The U.S. adult smoking rate fell to a historic low of 13.9 percent in 2017, reversing a one-year uptick, the U.S. Centers for Disease Control and Prevention said Tuesday.

The rate reflects that about 34 million adult Americans still smoke traditional cigarettes. The rate was 15.8 percent in 2016 and 15.1 percent in 2015.

The data comes in the CDC’s 52nd annual National Health Interview survey. It measures adults who smoke every day, some days or have ever smoked.

The CDC said the 2017 percentage represents an estimate, which could rise or decline slightly with the final report. The agency has no formal comment on the data.

The national adult smoking rate was 20.9 percent as recently as 2005 and 24.7 percent in 1997.

A historic low of 17.9 percent of North Carolina adults are considered as smokers, as well as 13.1 percent of youths, the N.C. Department of Health and Human Services said in September.

“Using statewide county-level data, for each percentage decrease in the adult smoking rate in North Carolina, there is a corresponding decrease each year of about 1,900 deaths statewide, and 67 deaths in Forsyth County,” said Dr. John Spangler, professor of family and community medicine at Wake Forest Baptist Medical Center.

“Additionally, for each percentage decrease in the adult smoking rate, Forsyth could potentially see a $46 million reduction annually in healthcare costs, while the state could see a $1.3 billion reduction.”

As has been the case in recent years with the annual adult and youth smoking rate reports, the key factors contributing to the decline depends on the anti-tobacco or anti-smoking perspective.

Anti-tobacco advocates cite the influence of “evidence-based strategies that have been implemented at the federal, state and local levels.”

The strategies include: tobacco tax increases; comprehensive smoke-free laws; well-funded tobacco prevention and cessation programs; mass media campaigns, health insurance coverage for tobacco cessation treatments; and laws raising the tobacco sale age to 21.

In 2017, the N.C. General Assembly raised the amount of funds for tobacco prevention programs by $1 million over the 2017-19 budget years for a total of $2.1 million. The additional funding is going toward “developing strategies to prevent the use of new and emerging tobacco products, including electronic cigarettes, by youth and people of childbearing age.”

The 2017 results “show once again that the fight against tobacco is entirely winnable if policy makers at all levels fully implement proven strategies,” said Matt Myers, president of the Campaign for Tobacco-Free Kids.

Meanwhile, anti-smoking advocates point out that the CDC data releases did not examine the impact of e-cigs on smoking rates.

E-cig use entered the U.S. retail mainstream in 2012 and has chipped away — particularly top-seller Juul and No. 2 Vuse of R.J. Reynolds Vapor Co. — steadily at the traditional cigarette market share.

“In keeping with the government’s relentless attack on e-cigarettes, the welcome decline in smoking was not linked to National Institutes of Health survey data showing that higher proportions of current vapers are former smokers,” said Brad Rodu, a professor of medicine at the University of Louisville and an anti-smoking advocate.

The NIH reported there were 8.91 million adult vapers in 2014, of which 71.1 percent were current smokers, 22 percent were former smokers and 6.9 percent were never smokers.

Just two years later, there 7.75 million adult vapers, of which 51.7 percent were current smokers, 34.8 percent were former smokers and 13.5 percent were never smokers.

“The only surprising thing is that those who have been fighting, rather than facilitating the move to low risk alternatives to cigarettes, still refuse to acknowledge something so obvious,” said David Sweanor, an adjunct law professor at the University of Ottawa and author of several e-cig and other tobacco and health studies.

“While vaping products cannot claim sole credit for the reported decline in smoking, the refusal to acknowledge their role requires willful blindness about shops that are now present in virtually every town in the country.

“It also requires a refusal to simply visit such shops and talk to the customers.”

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