Smoking decline slows in Minnesota

Fewer Minnesotans are trying cigarettes these days, but those who do smoke aren't trying as often to quit.

Those opposing trends help explain why a new survey of adult tobacco use in Minnesota showed little change over the last four years.

The large statewide survey by ClearWay Minnesota also showed a rise in e-cigarette use among young adults, and an insignificant decline in cigarette smoking overall.

The results, released Tuesday, suggest that smoking hasn't been snuffed out in Minnesota, despite two decades of progress, said Mike Sheldon, ClearWay's marketing director. "There's more work we can do and more we need to do to protect people from the dangers of tobacco."

The Minnesota Adult Tobacco Survey has been conducted every four years since 1999. The latest survey will be the last by ClearWay, though, because the quit-smoking organization, established with funds from the state's 1998 settlement with Big Tobacco, is scheduled to end its 25-year mission in 2022.

On one hand, the 2018 survey showed a 38 percent decline since 1999 in Minnesota adults who are currently smoking cigarettes — people who are predisposed to higher rates of lung cancer and other pulmonary diseases.

On the other hand, that smoking rate dipped only slightly between 2014 and 2018 — from 14.4 percent of all Minnesota adults to 13.8 percent. That drop was statistically insignificant, even for a relatively large survey of 6,000 Minnesotans, and was the smallest in ClearWay's history.

And while adults 18 to 24 are rapidly abandoning cigarettes, the data suggest they are turning to e-cigarettes — which have been marketed as quit-smoking alternatives but can contain nicotine and other harmful chemicals.

E-cigarette use among adults overall remained largely unchanged from 2014 to 2018 at around 6 percent of Minnesotans. But the share of young adults who use them spiked from 12.8 percent to 21.9 percent in the same period.

"In the face of new challenges from the tobacco industry, like e-cigarettes, the future of tobacco use in our state is once again uncertain," said Minnesota Health Commissioner Jan Malcolm.

In addition to surveys and public health campaigns, ClearWay provides a Quitplan program that connects smokers to telephone counseling as well as free gum, lozenges, patches and other products to wean people off cigarettes. Quitplan will end in 2020.

In 2014, the majority of smokers (53.4 percent) reported trying to quit in the prior 12 months. But less than half (45.7 percent) tried quitting in 2018.

ClearWay officials said state lawmakers could motivate more people to quit or refrain from smoking through new policies, including raising the minimum age for tobacco purchases to 21. Edina and nearly 20 other municipalities in Minnesota have taken that step at the local level.

Sheldon said the state's 2013 increase in taxes on tobacco products might have influenced a decline in smoking activity in the 2014 survey. But that influence might have eroded by 2018.

ClearWay defined active smokers in its survey as people who have had at least 100 cigarettes in their lifetimes and are currently smoking on a daily or semi-daily basis. More than 60 percent of Minnesotans did not meet this criteria and were labeled as "never smokers," the highest such rate in the history of ClearWay's surveys.

Exposure among nonsmokers to secondhand smoke, which also can increase risks of lung disease, appears to be declining as well. A record 92 percent of Minnesotans, including 66.3 percent of smokers, now have rules against smoking in their homes.

Jeremy Olson • 612-673-7744