Smoking prevalence in 2010: why the healthy people goal is unattainable

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Abstract
OBJECTIVES: This study examined the changes in smoking initiation and cessation needed to realize the Healthy People 2010 national adult smoking prevalence objective (13%). METHODS: Using data from the National Health Interview Surveys, we calculated smoking prevalence over time with a dynamic population demographics model, examining the effects of changes in smoking initiation and cessation. RESULTS: The draft objective is unattainable solely through decreases in smoking initiation. It could be achieved through smoking cessation alone only if cessation rates immediately increased by a factor of more than 3.5. Assuming plausible decreases in initiation and increases in cessation, the draft objective is virtually unattainable. CONCLUSIONS: The health objectives should challenge the status quo but be achievable. Formal analysis often can assist in establishing reasonable objectives.