prevalence rates for white-collar and blue-collar occupations. How-
ever, among women 45 to 64 years of age, smoking rates vary little
by occupational group (with the single exception of managers and
administrators), with white collar-workers, blue-collar workers, and
homemakers all having approximately the same smoking preva-
lence.

Among men, a more detailed breakdown of smoking by occupation
(Table 3) shows that painters, truck drivers, construction workers,
carpenters, auto mechanics, and guards and watchmen have the
highest rates of current smoking (among occupations having 100 or
more cases in the 1978-1980 NHIS), each exceeding 50 percent. In
contrast, electrical and electronic engineers, lawyers, and secondary
school teachers have the lowest rates of current smoking, all under
25 percent.

Among women, waitresses have a noticeably higher rate of current
smoking than other groups (Table 4), followed by cashiers, assem-
blers, nurses aides, machine operators, practical nurses, and packers
and wrappers-all of whom have rates of current smoking that equal
or surpass 40 percent. The lowest rates of smoking occur among
women employed as elementary school teachers, food service work-
ers, bank tellers, and sewers and stitchers.

Because of the exemplar role of physicians and nurses in regard to
health, their smoking rates are of special interest. Although the
sample is relatively small, physicians have among the lowest rates of
current smoking (18.1 percent). Among nurses, the pattern of
smoking reflects the white-collar-service worker distinction; regis-
tered nurses have among the lowest rates of current smoking, but
practical nurses have among the highest rates (Table 4).

Daily Cigarette Consumption

For men, occupational differences in cigarette consumption do not
follow the same patterns observed for prevalence. On the average,
adult male white-collar smokers consume 24 cigarettes per day,
essentially the same as the number of cigarettes consumed by blue-
collar smokers (23.3) (Table 5). In virtually all occupational sub-
groups, adult men report an average daily consumption exceeding 20
cigarettes. Consumption levels are highest among managers and
administrators and sales workers. These numbers represent daily
cigarette consumption and need to be interpreted with some caution,
as there may be a substantial underreporting of cigarette consump-
tion, and the tendency to underreport may not be constant across
occupational categories.

For women, no difference in consumption is found between white-
collar and blue-collar smokers. On the average, white-collar female
smokers consume 19.5 cigarettes per day, compared with 19.8

26


`FABLE 3.-Specific occupations with highest and lowest
     estimates of current smoking, men, aged 20 to
     64 years, United States, 1978-1980

Occupatio"

Highest rates

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Painters. construction and maintenance (5101

Truck drivers (715)
Construction laborers. except carpenters' helpers (7511
Carpenters (4151

Auto mechamcs 14731

Guards and watchmen (9621

Janitors and sextons (903)

Assemblers WIZI

Electricians 14301
Sales representatives. wholesale trade (282)

Lowest rates

1.   Electrical and electronic engineers 10121                        16.2

2.  Lawyers (031)                                      21.9

3. Secondary school teachers (144)                            24.9

4.  Accountants (001)                                    26.8

5.  Real estate agents and brokers (270)                         27.8

6  Farmers N301)                                       28.1

55.1

53.6

53.0

50.8

50.5

505

49.8

48.7

48.3

48.1

NOTE: Adapted from Table 22 in Technical Addendum Only thme occupatmns with at least 100 men (aged 20
to 641 in the 197%1980 NHIS are Included Numbers in parentheses denote code values from the U.S. Bureau of
the Census 1970 classlticatmn of occupations.

SOURCE: National Center for Health Statistics, Natmnal Health Interview Surveys. 197t%1980 (combmed).
(See Technical Addendum.)

cigarettes for blue-collar smokers, 19.4 cigarettes for homemakers,
and 19.0 cigarettes for service workers. Female smokers employed as
managers or administrators or as craftsmen or kindred workers
report the highest consumption levels, averaging more than 20
cigarettes per day; women employed in professional, technical, or
kindred occupations report lower average daily consumption. How-
ever, like the men, these differences are not large, averaging fewer
than two to four cigarettes per day.

The higher the average daily consumption of cigarettes within an
occupational group, the more likely it is that this group will also
contain a higher percentage of heavy smokers (more than 20 or more
than 40 cigarettes a day). Overall, 72 percent of the male smokers
employed in white-collar occupations reported smoking more than 20

27


TABLE 4.-Specific occupations with highest and lowest
      estimates of current smoking, women, aged 20
      to 64 years, United States, 1978-1980

OccupatKm

Current smokers
IpercentageJ

Highest rates

1   Wamesses 19151

2   Cashiers 13101

3   Assemblers 1602

4   Nurses aides. orderhes. and attendants ,925)

5  .Machine operatives 16901

6   Practxal nurses 19261

i  Packers and wrappers, excluding meat:produce 16431

8  Checkers, exammers. and inspectors; manufacturmg (6101

9  Managers and administrators n e.c. ' 12451

10  Hairdressers and cosmetologtsts 49441


Lowest rates

51.1

44.2

42.9

41.0

41.0

40.3

40.0

39.3

38.0

37.5

I   Elementary school teachers (1421                            19.8

2.   Food service workers 89161                               24.6

3  Secondary school teachers 11441                            24.8

4   Bank tellers 13011                                     25.7

5   Sewers and stlrchers 1663:                                25.8

6  Regtstered nurses 0751                                 27.2

7  Child care workers, excludmg prwate households (9421               28.9

SOTE Adapted from Table Z m Technical Addendum Only those occupatmns with at least 1W women (aged
20 to 64 m the lY7&1YR(l SHIS are mciuded Numb+vs m parentheses denote code values from the U S. Bureau of
the (`ensus 1970 ciass,ficat~un 01 occupations
  Sot elsewhere ciawfied
SOURCE Satmnal Center for Health Srat,st,cs. National Health Inrerwew Surveys. 1978-1880 ~combmedl
See Technical Addendum

