DefinitionA current smoker is defined as a person 18 years or older who has smoked more than 100 cigarettes in his or her lifetime and currently smokes every day or some days.
NumeratorNumber of survey respondents who reported they were current cigarette smokers
DenominatorTotal number of BRFSS survey respondents
Data Interpretation IssuesData for this indicator report are from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing survey of adults regarding their health-related behaviors, health conditions, and preventive services. Data are collected in all 50 states, D.C., and U.S. territories. Responses have been weighted to reflect the New Mexico adult population by age, sex, ethnicity, geographic region, marital status, education level, home ownership and type of phone ownership.
The survey is conducted using scientific telephone survey methods for landline and cellular phones (with cellular since 2011). The landline phone portion of the survey excludes adults living in group quarters such as college dormitories, nursing homes, military barracks, and prisons. The cellular phone portion of the survey includes adult students living in college dormitories but excludes other group quarters.
Beginning with 2011, the BRFSS updated its surveillance methods by adding in calls to cell phones and changing its weighting methods. These changes improve BRFSS' ability to take into account the increasing proportion of U.S. adults using only cellular telephones as well as to adjust survey data to improve the representativeness of the estimates generated from the survey. Results have been adjusted for the probability of selection of the respondent, and have been weighted to the adult population by age, gender, phone type, detailed race/ethnicity, renter/owner, education, marital status, and geographic area. Lastly and importantly, these changes mean that the data from years prior to 2011 are not directly comparable to data from 2011 and beyond. Please see the [https://ibis.health.state.nm.us/view/docs/Query/BRFSS/BRFSS_fact_sheet_Aug2012.pdf BRFSS Method Change Factsheet].
The "missing" and "don't know" responses are removed before calculating a percentage.
Why Is This Important?Smoking is the leading preventable cause of death in the United States. Smoking is initiated and established primarily during adolescence, with more than 80% of adult smokers first smoking before age 18. One in six adults and one in nine youth smoke in New Mexico. About half of all lifetime smokers will die early because of their tobacco use. In New Mexico, about 2,800 people die from tobacco use annually and another 84,000 are living with tobacco-related diseases. Annual smoking-related medical costs in New Mexico total $844 million.
According to the CDC's SAMMEC (Smoking Attributable Mortality, Morbidity, and Economic Costs) website, smoking is responsible for a significant proportion of the deaths from numerous types of malignant neoplasms (e.g., lung, esophageal, and laryngeal cancers); from cardiovascular diseases (e.g., ischemic heart disease, cerebrovascular disease); and from several respiratory diseases (e.g., bronchitis, emphysema, chronic airway obstruction). Combined, these smoking-related deaths make smoking the leading behavioral cause of death in the United States.
Healthy People Objective: TU-1.1, Reduce tobacco use by adults: Cigarette smokingU.S. Target: 12.0 percent
Other ObjectivesSubstance Abuse Epidemiology Report Indicator
The Adult Smoking Prevalence indicator is specifically included in the New Mexico Department of Health (NMDOH) Strategic Plan. The indicator (percent of adults who smoke) appears in the NMDOH Strategic Plan under the objective to reduce tobacco use in the Result 1 Section: Improved health outcomes for the people of New Mexico. Tobacco use is considered a super-priority public health area by the Department of Health and is also included in the State Health Improvement Plan as a priority health indicator.
New Mexico Community Health Status Indicator (CHSI)
How Are We Doing?Although overall cigarette smoking continues to decline, smoking rates continue to be higher among certain population groups including people with lower levels of education or income, the uninsured, people with a disability, African Americans, and people who identify as lesbian, gay, or bisexual. In addition, the landscape of tobacco use and nicotine addiction is changing in light of emerging products such as e-cigarettes, hookah, and a variety of flavored tobacco products. About 5% of NM adults and 24% of NM high school youth use e-cigarettes and many of these individuals are using them in combination with traditional cigarettes.
How Do We Compare With the U.S.?Adult smoking prevalence in New Mexico continues to track closely to the US rate, about one in six adults. In New Mexico, adult smoking has declined significantly, from 21.5% in 2011 to 17.5% in 2017.
What Is Being Done?The NM Tobacco Program has a five-year action plan for 2015-2020 to do the following work together with its contractors and other statewide partners.
GOAL 1: Prevent Initiation of Tobacco Use among Youth and Young Adults
Strategy 1a: Educate and inform stakeholders and decision-makers about evidence-based policies and programs to prevent initiation of tobacco use.
Strategy 1b: Establish and strengthen tobacco-free policies in schools and on college or university campuses.
