Next up are products that can mimic the behavioral aspects of smoking but use essentially harmless nicotine. In countries where products like iQOS have been approved, smoking cessation and harm reduction is as high as 70%, much better than the 10% of gums, patches, and hypnosis and even exceeding the 20% success of vaping tools like Juul.
Some people who likely wanted to rebel in youth took up smoking and now want to stop - 65% of adult smokers, according to recent survey results. In only two states did quit attempt prevalence decrease, New York and Tennessee. In the Tennessee case, cessation has been successful, so those remaining are more entrenched in wanting to do it, while during the data gathering of the 2011–2017 Behavioral Risk Factor Surveillance System (BRFSS) surveys(1) New York City boosted taxes on cigarettes, which created a much greater market for "loosies" while making government increasingly dependent on smoking revenue, and their government also penalized smoking cessation.(2)
| Alabama | 79.3 (66.9–87.9) | 69.5 (63.3–75.1) | 64.2 (59.1–69.0) | 57.7 (50.1–65.0) |
| Alaska | 70.8 (45.9–87.3) | 60.1 (49.4–70.0) | 66.9 (58.3–74.4) | 58.5 (45.6–70.4) |
| Arizona | 78.8 (69.7–85.8) | 74.1 (69.9–77.9) | 59.7 (56.1–63.2) | 52.6 (47.5–57.6) |
| Arkansas | 72.7 (46.9–88.9) | 73.8 (65.1–81.0) | 60.5 (53.2–67.3) | 50.1 (40.9–59.3) |
| California | 78.4 (68.2–86.0) | 65.1 (59.0–70.8) | 70.1 (64.0–75.7) | 66.3 (55.6–75.5) |
| Colorado | 70.7 (60.2–79.3) | 74.0 (69.4–78.1) | 63.2 (58.2–68.0) | 52.3 (45.2–59.4) |
| Connecticut | 76.7 (62.8–86.6) | 79.0 (73.2–83.9) | 65.3 (60.2–70.0) | 58.7 (50.0–66.8) |
| Delaware | 84.5 (69.7–92.8) | 77.4 (69.9–83.5) | 63.1 (56.0–69.7) | 55.9 (43.5–67.6) |
| District of Columbia | 78.1 (53.9–91.6) | 65.7 (57.2–73.3) | 74.9 (68.6–80.2) | 71.2 (61.4–79.3) |
| Florida | 85.5 (75.5–91.8) | 69.9 (63.8–75.3) | 65.8 (60.7–70.5) | 57.4 (49.3–65.1) |
| Georgia | 74.1 (58.0–85.5) | 67.1 (60.6–72.9) | 61.0 (55.0–66.6) | 55.4 (47.1–63.5) |
| Hawaii | 76.4 (61.2–87.0) | 70.7 (64.7–76.0) | 62.1 (56.0–67.9) | 50.0 (39.0–61.1) |
| Idaho | 78.9 (64.5–88.5) | 64.8 (56.3–72.4) | 55.3 (47.1–63.3) | 55.5 (44.6–66.0) |
| Illinois | 60.5 (40.2–77.7) | 70.1 (63.5–75.9) | 60.8 (54.6–66.6) | 60.3 (51.4–68.7) |
| Indiana | 71.4 (62.1–79.2) | 62.6 (58.4–66.5) | 60.4 (57.1–63.7) | 52.9 (47.7–58.1) |
| Iowa | 63.6 (50.5–75.0) | 63.5 (58.4–68.2) | 56.1 (51.6–60.6) | 55.1 (47.7–62.4) |
| Kansas | 76.8 (70.2–82.3) | 68.6 (65.5–71.6) | 57.5 (54.5–60.5) | 52.5 (47.8–57.2) |
| Kentucky | 72.3 (56.9–83.7) | 67.7 (62.4–72.6) | 53.0 (47.5–58.3) | 62.2 (53.9–69.8) |
| Louisiana | 68.1 (55.1–78.8) | 74.4 (69.0–79.2) | 65.5 (59.9–70.7) | 64.2 (54.7–72.7) |
| Maine | 80.8 (57.8–92.8) | 62.5 (56.2–68.4) | 59.8 (54.5–65.0) | 54.3 (46.6–61.8) |
| Maryland | 65.5 (49.1–78.8) | 69.5 (63.3–75.0) | 62.0 (57.2–66.6) | 65.0 (57.8–71.5) |
| Massachusetts | 70.3 (50.9–84.5) | 70.0 (61.6–77.3) | 59.4 (51.9–66.5) | 59.1 (46.6–70.6) |
| Michigan | 76.6 (66.4–84.4) | 67.2 (62.7–71.5) | 64.1 (60.2–67.8) | 61.3 (54.8–67.4) |
| Minnesota | 71.5 (62.0–79.5) | 67.2 (63.2–70.9) | 60.0 (56.4–63.4) | 55.8 (50.1–61.3) |
| Mississippi | 85.7 (67.1–94.6) | 56.2 (48.2–63.9) | 62.5 (56.5–68.0) | 53.5 (44.7–62.0) |
| Missouri | 71.4 (60.0–80.6) | 59.4 (53.3–65.3) | 57.8 (52.6–62.9) | 52.8 (45.0–60.5) |
| Montana | 60.7 (45.0–74.4) | 66.2 (59.8–72.1) | 57.8 (51.3–64.1) | 48.9 (40.1–57.7) |
| Nebraska | 75.1 (65.2–82.9) | 68.6 (63.8–73.0) | 57.1 (52.4–61.7) | 51.2 (43.9–58.4) |