cigarettes a day, and over 21 percent reported smoking 40 or more
cigarettes a day (Table 6). Comparable figures for blue-collar
smokers are 72 percent and 18 percent, respectively.

Among adult women (Table 71, the percentage of heavy smokers is
generally lower than for men, with women employed as craftsmen or
kindred workers reporting higher percentages of heavy smoking
than other female occupational groups. The pattern for homemakers
closely parallels that of white-collar workers, but service workers
have slightly lower rates of heavy smoking than white-collar
workers. For both men and women, and across virtually all
occupational groups, smokers 45 years of age or older are more likely

28


TABLE B.-Estimates of average daily cigarette
      consumption among current smokers by sex,
      age, and occupation, aged 20 to 64 years,
      United States, 1978-1980

Occupatuxl

       women                    .Men

TOtal     2&44     4%64     Total     2M4     45-a

Total              19.3      19.1      19.6      23.2      22.2      25 1

Currently employed     19 2      19 0      19 a      23 4      22 4      25.6

White-collar total       19 5      19 1      20 4      24 0      "2 6      26.9

Professional.
technical, and
kindred workers

Managers and
administrators.
except farm

Sales workers

Clerical and
kindred workers

18 3

17 9

19 3

215

19 8

25 4

21 1      206      22.0      26 2      25.2      28.1

19.1      18.0      21.0      25.1      22.7      30.3

19.6      19.4      20.1      22.3      21.8      23.2

Blue-collar total       19.8      19.9      19.4      23.3      22.6     25.1

Craftsmen and
kindred workers

Operatives and
kindred workers

Laborers, except
farm

22.4      22.3      22.5      24.4      23.7      26.1

18.4      22.4      21.7      24.2

25.6      21.5

23.6

service

18.9      21.5

24.7

Farm

19.2



18.9


19.0


18.0


21.2



19.4

19.5



18.1


19.0


18.0


21.2



19.4

18.0

Unemployed

Usual activity,
homemaking

20.9


215



-

20.9


19.9


20.2


20.1



-

21.7

21.3

26 0

19.4

SOURCE: Natmnal Center for Health Statistln, ?iational Health Internew Surveys. 1978-1980 icomblnedl.
(See Technical Addendum.1

to report a higher percentage of heavy smokers than their 20- to 44-
year-old counterparts.

Age of Initiation

Men employed as blue-collar workers initiate smoking approxi-
mately 14 months earlier, on the average, than men employed in
white-collar occupations (Table 8). The earliest ages of initiation are

29


TABLE 6.-Estimates of the percentage of current smokers
       who smoke more than 20 or more than 40
      cigarettes daily, by age and occupation, men,
      aged 20 to 64 years, United States, 1978-1980

                   Total             20.44            45-64

Occupation         220      >a     220     240     220     240

Total              70.6      18.8      66.5      15.7      74.8      24.5

Currently employed     71.4      19.1      69.3      16.1      76.0      25.7

Whit&collar total       72.1      21.1      69.5      16.9      77.6      29.5

Professional,
technical, and
kindred workers

Managers and
administrators,
except farm

Sales workers

Clerical and
kindred workers

66.5      17.3      61.9      12.9      76.7      26.8

79.1      24.5      77.7      20.0      81.6      33.3

74.2      23.7      70.0      17.8      83.0      36.1

64.2      17.2      64.1      16.2      64.6      19.0

Blue-collar total       11.8      18.3      70.1      16.1      76.3      24.1

Craftsmen and
kindred workers

Operatives and
kindred workers

Lalmers. except
farm

75.3      21.2      73.6      18.7      79.6      27.2

694      15.6      68.3      13.5      72.1      21.4

65.7      15.1      63.1      14.2      74.6      17.9

Service             66.6      16.0      63.0      11.5      73.6      24.7

Farm

62.1

16.5

56.3 '

16.6 '

16.4 '

Unemployed          65.9      16.3      61.3      12.9

68.0 '


81.1 '



-

27.6 '

Usual actwlty.
homemakmg

-

-

-

-

' i 1W cases in the denominator lunwelghted sample).
SOURCE Natmnal Center for Health Statistics. Natmnal Health lnterv~ew Surveys. 197&1980 icombined
&e Techmcal Addendum 1

reported by men employed as laborers (16.5 years), operatives or
kindred workers (16.6 years), or craftsmen or kindred workers (16.8
years). Men employed in professional, technical, or kindred occupa-
tions, or as managers or administrators, sales workers, or clerical or
kindred workers report later onset of smoking, ranging between 17.7
and 18.1 years of age.

