Smoking cigarettes and exposure to secondhand tobacco smoke kill an estimated 443,000 Americans each year, according to the Centers for Disease Control and Prevention (CDC). Since the passage of a federal law imposing high taxes on cigarettes, total consumption of the product has steadily declined by 32.8 percent.


But a new study from the CDC shows that over roughly the same period, the use of pipe tobacco and large cigars — tobacco items not taxed as highly as cigarettes — has risen dramatically.


The study used data from the Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau to calculate consumption for all forms of smoked tobacco products and to estimate the per unit use of each type. According to the report, total consumption of all smoked tobacco products — which includes cigarettes, roll-your-own tobacco, pipe tobacco and cigars — declined by 27.5 percent between 2000 and 2011.


Yet despite the overall decline, the consumption of non-cigarette smoked tobacco products increased by 123 percent.


The use of roll-your-own tobacco declined by 56.3 percent over the study period, but pipe tobacco use rose. The largest changes for this switch took place from 2008 through 2011, coinciding with the 2009 increase in the federal tobacco excise tax that created tax disparities between product types, and made pipe tobacco less costly than roll-your-own tobacco. During those years, roll-your-own use fell from the equivalent of 10.7 billion cigarettes to 2.6 billion, down 75.7 percent. Pipe tobacco consumption rose from the equivalent of 2.6 billion to 17.5 billion, a 6.73-fold increase.


The agency also noted large changes in the use of small and large cigars. From 2000 through 2011, the use of small cigars fell 65 percent and consumption of large cigars rose by a factor of 3.33.


Like with pipe tobacco, the most notable increase took place from 2008 through 2011 when small cigar use fell from 5.9 billion to 0.8 billion, dropping 86.4 percent, while the consumption of large cigars rose by a factor of 2.26, from 5.7 billion to 12.9 billion. Again, since 2009 large cigars have been less heavily taxed than small cigars and manufactured cigarettes.


The study, "Consumption of Cigarettes and Combustible Tobacco—United States, 2000-2011," was published Aug. 3 in Morbidity and Mortality Weekly Report.