Fewer young adults are smoking, but more people are obese, shows US survey

BMJ 2013; 346 doi: (Published 24 May 2013) Cite this as: BMJ 2013;346:f3433
  1. Michael McCarthy
  1. 1Seattle

The prevalence of smoking among US adults is holding steady, at about 20%, while the obesity rate has risen despite the fact that more people say they are physically active, a new report has found.

The report was based on data collected from 76 669 household interviews conducted as part of an ongoing survey by the National Center for Health Statistics of the Centers for Disease Control and Prevention.1

The report, the fifth in a series, focused on five aspects related to health behavior: alcohol use, cigarette smoking, physical activity during leisure time, body mass index, and sleep. These have been targeted by the Healthy People 2020 initiative, a 10 year project launched in 2010 to improve the health of US citizens.

The survey found that about a fifth of US adults remained smokers, while 21% were former smokers and 59% had never smoked. Although the overall prevalence of smoking held steady, it edged down among young adults, to 21% from 24% reported in the preceding survey period (2005-07). Nearly three quarters (73%) of adults aged 18 to 24 years had never smoked, the survey found.

Smoking was much more common among people from lower income families, with the prevalence among those living at the federal poverty level running twice as high as that among people from families in the highest income group (29% versus 14%).

A little under half of adults (46%) met federal guidelines on aerobic physical activity, while a third (34%) reported that they did not engage in any aerobic physical activity in their leisure time. These numbers reflected some improvement, with the proportion reporting no physical activity falling from the 40% found in the 2005-07 survey. Wealthier people—those with a family income four times the poverty level or more—were nearly twice as likely to have met the activity guideline than were adults with a family income below the poverty level (57% versus 32%).

Despite the reported increase in physical activity, the proportion of US adults who were obese rose from 25% to 27%. Nearly two thirds of US adults (62%) were overweight (which includes obese people). Only 36% of adults were in the healthy weight range. Again, a higher income was associated with a healthier profile, with 24% of those with a family income at least four times the poverty level reporting being obese, whereas the figure was 30% among those with a family income below the poverty level.

Nearly two thirds (65%) of US adults reported drinking alcohol, the survey found, with 5% engaging in “heavier” drinking, defined as more than seven drinks a week on average for women and 14 for men. Wealthier Americans were more likely than those on lower incomes to drink: 77% of adults with a family income at least four times the poverty level but only 49% of those with a family income below the poverty level reported drinking alcohol.

In addition to the differences in the findings according to income, the survey identified differences between the sexes and between different ethnic groups. For example, in comparison with white, black, or American Indian or Alaska native adults, Asian adults were less likely to be smokers (with a prevalence of 10%), to be obese (10%), or to engage in risky drinking (defined as five or more drinks in a day) (11%).

White adults, on the other hand, were nearly twice as likely as black adults to engage in risky drinking (26% versus 14%); and although black adults were more likely than other adults to be physically active, they were also more likely to be obese (37% versus 27% overall).


Cite this as: BMJ 2013;346:f3433


  • Observations: Big Tobacco lights up e-cigarettes (BMJ 2013;346:f3418, doi:10.1136/bmj.f3418)


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