties. Each county within a grouping shares the same prevalence. *Rates are rounded to the nearest tenth; ranks were determined before rounding.

Table 2 Prevalence (%) of Smokeless Tobacco Use (Men) by County WVBRFSS, 1999-2003
County	%	Rank*	County	%	Rank*
Barbour	23.0	9	Monongalia	14.2	25
Berkeley	11.6	33	Monroe	23.6	8
Boone	20.6	13	Morgan	15.8	20
Braxton	30.3	2	Nicholas	30.3	2
Brooke	11.8	32	Ohio	11.9	31
Cabell	10.1	34	Pendleton	28.4	3
Calhoun	30.9	1	Pleasants	26.0	5
Clay	30.9	1	Pocahontas	28.4	3
Doddridge	20.9	12	Preston	24.0	7
Fayette	19.7	14	Putnam	14.2	26
Gilmer	30.9	1	Raleigh	21.9	10
Grant	13.6	28	Randolph	24.0	6
Greenbrier	23.6	8	Ritchie	20.9	12
Hampshire	15.8	20	Roane	30.9	1
Hancock	5.9	36	Summers	23.6	8
Hardy	28.4	3	Taylor	23.0	9
Harrison	17.6	18	Tucker	24.0	7
Jackson	21.3	11	Tyler	26.0	5
Jefferson	6.0	35	Upshur	15.7	22
Kanawha	13.0	29	Wayne	14.6	24
Lewis	20.9	12	Webster	30.3	2
Lincoln	20.6	13	Wetzel	26.0	5
Logan	14.1	27	Wirt	21.3	11
McDowell	18.8	17	Wood	12.8	30
Marion	15.2	23	Wyoming	28.1	4
Marshall	15.9	19	Total WV	17.1
Mason	19.6	15
Mercer	19.0	16
Mineral	13.6	28
Mingo	15.8	21
Note: The data from counties sharing the same rank were combined due to low sample sizes. Aggregated sample sizes were large enough for 24 of the 55 counties to stand alone. The data from the remaining 31 counties were combined into 12 groupings of counties. Each county within a grouping shares the same prevalence. *Rates are rounded to the nearest tenth; ranks were determined before rounding.

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