For women, blue-collar and service workers report a somewhat
earlier onset of smoking than white-collar workers or homemakers

30


TABLE `I.-Estimates of the percentage of current smokers
       who smoke more than 20 or more than 40
      cigarettes daily, by age and occupation, women,
      aged 20 to 64 years, United States, 1978-1980



                   Total             20-44            45-64

Occupation         2 20      _> 40      > 20      140     120 240

Total              58.6     114       57.1      10.8      61.3      12.4

Currently employed     58.5     113       57.2      10.9      61.7      12.3

White-collar total       59.4     118       57.8      11.0      63.2      13.8

Professional.
technical, and
kindred workers

Managers and
administrators.
except farm

Sales workers

Clerical and
kindred workers

52 8     10 8       52.0       9.8      55.0      1B.8

63.4     15.6       59.0      14.6      71.8      17.5

56.8      99       55.0       6.5      59.9 *     16.0 o

61.6

11.5

60.6

11.3


11.5



18.2 *



10.5



50'


11.9


5.5 '


14.4



10.9

643

12.0

Blue-collar total       62.0     11.2       61.2

64.0      10.6

Craftsmen and
kindred workers

Operatives and
kindred workers

Laborers, except
farm

70.0     18 2       67.4 *

75.5 *

18.1'

60.4

99

60.3

60.7

8.4

56.7 '     6.0 *       55.2 '

70.9 *     15.6 o

Service


FarIll

54.6

11.6

53.6

57 1

65.4 '

4.9 '


14.8



113

63.5 '

802'

Unemployed

62.1

61.7

64 4 *

Usual activity.
homemaking

59.1

58.4

60.0

11.0


0.0 *


17.0 o



11.8

* s: 100 cases in the denommator iunweighti samplel
SOURCE. National Center far Health Statmtics Natmnal Health Inrerwew Surveys. 197%1980 lcombmedi
(See Technical Addendum 1

(about 6 months). The earliest age of initiation occurs among women
employed as laborers (17.4 years of age) or operatives or kindred
workers (18.5 years of age), and the latest age of initiation occurs
among women employed in professional, technical, or kindred
occupations (19.4 years of age). Across all occupational categories,
men report an earlier age of initiation than women; this difference is
most pronounced within the 45 to 64 age group.

31


TABLE %-Estimates of average age of initiation of
      smoking among current and former smokers by
      sex, age, and occupation, aged 20 to 64 years,
      United States, 1978-1980

0ccupat10n

       Women                    Men

Total     2M4     45-64     Total     2b44     45-64

Total

Currently employed

White-collar total

Professional.
technical, and
kindred workers

Managers and
administrators,
except farm

Sales workers

Clerical and
kindred workers

Blue-collar total

Craftsmen and
kindred workers

Operatives and
kindred workers

Laborers, except
farm

Service

Farm

Unemployed

Usual act1wty.
homemaking

i9.0

18.6

18.5

18 2

18.1

18.0

18.2

17.6

17.6

21.2

21 .o

20.9

21.2

20.7

21.2

20.9

21.3

22.9

21.1

16.5

21.4

18.4

21.1

21.3

17.2

17.3

17.9

18.1

17.8

17.8

17.7

16.7

16.8

16.6

16.5

17.2

17.0

169

16.9

17.0

17.6

17.6

17.5

16.5

16.5

16.4

16.4

169

16.4

16 4

17 6

18.7

18.0

18.4

18.2

SOURCE Natmnal Center for Health Statistics. Natmnal Health Interview Surveys. 197&1980 tcombinedl.
<See Technail Addendum I

An important inference of the age of initiation reported in Table 8
is that a substantial fraction of smokers report beginning to smoke at
ages when they would be first entering the workforce. This suggests
that a set of influences that promote initiation may be present in the
initial socialization into the workforce.

32


Quitting Behavior

Because cigarette smoking usually begins between the ages of 12
and 25 (US DHEW 1979; US PHS 1973, 1976) the prevalence of
smoking among people 25 years of age or older is determined in large
part by the rate at which they st,op smoking (or die). The percentage
of former smokers (as a portion of "ever smoked") by occupational
group is reported in Table 9. For men, relatively higher percentages
of former smokers are found among professional, technical, and
kindred workers (55.2 percent) and managers and administrators
(47.7 percent)--the same occupational groups reporting lower rates
of current smoking (Table 2). The striking feature for women is the
uniformly lower percentage of former smokers when compared with
men. However, even here the same general pattern can be found;
occupations that have lower rates of current smoking also tend to
have a higher percentage of former smokers. In general, there are
substantial differences by occupational category, with white-collar
workers of both sexes having a higher percentage of former smokers
than blue-collar workers. This white-collar-blue-collar difference is
most pronounced among men. Among women, homemakers tend to
mirror the pattern of white-collar women.

It does not appear that the lower percentage of former smokers in
blue-collar occupations occurs simply because blue-collar workers
are less likely than white-collar workers to attempt to quit. Among
men, white-collar current smokers are more likely to report "a
serious attempt" to quit smoking (Table lo), but these differences are
typically only half as large as the white-collar-blue-collar differences
in the proportion of former smokers. Among women, the white-
collar-blue-collar differences are relatively small and show a mixed
pattern.