GOAL 2: Eliminate Nonsmokers' Exposure to Secondhand Smoke
Strategy 2a: Increase voluntary policies for smokefree multi-unit housing.
Strategy 2b: Implement evidence-based mass-reach health communication interventions to reduce exposure to secondhand smoke.
GOAL 3: Promote Quitting Tobacco Among Youth and Young Adults
Strategy 3a: Support state quitline capacity
Strategy 3b: Increase engagement of health care providers and systems to expand utilization of proven cessation methods
Strategy 3c: Expand insurance coverage and availability of comprehensive cessation services
Strategy 3d: Promote health systems changes to support tobacco cessation
Strategy 3e: Implement evidence-based mass-reach health communication interventions to increase cessation and promote the quitline.
GOAL 4: Identify and Eliminate Tobacco-Related Disparities (see Health Program Information section)
Evidence-based PracticesAddressing tobacco use is best done through a coordinated effort to establish tobacco-free policies and social norms, to promote and assist tobacco users to quit, and to prevent initiation of tobacco use. This comprehensive approach combines educational, clinical, regulatory, economic, and social strategies. Research has documented strong or sufficient evidence in the use of the following strategies:
- Increasing the unit price of tobacco products
- Restricting minors' access to tobacco products; restricting the time, place, and manner in which tobacco is marketed and sold
- Strategic, culturally appropriate, and high impact health communication messages (mass media), including paid TV, radio, billboard, print, and web-based advertising at state and local levels
- Ensuring that all patients seen in the health care system are screened for tobacco use, receive brief interventions to help them quit, and are offered more intensive counseling and low- or no-cost cessation medications; providing insurance coverage of tobacco use treatment; phone- and web-based cessation services are effective and can reach large numbers of tobacco users;
- Passage of laws and policies in a comprehensive tobacco control effort to protect the public from secondhand exposure
- Focusing tobacco prevention and cessation interventions on populations at greatest risk in an effort to reduce tobacco-related health disparities
Sources: CDC. Best Practices for Comprehensive Tobacco Control Programs - 2014 (www.cdc.gov/tobacco/stateandcommunity/best_practices/pdfs/2014/comprehensive.pdf)
The Guide to Community Preventive Services: Tobacco Use - 2010 (www.thecommunityguide.org/tobacco/index.html)
Health Program InformationIDENTIFYING AND ELIMINATING TOBACCO-RELATED DISPARITIES: The NM Tobacco Program has identified six priority populations based on the disproportionate impact or burden of tobacco use. The groups include: American Indians (Navajo and Pueblo); African Americans; people with disabilities; Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) people; Asian Americans/Pacific Islanders; and people whose primary language is Spanish. In addition to these six populations, people living in poverty are an overarching population of focus in the Tobacco Program, and there are also significant efforts in reaching young adults (18-29 year olds).
One of the most significant accomplishments in tobacco disparities and health equity work in NM is the development and growth of statewide Priority Population Networks. There are seven Networks who engage their respective populations through outreach and education efforts aimed at increasing awareness of tobacco disparities, improving access to culturally- and linguistically-appropriate tobacco prevention and cessation resources, and in developing innovative or promising practices. In addition, since 2012, the Tobacco Program and the Networks have engaged in a process of ongoing mutual advisement, which has been integral to ensuring a voice and input from community representatives and a venue for the sharing CDC Best Practices and tools and strategies developed by National Networks. The formal advisement process occurs three times per year, with additional work in between meetings.
A specific example of a project addressing disparities is the development of a new culturally appropriate Spanish-language media campaign to promote cessation services to NM tobacco users who speak Spanish as their primary language. The DEJELO YA campaign incorporates cultural concepts (e.g., family, respect, confidence, perseverance) that are important and valued by this community. The Spanish-speaking population Network conducted formative research that was used to advise the statewide media contractor in a unique partnership to jointly develop culturally- and linguistically-appropriate media messaging to promote cessation services to this underserved population in NM. Rather than simply translating an English campaign, the DEJELO YA campaign developed messages in Spanish by native speakers of the language to ensure that the message would resonate with the target audience.
Another example of promoting health equity is the Have a Heart campaign, where the NM Department of Health used awareness of diabetes among Navajo and Pueblo communities to educate members on the less well-known dangers of secondhand smoke. The Department created a single message about the harmful environment secondhand smoke creates for everyone, especially people with diabetes. The Have a Heart campaign used artwork by local artists, placed ads in English and the local tribal language on Navajo radio stations, and aired messages in Navajo Indian Health Service clinic waiting rooms.