| Nevada | 76.3 (52.4–90.4) | 67.0 (57.5–75.3) | 60.9 (51.6–69.5) | 51.2 (40.1–62.2) |
| New Hampshire | 72.9 (53.7–86.1) | 61.8 (52.8–70.0) | 62.3 (56.1–68.1) | 63.6 (54.5–71.7) |
| New Jersey | 77.9 (57.7–90.1) | 76.0 (69.7–81.3) | 64.9 (59.4–70.0) | 69.2 (60.9–76.5) |
| New Mexico | 69.9 (54.5–81.8) | 70.0 (63.5–75.7) | 64.3 (58.3–69.8) | 51.5 (43.4–59.4) |
| New York | 70.8 (55.8–82.4) | 68.9 (63.9–73.6) | 64.4 (59.7–68.8) | 59.9 (52.2–67.1) |
| North Carolina | 68.2 (53.4–80.1) | 71.3 (64.1–77.6) | 58.6 (51.8–65.0) | 63.8 (53.0–73.3) |
| North Dakota | 84.4 (72.3–91.8) | 67.8 (61.7–73.3) | 47.4 (42.2–52.6) | 54.6 (47.6–61.5) |
| Ohio | 73.3 (61.7–82.4) | 63.4 (58.5–68.0) | 58.8 (54.5–62.9) | 53.8 (47.5–60.1) |
| Oklahoma | 75.0 (62.7–84.2) | 68.0 (62.3–73.1) | 63.3 (58.0–68.2) | 52.8 (45.6–59.8) |
| Oregon | 58.9 (43.7–72.6) | 69.2 (63.3–74.6) | 57.9 (51.9–63.7) | 55.4 (45.7–64.7) |
| Pennsylvania | 80.6 (69.7–88.2) | 66.6 (60.7–72.0) | 58.9 (53.8–63.9) | 57.6 (48.0–66.6) |
| Rhode Island | 80.8 (59.0–92.5) | 68.7 (59.5–76.6) | 68.4 (62.2–74.0) | 65.8 (56.4–74.1) |
| South Carolina | 72.5 (60.0–82.3) | 69.1 (64.0–73.8) | 63.1 (58.8–67.3) | 55.8 (49.5–61.8) |
| South Dakota | 76.9 (61.2–87.5) | 68.7 (59.4–76.7) | 58.0 (50.2–65.5) | 52.0 (41.3–62.5) |
| Tennessee | 77.8 (64.5–87.1) | 62.9 (56.5–68.8) | 55.5 (50.0–60.9) | 49.1 (40.8–57.5) |
| Texas | 78.0 (62.1–88.5) | 70.5 (64.2–76.1) | 70.6 (63.5–76.8) | 59.7 (47.2–71.1) |
| Utah | 76.9 (65.7–85.3) | 69.6 (64.1–74.7) | 58.4 (51.8–64.7) | 56.4 (44.6–67.6) |
| Vermont | 86.5 (72.0–94.1) | 64.3 (57.3–70.7) | 62.4 (56.2–68.3) | 60.3 (51.2–68.8) |
| Virginia | 80.4 (68.4–88.6) | 71.6 (66.3–76.3) | 59.0 (53.9–64.0) | 53.6 (46.2–60.8) |
| Washington | 77.3 (66.0–85.7) | 72.4 (68.1–76.4) | 61.6 (57.1–65.8) | 60.3 (53.6–66.7) |
| West Virginia | 84.7 (73.5–91.7) | 62.0 (56.6–67.0) | 56.4 (51.9–60.8) | 50.4 (43.2–57.5) |
| Wisconsin | 66.4 (49.2–80.2) | 58.8 (51.7–65.6) | 56.3 (49.9–62.5) | 57.7 (47.2–67.6) |
| Wyoming | 73.7 (60.6–83.6) | 67.4 (60.6–73.6) | 59.5 (52.9–65.7) | 57.5 (48.5–66.0) |
| Guam | 96.0 (87.8–98.8) | 71.8 (62.0–80.0) | 64.9 (55.3–73.5) | 61.8 (37.6–81.2) |
| Puerto Rico | 87.3 (73.0–94.6) | 75.2 (66.3–82.4) | 53.6 (43.9–63.0) | 54.3 (39.0–68.7) |
| Median | 76.4 | 68.6 | 60.8 | 55.8 |
Abbreviation: CI = confidence interval.
* Quit attempt percentages were calculated among current cigarette smokers who answered yes to the question “During the past 12 months, have you stopped smoking for 1 day or longer because you were trying to quit smoking?” and also among former cigarette smokers who answered “within the past month,” “within the past 3 months,” “within the past 6 months,” or “within the past year” to the question “How long has it been since you last smoked a cigarette, even one or two puffs?”
(1) BRFSS is an annual state-based telephone (landline and cellular) survey of a randomly selected representative sample of noninstitutionalized U.S. adults aged ≥18 years.* During 2011–2017, BRFSS sample sizes ranged from 441,456 (2014) to 506,467 (2011). Median survey response rates ranged from 45.3% (2017) to 53.0% (2011) for landlines and from 27.9% (2011) to 47.2% (2015) for cellular phones.
(2) Government advocates insist that bans on smoking in some places and high taxes had some impact but in no other area of public health have those techniques to any substantial degree so skepticism is warranted. Education and alternatives remain the recipe for success.
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