Recent Changes in Smoking Behavior

A comparison of smoking estimates for the period 1970-1980
reveals several interesting changes by occupational group and sex
(Table 11). Among men, there was a 19 percent proportionate decline
in smoking prevalence between 1970 and 1980 for white-collar
workers (40.8 vs. 33.0 percent), compared with a 14 percent decline
for blue-collar workers (55.0 vs. 47.1 percent). Occupations with the
largest decline in male smoking include professional, technical, and
kindred occupations (21 percent decline) and farm workers (20.7
percent decline); the unemployed (3.6 percent) and service workers
(10.9 percent1 had the smallest proportionate declines in smoking
prevalence.

Among white-collar women, there was a proportionate reduction
in smoking prevalence of 11.6 percent between 1970 and 1980 (36.1

33


TABLE 9.-Estimates of the percentage of former smokers
      by sex, age, and occupation, aged 20 to 64
      years, United States, 1978-1980

Occupation          Total

Women                    Men

20-44     4S64     Total     2cL44     4S64

Total              33.2      30.2      35.7      40.0      34.2      48.7

Currently employed

31.4

30.1

34.2

40.8

35.1

50.5

Whitecollar total       33.8      32.7      36.4      48.1      42.7      56.4

Professional,
technical, and
kindred workers

Managers and
administrators.
except farm

Sales workers

Clerical and
kindred workers

41.1      40.1      43.8      55.2      51.8      61.3

30.2      30.9      28.6      47.7      39.9     57.9

32.0      30.9      34.1      39.1      32.8     49.1

31.3      29.4      35.9      40.9      36.4      47.8

Blue-collar total

24.9

22.8

29.8

34.8

29.5

45.4

Craftsmen and
kindred workers

Operatwes and
kindred workers

Laborers. except
farm

238      24.9      21.4'     36.7      31.1      46.8

24.6      21.8      30.9      33.8      28.8      44.1

307'

270'

53.5'

29.7

25.0

41.9

sen~lce             26.2      24.2      62.2      32.0      27.0     40.0

Farm

325'

25.7

25.0'


22.7



30.9

30.5'

Unemployed

39.7

45.7


30.0

38.3      51.5

26.0      40.6

Usual activity,
homemakmg

33.5

37.2

-

-

SOURCE Sarnnal Center for Health Statistics. Natmnal Health Interview Surveys, 1978-1980 Icombinedl.
See Technral Addendum I

vs. 31.9 percent), but blue-collar women showed virtually no change
in smoking prevalance (1.0 percent proportionate increase).

The greater rate of decline in smoking prevalence for men has
produced two fundamental changes in the occupational smoking
patterns in this country. In 1970, men employed in professional,
technical, or kindred occupations or as managers or administrators
had a higher rate of smoking than their female counterparts. By the
end of the decade, this pattern had been reversed; a slightly higher
percentage of women in these two occupational groups now smoke

34


TABLE lO.-Estimates of the percentage of current smokers
      who have ever seriously attempted to quit by
      sex, age, and occupation, aged 20 to 64 years,
       United States, 1978-1980

Occupation

       Women                   Men

TOtal     2M4     4s64     Total     2@44     4s

1 otal              59 3      60.6      56.8      602      59 1      62.4

Currently employed     58.4      60.3      54 1      601      59.2      62.0

Wh6z-collar total       59.7      61.7      54 a      636      627      65.3

Pr&SSiO"al.
techmcal, and
kindred workers

Managers and
administrators,
except farm

Sales workers

Clerical and
kindred workers

62.2      622      62 1      688      666      73.8

61.0      644      54.8      60.2      59.5      61.5

59.3      63.4      520      609      59.2      64.5

58.3      60.6      525      648      66.6      613

Bluesollar total       58.7      588      584      586      577      61.0

Craftsmen and
kindred workers

Operatives and
kindred workers

Laborers, except
farm

57.1      52.2'     679'     59 4      569      60.7

58.8      60.1      55.6      57 9      567      61.1

62.6'     619'

57.4


77.5'


66.4



60.8

58.9


77.3 *


649



60.9

689'


540


78.9 o


74.8'



60.7

57 4      56.0      62.2

Service

55.1

53.7

57.9

Farm

610      613'     60.7'

Unemployed

609

Usual activity,
homemaking

585



-

69 1 o

* c 100 cases I" the denommator lunweqhti sample1
SOURCE: National Center for Health StatMxs. National Health Intervww Surveys, 197%1980 rcombinedl
t&e Technical Addendum /

cigarettes. If the previous lo-year trends prevail, by the end of this
decade women are likely to reach parity with men in the prevalence
of smoking among blue-collar workers (as an aggregate) and clerical
and kindred workers, and to surpass men in smoking prevalence in
two additional occupational categories: craftsmen and kindred
workers and laborers.

