Americans are smoking fewer cigarettes, but the use of other forms of combustible tobacco has jumped dramatically, the CDC is reporting.
Over a 12-year period, total consumption of cigarettes fell 32.8 percent, the agency reported in the Aug. 3 issue of Morbidity and Mortality Weekly Report.
But over the same time, the use of pipe tobacco and large cigars skyrocketed, by factors of 5.82 and 3.33 respectively, the agency reported.
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Overall, the agency found, smoking registered a steady decline â€" adding up to 27.5 percent over the whole study period -- but the decline in cigarette consumption was partly offset by an increase in the use of other forms of smokable tobacco, which more than doubled from 2000 through 2011.
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The consumption estimates come from an analysis of excise tax information from the Treasury Department's Alcohol and Tobacco Tax and Trade Bureau. Using monthly tax data, the CDC researchers estimated the per unit consumption of each type of product.
The cigarette equivalent consumption of roll-your-own tobacco fell 56.3 percent over the study period, but pipe tobacco use rose by a factor of 5.82.
The largest changes took place from 2008 through 2011 â€" a period when tax changes made pipe tobacco relatively less expensive than roll-your own tobacco, the CDC reported.
During those years, roll-your-own consumption fell from 10.7 billion cigarette equivalents to 2.6 billion, down 75.7 percent, and pipe tobacco use increased from 2.6 billion cigarette equivalents to 17.5 billion, a 6.73-fold increase.
The agency also noted large changes in the use of small and large cigars.
Small cigars, defined as weighing no more than 3 pounds for 1,000 cigars, are often nearly indistinguishable from cigarettes. Large cigars must weigh more than 3 pounds per 1,000.
From 2000 through 2011, the use of small cigars fell 65% and consumption of large cigars rose by a factor of 3.33.
Again, the largest changes took place from 2008 through 2011: small cigar use fell from 5.9 billion to 0.8 billion, dropping 86.4 percent, while the consumption of large cigars rose by a factor of 2.26, from 5.7 billion to 12.9 billion.
"The rise in cigar smoking, which other studies show is a growing problem among youth and young adults, is cause for alarm," said Dr. Tim McAfee, director of CDC's Office on Smoking and Health and one of the report's authors.
The authors cautioned that the numbers only reflect legal sales and use of tobacco; illicit, untaxed tobacco would not be captured in the analysis.
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