Smokers’ populations broken down

WARREN — The U.S. Food and Drug Administration reports 36 percent of adults in Trumbull County smoke. Last year, that number was 19 percent, according to numbers available from the Centers for Disease Control Prevention.

Robert Pinti, deputy health commissioner for the Warren City Health District, said he was shocked by the 17 percent increase in one year.

“That doesn’t even sound anywhere near close to where it should be,” he said. “The progress was going pretty well for quite some time. The first thing that comes to my mind is, what could have made that significant of a difference?”

Pinti offered the increased popularity of vaping, especially among the younger generation, and the FDA does not distinguish between vapes with nicotine and cigarettes. According to a 2016 surgeon general’s report, vaping has tripled in popularity with middle- and high-schoolers in the past seven years.

As these young tobacco users age into the survey, which considers persons 18 and above, they could account for some of the jump in the smoking population.

Another explanation might be the CDC’s decision to change its survey method, used by the County Health and Roadmaps report that figured the 19 percent in 2017, between 2016 and 2017. A different methodology could produce unusual differences in year-to-year or survey-to-survey reports.

Still, though, FDA spokesman Michael Felberbaum said Trumbull County has some of the highest usage rates in the country, something survey methods or vaping alone can’t explain. The demographics of Warren, however, paint a picture of a community extremely vulnerable to smoking.

For example, as people reach higher levels of education, the rate of smoking drops.

According to the CDC, adults with a GED smoke at a rate of 34 percent, while adults with an associate degree smoke at a rate of 16.6 percent. Then, representing the largest drop, adults with a bachelor’s degree smoke at a rate of 7.4 percent.

According to the U.S. Census Bureau’s 2016 data, 18 percent of adults in Trumbull County 25 years old and older have a bachelor’s degree, more than 14 percent below the national average.

Trumbull County’s less educated population corresponds to a high rate of poverty, with 17 percent living below or at the poverty line, 5 percent above the national average.

And 26 percent of impoverished Americans smoke, while only 14 percent of Americans living above the poverty line smoke.

As poverty correlates with physical and mental health problems, so too does smoking. Thirty-one percent of cigarettes are smoked by mentally ill adults and 48 percent of mentally ill people living below the poverty line smoke.

“(People with mental illnesses) are a real difficult population to try to do a smoking cessation program with,” said April Caraway, executive director of the Trumbull County Mental Health and Recovery Board. “So often they say, ‘But it makes me feel better, it calms me.'”

The board contracts with 23 organizations in Trumbull County to provide services to the mentally ill and addicts. According to their 2016 report, 12,304 people used their treatment services, compared to 7,295 in 2006. Though the jump in clients is likely to be in part due to increased service and reduction of stigma, one treatment category is a particular problem in Trumbull County.

Coinciding with the opioid epidemic, which claimed more than 100 lives in 2017, the fourth-most-treated disorder among their adult clients was opioid use disorders.

In turn, three out of four people with opioid disorder smoke cigarettes. Caraway said in general illicit drug use coincides with cigarette use.

“It is very common. We are seeing a lot of people who are using heroin, cocaine, meth. It really seems part of the addiction that if they can’t get one drug, they’ll get another,” Caraway said. “Usually smoking is part of it, just for anyone with an addiction, smoking seems to be part of it.”