As is shown in Table 12, only one specific occupational group for
men showed a net gain in smoking prevalence between 1970 and

35


TABLE Il.-Estimates of the percentage of current smokers
      by sex and occupation, aged 20 to 64 years,
       United States, 1970-1980

Occupation

   1970            19761980        Net change

M       w       M       W       M       W

Total              48.1      36.0      40.9      33.2      -1.2      -2.8

Currently employed     47.9      36.5      39.9      33.3      -8.0      -3.2

White-2oliar total       40.8      36.1      330      31.9      -7.8      4.2

Professional.
technical, and
kmdred workers

Managers and
administrators,
except farm

Sales workers

Clerical and
kindred workers

32.5      29.0      25.7      26.5      4.8      -2.5

443      42.8      36.3      38.3

48.5      378      40.6      33.3

4.5

4.5

45.4      37.9      37.7      33.2

4.7

Blue-collar total       55.0      37.7      47.1      38.1

-8.0

-7.9



-7.7


-7.9



-7.1



-7.8



-10.4


-5.8


-8.2


-2.0

+a.4

Craftsmen and
kindred workers

Operatives and
kmdred workers

Laborers. except
farm

53.2      40.1      46.1      44.6

+4.5

56.4      37.7      48.6      37.0

-0.7

57.2      28.2'     46.8      36.2

t8.0

Service

533


39.7


55.9

39.4

20.8

47.5


315


53.9

37.4

-2.0

Farm

22.6

Unemplqwi

42.3

39.6

+ 1.8


-2.7

Usual actwity.
homemaking

35.3              33.0              -2.3

*  1W cases m the denominator lunwelghted sample1
SOURCE Satmnal Center for Health Statistics. Sational Health lnterwew Surveys. 1970 and 197E1980
icombmedr <See Technical Addendum.,

1980 (i.e., electricians), but painters, farm laborers, stock clerks and
storekeepers, and deliverymen and routemen had net reductions in
excess of 10 percentage points. Among women (Table 13), three
occupational groups showed a net increase in smoking prevalence
between 1970 and 1980 (practical nurses, cashiers, and packers and
wrappers), but relatively large net declines in smoking prevalence
occurred among receptionists, waitresses, bank tellers, secretaries,
and hairdressers and cosmetologists.

36


TABLE 12.-Specific occupations with largest estimated net
      changes in smoking prevalence between 1970
      and 1980, men, aged 20 to 64 years, United
        States

Occupation

Net change U97C-1980'1
in current smoking

Largest "et gains

1. Electricians (4301~4211                                 + 3.9

Largest net reductions

1.  Painters. constructmn and maintenance r51011~4951

2.  Farm laborers, wage workers G322)/19021

3. Stockclerks and storekeepers 1381Vr3501

4.  Dehverymen and routemen (7051it650

5. Foremen n.e.c ' 14411/(430)

6. Machinists 14611/(465)

7. Checkers. examiners. and mspectors;

-17.1

-14 5

-12 0

-11.6

43.9

a.7

  manufacturing (6101:(6431

8.  Managers and admmistratcrs n.e.c. ' t245V(2901

9. Assemblers 1602~0631 I

10. Accountants @01~/@00l

437

4.1

-7.0

-6.8

NOTE: Adapted from Table 23 m Techmcal Addendum Only those c-xupatmns with at least 1M men (aged 20
to 641 in the 197&1980 NHIS are included Numbers in parentheses represent the occupatvxxtl codes used in the
1970-1980 HIS and the 1970 HIS.
' Not elsewhere classified.
SOURCE: National Center for Health Statistics. National Health Interweu Surveys. 1970 and 1978-1980
kombmedr tSeeTechmca1 Addendum.1

The lo-year changes in daily consumption patterns show that
among white-collar men, there was a 1.8 percent proportionate
increase in the percentage of smokers who averaged 20 or more
cigarettes a day, compared with a 3.3 percent increase for blue-collar
men (Table 14). Professional, technical, and kindred workers, clerical
and kindred workers, and the unemployed showed a net decrease in
the percentage of smokers of 20 or more cigarettes a day. The overall
pattern is one of modest differences.

For women, the proportionate increase in number of smokers of 20
or more cigarettes a day was 7.4 percent for white-collar workers
(55.3 vs. 59.4 percent) and 4.8 percent for homemakers (56.4 vs. 59.1
percent). Service workers showed virtually no change between 1970
and 1980. Among blue-collar women however, the proportionate
increase in smokers of 20 or more cigarettes a day was a much larger
20.4 percent (51.5 vs. 62.0 percent). High proportionate increases in
20-plus smokers occurred among women employed as operatives or

37


TABLE 13.-Specific occupations with largest estimated net
      changes in smoking prevalence between 1970
       and 1980, women, aged 20 to 64 years, United
        States

