Health >> Tobacco >> Tobacco: Notes & Sources

Tobacco: Notes & Sources


Any tobacco use (teens): For 2010 King County and Washington State data for teens, “any tobacco use” included any one or more of the following: cigarettes, cigars, cigarillos, or little cigars; chewing tobacco, snuff, or dip; or any tobacco that tastes like fruit, candy, or alcohol. The 2010 survey questions differed in several ways from those in previous years. For example, a question about hookah use was dropped in 2010.  Hookah use has traditionally been higher in King County than in other counties, so comparisons of “any tobacco use” with data from previous years will not be valid.

Confidence interval (also called "error bar") is therange of values that includes the true value 95% of the time. If the confidence intervals of two groups do not overlap, the difference between groups is statistically significant (meaning that chance or random variation is unlikely to explain the difference).            

King County regions: The geographic boundaries of the four King County sub-regions (North, Seattle, East, and South) are defined by the aggregation of zip codes for adults and by the aggregation of school districts for teens.

Race/Ethnicity: Federal standards mandate that race and ethnicity (Hispanic origin) are distinct concepts requiring 2 separate questions when collecting data from an individual. "Hispanic origin" is meant to capture the heritage, nationality group, lineage, or country of birth of an individual (or his/her parents) before arriving in the United States. Persons of Hispanic ethnicity can be of any race. Communities Count's terms for racial/ethnic groups are derived from those used by the U.S Census Bureau in 2010.

  • Communities Count terms:  Hispanic, Non-Hispanic, White Non-Hispanic, Black, American Indian/Alaska Native (AIAN), Asian, Native Hawaiian/Pacific Islander (NHPI), White, and Multiple Race (Multiple). Persons of Hispanic ethnicity can be of any race and are included in other racial categories. Racial/ethnic groups are sometimes combined when sample sizes are too small for valid statistical comparisons of more discrete groups. 
  • 2010 Census terms: Hispanic or Latino, Not Hispanic or Latino, White alone (Not Hispanic or Latino),  Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, White, Some Other Race, and Two or More Races.
  • Surveys collecting data on teens do not follow the above convention of asking separate questions about race and ethnicity. Categories are therefore mutually exclusive, so teens are considered White non-Hispanic, Black non-Hispanic, etc.  Teens who choose multiple categories are considered multiple race.


Data have been averaged over 3 or 5 years to enable comparisons across groups that would otherwise be too small for detection of statistically significant results.

New! Interact with Communities Count data using Weave, our new data visualization tool. Zoom into maps for more detail -- from Washington State to King County all the way down to census tracts or zip codes. Mouse over entries to see labels and values (plus upper and lower bounds of confidence intervals). Right click to export or print images. Weave (Web-based Analysis and Visualization Environment) is an open-source, web-based platform developed at the Institute for Visualization and Perception Research at the University of Massachusetts Lowell in partnership with the Open Indicators Consortium.

Second-Hand Smoke: Exposure to second-hand smoke also poses a significant health risk.  A study in King County found that residents in households with annual income below $10,000 were 7 times more likely than those with income above $75,000 to report 1 or more days of smoke exposure inside the home. 

Statistical Significance: Unless otherwise noted, any difference mentioned in the text is statistically significant (unlikely to have occurred by chance).

Teen Cigarette smoking and total tobacco use among 8th, 10th, and 12th graders: Washington State data (2010 Healthy Youth Survey)


Smoked cigarettes in the past 30 days

Any tobacco use in past 30 days



Margin of Error


Margin of Error

8th Grade





10th Grade





12th Grade






Data Sources

Adult smoking data are from the Washington State and national Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a random telephone interview survey of non-institutionalized adults ages 18 and older that has been conducted in King County every year since 1987. Starting in 2003, the BRFSS was administered in English and Spanish. The limitations of an English-and-Spanish-only telephone survey include the following: a) people who do not have a land line telephone or who do not speak English or Spanish are excluded, and b) people who have less education and lower incomes are underrepresented. For additional information on the Washington State BRFSS, see:     For additional information on the national BRFSS, see

Local and state data on teen tobacco use are from the Washington State Healthy Youth Survey (, a survey of public school students in grades 6, 8, 10, and 12. National data are from the 2009 National Youth Risk Behavior Surveillance System ( Data from local and national surveys are not directly comparable due to differences in ages/grades of students surveyed, survey questions, and other methodological differences.

Other Sources

Addiction to tobacco most likely during adolescence: Johnston LD, O’Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future, national results on adolescent drug use: overview of key findings, 2009. Bethesda (MD): National Institute on Drug Abuse; 2010.

City Health Profiles provide demographic and health information for 25 geographic areas in King County – mostly large cities (e.g., Seattle, Bellevue), groups of small cities (Bothell/Woodinville), or combinations of cities with nearby unincorporated areas (e.g., Renton/Fairwood). Each report has seven sections:

  • Demographics
  • General health status
  • Leading causes of death
  • Health risk factors and chronic diseases
  • Injury and violence-related mortality
  • Maternal and infant health
  • Access to care and preventive services

School District Health Profilesprovide demographic and health information for several school districts in King County.  The profiles were developed by Public Health-Seattle and King County in collaboration with school districts for the purpose of informing school policy-makers and administrators, health and wellness planners, and the public about student health indicators at the district level.The data come from the Healthy Youth Survey, which is administered every 2 years to students in grades 6, 8, 10, and 12.  Each profile report has 6 sections: 

  • Demographics of survey respondents
  • Obesity, physical activity, and dietary behaviors
  • Mental health
  • Personal safety and violence
  • Alcohol, tobacco, and other drug use and second-hand smoke exposure
  • 3 additional indicators, selected by each district (examples: adults to turn to for help when feeling sad or hopeless; family skipped meals in past 12 months due to finances; bullied in the past 30 days because of face, ethnicity, or national origin) 
Disparities in Adult Smoking

 Health Impacts of Tobacco: Smoking & Tobacco Use Fact Sheet,Centers for Disease Control and Prevention,, accessed 12/01/2012.

Hookahs: Smoking and Tobacco Use Fact Sheet, Centers for Disease Control and Prevention,, accessed 01/16/2013.

Policy Interventions to Reduce Teen Hookah Smoking:  Morris DS, Fiala SC, Pawlak R. Opportunities for Policy Interventions to Reduce Youth Hookah Smoking in the United States. Prev Chronic Dis 2012;9:120082. DOI:, accessed 1/23/2013.

Public Health Data Watch: Tobacco Use in King County:  This May, 2012 report includes charts comparing income and racial disparities in cigarette smoking in the 15 largest counties in the United States.  Disparities in King County are greater than those in the other counties., accessed 1/23/2013.

Tobacco Prevention Program, Public Health - Seattle & King County: Provides information about King County tobacco prevention efforts, including grants, news releases, an interactive online no-smoking policy guide for affordable housing providers, and other helpful links.