Occupation

Net change (197C-1980,
in current smoking

Largest net gains


1. Practical nurses 19261/@42)

2. Cashiers t310V1312)

3  Packers and wrappers, except meat and produce (643Vf693)

Largest net reductions

14.3

+3.7

+2.6

1  Receptionists l364Vt3411                                 -10.6

2   Wamesses (915vt8751                                   -9.0

3.  Bank tellers 13011/(305)                                  -9.0

4.  Secretaries n.e c. I (372)/(342)                              a.1

5.  Hairdressers and cosmetologists (944)/(843)                      -7.4

6.  Cooks. except private household 1912W325)                      -5.5

7.  Typists ~391)1(360)                                     -4.9

8.  Managers and administrators n.e.c. ' L`245VG90)                   -4.2

9.  Bookkeepers (305Vf3101                                 -4.2

NOTE Adapted from Table 23 in Techmcal Addendum. Only those occupations wtb at least 100 women (aged
20 to 64) m the 197b1980 NHIS are included Numbers in parentheses represent the occupational codes used m
the 197G1980 HIS and the 1970 HIS
`Sot elsewhere cla.wfied
SOURCE. National Center for Health Statistics. National Health Interview Surveys. 1970 and 197b1980
Icombmedl. l&e Technical Addendum.1

kindred workers (37.8 percent) or craftsmen or kindred workers (33.2
percent). If these lo-year trends continue, by the end of this decade
female blue-collar smokers may surpass their male counterparts in
the percentage classified as moderate to heavy smokers (i.e., smoking
more than 20 cigarettes a day).

Among men, the net change in smokers averaging more than 40
cigarettes a day generally parallels that of 20-plus smokers (Table
15). Only the unemployed show a net decrease in the percentage of
current smokers averaging 40 or more cigarettes a day. Among
women, the net changes in heavy smoking between 1970 and 1980
are relatively modest.

Birth Cohorts

Although there has been a lo-year decline in smoking prevalence
for male blue-collar and white-collar workers and for female white-

38


TABLE 14.-Estimates of percentage of current smokers
     who smoke 20 or more cigarettes daily, by sex
      and occupation, aged 20 to 64 years, United
       States, 1970-1980

   1970            197bl980        Net change

M       W       M       W       M       W

Total              685

69 5

White-collar total

70.9

Pr0fess10nal.
technical, and
kmdred workers

Managers and
administrators,
except farm

Sales workers

Clerd and
kindred workers

69.0

75.5      58.1      79.1      63.4      -3.6     -5.3

69.8      52.2      74.2      56.8      -4.4     -4.6

66.0

Blue-collar total

69.5

Craftsmen and
kindred workers

Operatives and
kmdred workers

Laborers. except
farm

72.0

68.3

64.2

Service

65.2

Farm

60.5

Unemployed

67.5

Usual activity.
homemaking

55 1

54 4

55 3

47 5

58.2

51.5

52.7 '

51.1

66.6 *

53.2

50.1 *


49.7



56 4

70 6

714

72.2

665

64.2

71 a

75.3

69.4

65.7

66.6

62.1

65.9

58 6

58 5

59.4

52.8

616

62.0

70.0

60.4

56.7 *

54.6

64.4 *

62.1

59.1

-21

-19

+ 1.3

-2 5

-1.8

t2.3

1-3.3

+l.l

+I.5

il.4

+1.6


-1.6

-

-35

-4.1

-4.1

+5.3

t3.4

+ 10.5

+ 17.3

+ 19.3

-9.9

+ 1.4

+ 15.3


- 12.4

+ 2.7

* <_ 100 cases I" the denommator (unuwghted sample;
SOURCE National Center for Health Statlstlcs. National Health lnterwew Surveys. 197&19m (combinedr
(See Technical Addendum.1

collar workers, service workers, and homemakers, this does not
necessarily indicate that rates of lung cancer (and other cigarette-
linked diseases) will decline in the near future. What transpires
during the next 10 to 20 years with regard to lung cancer incidence
and mortality will be determined by those birth cohorts now
entering the ages at which substantial numbers of lung cancer
deaths occur. Figures 1 through 6, based on data from the combined
1978-1980 NHIS, present the prevalence of smoking among succes-

39


TABLE 15.-Estimates of percentage of current smokers
      who smoke 40 or more cigarettes daily, by sex
      and occupation, aged 20 to 64 years, United
       States, 1970-1980

Occupation

   1970            19761980        Net change

M       W       M       W       M       W

Total

15.7

8.0

18.8

11.4

-3.1

-3.4

Currently employed     15.9       7.8      19 1      113      t3.2     +3.0

White-collar total

18 4

8.1

21.1

11.8

-2.8

-3.7

Professional,
technical, and
kmdred workers

Managers and
administrators.
except farm

Sales workers

Clerical and
kmdred workers

14.9       4.9      17.3      10.8      -2.4     + 5.9

22 8       9.8      24.5      15.6      - 1.7     +5.8

18.4       7.2      23.7       99      r5.3     +2.7

is.0       9.2      17.2      11.5      t2.2

Bluesollar total

15.0

70

18.3

11.2

c3.3

~2.3


+4.2

Craftsmen and
kmdred workers

Operatwes and
kindred workers

Laborers, except
farm

16.1       96'     21.2      18.2      t5.1     18.6

14.8       6.6      15.6       9.0      7 0.8     +2.4

118

???? o


8.5


10.1 *


10 9



81

15.1       6.0 *     73.3      -4.1

Service

145

16.0

116


4.9 '


148



11.3

f1.5

t3.1

Farm

10 3

16.5

t6.2      -5.2

Unemployed          184

16.3

Usual actwxg.
homemaking

-2.1



-

T3.9

-

~3.2

' 1W cases m rhe denominator funwelghted samplel
SOURCE Natuxml Center ior Health Statistics. Natmnal Health Interview Surveys. 1970 and 1978-1980
~combmed~ t.See Technical Addendum I

sive cohorts born during each decade of the first half of this century.
The prevalence of smoking for each cohort is presented from 1900 to
1978 for men and women and for whites and blacks of both sexes.
Men who are 50 to 60 years of age, the 1921-1930 birth cohort, are at
the age at which the incidence of lung cancer increases rapidly.

Among white-collar workers (Figure 71, this cohort of men is
currently smoking at a higher rate than the cohort they are
replacing (1911-1920). The 1921-1930 cohort exhibits an exceptional-


----

1900    1910   1920    1930    1940    1950    1960    1970    1990

                      Yeer

FIGURE I.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
       U.S. men, 1900-1978

SOURCE Data from National Center for Health Statistics, National Health Interview Surveys, 197S-1980
(combined).

ly high peak prevalence of 74.6 percent-which has since declined to
36.3 percent-but is still higher than the current 28.3 percent
prevalence estimate for the 1911-1920 cohort. However, one encour-
aging note is that the 1921-1930 cohort is currently smoking less
frequently at age 50 to 60 than the 1911-1920 cohort did when they
were 50 to 60 years of age (36.3 vs. 40.1 percent). If the 1921-1930
cohort of white-collar men achieves the same proportionate reduc-
tion in smoking during the next 10 years as the 1911-1920 cohort did
during the previous 10 years, by 1990 the 1921-1930 birth cohort will
be smoking at a lower rate than the 1911-1920 cohort did in 1978. In
a continuation of this general trend, all cohorts of white-collar men

41


751  i   /      / i

70 4      !            I      I


6%                 1911-1920 "
       d
60'                     /I    I I

I i     I      I

30                           1     I '
                                  I i

25                     1

1900    1910    1920    1930    1940    1950    1960    1970    1960

                       YW

FIGURE 2.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
       white U.S. men, MOO-1978
SOURCE: Data from National Center for He&h Statistics. National Health Intemiew Surveys, 197M980
b3mbinedL

after the 1921-1930 cohort have lower rates of smoking than
previous cohorts at comparable ages, and also have successively
lower rates of peak prevalence.

The same general pattern in evidence for white-collar men also
applies to blue-collar men (Figure 8). The 1921-1930 birth cohort has
a higher current and peak smoking prevalence than the 1911-1920
cohort they are replacing. However, the 1921-1930 cohort is current-
ly smoking at a lower rate than the previous cohort (1911-1920) was
at the same age (10 years ago). Similarly, the 1931-1940 cohort is
currently smoking at a higher rate than the 1921-1930 cohort, but
less frequently when compared with the 1921-1930 cohort 10 years

42


If
$ 35


  30


  25

20


15


10


5


0

1900    1910    1920    1930    1940    1950    1960    1970    1080
                        Ye&II

FIGURE S.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
      black U.S. men, 1900-1978
SOURCE: Data from National Center for Health Statistica, National Health Interview Surveys. 1978-1980
Icombined)

earlier. After the 1921-1930 cohort, each successive birth cohort has
a lower peak prevalence, suggesting less total cigarette exposure
than for the previous cohort.

If present trends in male smoking continue, successive birth
cohorts of white-collar and blue-collar workers will arrive at the ages
of increasing lung cancer incidence with a lower rate of current
smoking and lifetime exposure than the previous birth cohorts. For
white-collar men, this pattern began with the 1911-1920 cohort, but
blue-collar men exhibit this pattern beginning with the 1921-1930
cohort. This same pattern of decreasing smoking prevalence across
successive birth cohorts also characterizes each main subcategory

43


65 -   I i

  55


  60


  45
$40
i 35
Il.

30


  25


  20


  15


  10


  5


  0

1900    1910    1920    1930    1940    1950    1960    1970    1960
                       YW

FIGURE 4.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
       U.S. women, NO&1978
SOURCE Data from Sationai Center for Health Statistics, National Health Interview Surveys, 197&19EKl
lcombinedl

within the white-collar and blue-collar categories, including profes-
sional, technical, and kindred workers, managers and administra-
tors, craftsmen and kindred workers, and operatives and kindred
workers (See Technical Addendum, Figures 13 through 16).

Among white-collar women the same general pattern is found as is
in evidence for men (Figure 9). The peak prevalence of smoking is
highest in the 1931-1940 cohort; however, beginning with the 1921-
1930 cohort, each successive birth cohort of women employed in
white-collar occupations has a lower rate of smoking in 1978 than
the previous cohort did 10 years earlier. This pattern is especially
pronounced for the 1941-1950 and 1951-1960 cohorts, and is similar

44


65


60

30


25


20

0

1900    1910    1920    1930    1940    1950 1960    1970 1960
                       Yew

FIGURE B.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
       white U.S. women, 1900-1978
SOURCE: Data from National Center for Health Statistics, Natmnal Health Interview Surveya. 197b1980
eombinedl.

to that found among professional, technical, and kindred workers
and clerical and kindred workers (Technical Addendum, Figures 17
and 18). Among homemakers, the largest category of women aged 20
to 64, this same general pattern is also found (Figure 10).
Although the overall birth cohort patterns for white-collar women
and homemakers are similar to those of men in regard to current
smoking, one important difference should be noted. For men, the
birth cohort with the highest peak prevalence is the 1921-1930
cohort, but for female white-collar workers and homemakers this
occurs with the 1931-1940 cohort.

45


70

65

60,

55-
504

45
,
40                                                 1941-1950
                                                  1931-1940
35                                                 1951-1960
30                                                 1921-1930

25                                                 1911-1920
20

15


10                                                 1901-1910
5


0

1900    1910    1920    1930 1940    1060   l&O   1970 1960

FIGURE B.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
       black U.S. women, 1966-1978
SOURCE, Data from Netlord Center for Health Statistics, National Health Interview Surveys, 1978-1980
(combine8

In contrast with white-collar women and homemakers, the 1941-
1950 cohort of blue-collar women has the highest peak prevalence
(Figure 11). The 1931-1940 and 1941-1950 cohorts each exhibit
approximately the same smoking rates in 1978 as did the previous
cohort 10 years earlier. Only the 1951-1960 cohort of blue-collar
women has significant potential to redirect this trend of increasing
prevalence downward, and this will depend on whether this cohort
can sustain its current downward trend in smoking prevalence.

Service workers represent another important category of em-
ployed women, and their birth cohort smoking patterns resemble
white-collar workers in some ways and blue-collar workers in other

46


60

55

50

45

240
6
2 36

30

25

20


15


10


5

0

-t-
1901-1910

                                             -G
4       I  I  I   I   I        hx
      I  /?f
                    I L


                                   /
                                   I
     I   d      I    I L-

             I      i      1'
           / /    1
                             `I
                 A        I! I
                1 i    -. 1951-19ia
    ,/J I        I

+.-G. ..T ..,. ,..T T 7 ,.., r....q . ..y<.?.-,,~~.. ,.....  i

1901-1910

1960   rno   I!& 1930 l&o 1950 19&J    1970 lee0

                       YeU

FIGURE `I.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
      U.S. men employed in white+oIIar occupations,
        BOO-1978

SOURCE: Data from National Center for Health Statistics, National Health Interview Surveys. 197ElW0
(combined).

ways (Figure 12). Like white-collar women, female service workers
reached their highest peak prevalence with the 1931-1940 birth
cohort, and subsequent cohorts have experienced much lower peaks.
However, like blue-collar women, the 1921-1930 cohort of female
service workers continued to smoke at a higher rate in 1978 than the
previous cohort at the same age. This pattern becomes more
pronounced with the 1931-1940 cohort, but then reverses, with the
1941-1950 cohort reporting a lower smoking prevalence in 1978 than
the previous cohort 10 years ago.

47


T

1911-1920

o\          j                  `, ,r
    -  !  4 (-~,,~--c-,.e,-$-h I/ - /  A--
1900    1910   1920 1930 1940 1950 1960    1970    1960
                       YecU

FIGURE &-Changes in the prevalence of cigarette
     smoking among successive birth cohorts of
     U.S. men employed in blue-collar occupations,
        1900-1978

SOURCE: Data from Natmnd Center for Health Stati?.tics. Natmnal Health Interview Surveys. 1978-1980
(combmed).

Race

Among black men there are almost twice as many blue-collar
workers as white-collar workers (Table 16). This contrasts with white
men, who fall about equally into the white-collar and blue-collar
categories. Additionally, blacks of both sexes are more heavily
concentrated in the service category of workers, making this
category an important one to consider when examining occupational
differences in smoking by race. Black men are also almost twice as

48


1900    1910    1920    1930    1940    1950    1960    1970    lB60

                      YBU

FIGURE S.-Changes in the prevalence of cigarette
      smoking among successive birth cohorts of
      U.S. women employed in white-collar
      occupations, 1900-1978
SOURCE. Data from National Center for Health Statistics, National Health Interview Surveys. 1978-1980
Icombined).

likely as white men to fall into the "Not Employed" category, which
includes both unemployed people and those "not in the labor force."

The differences in smoking prevalence between black men and
white men parallel the differences between blue-collar and white-
collar workers (Table 171, with black men having a considerably
higher smoking prevalence (47.7 percent) than white men (40.2
percent). Among men, blue-collar workers have considerably higher
smoking rates than white-collar workers within each racial group,
with black male blue-collar workers having the highest smoking
prevalence (52.1 percent).

49


25

1900    1910    1wO    1939    '940    1950    1960    1970    1990

                      YecV

FIGURE lO.-Changes in the prevalence of cigarette
     smoking among successive birth cohorts of
      U.S. women classified as homemakers, 1!IOO-

1978

SOURCE: Data from National Center for Health Statistica. National Health Interview Surveya, 197b1990
(combined).

Among black women, there is little difference in smoking preva-
lence between occupations, although homemakers have a somewhat
higher smoking rate (Table 17). However, among white women, the
expected white-collar, blue-collar, service worker differences prevail,
with blue-collar and service workers having a higher smoking
prevalence (39.6 and 38.7 percent, respectively) than white collar
workers (32.0 percent).

As shown in Table 17, black workers are considerably less likely
than their white counterparts to be heavy smokers (smoking 20 or
more cigarettes daily). This holds true for all categories of workers

50