Origin and use of the 100 cigarette criterion in tobacco surveys

Truly global standards and definitions will likely never exist for tobacco control surveillance. One difference across definitions of smoking status is whether or not a lifetime consumption of 100 cigarettes is a necessary criterion for ever and current smoking. Frequently asked questions about this measure demonstrate a need for information on its development and appropriateness in different settings. This commentary attempts to assemble information on the origin and adoption of this measure and provide some critical commentary on its usefulness. The question has been traced to Canadian and American mortality cohort studies from the mid-1950s. From there it has spread to inconsistent use in many settings. To our knowledge, it was not originally (or since) empirically defined as a threshold of exposure related to health consequences or future smoking risk when used in youth. Anecdotal evidence over several decades, however, shows the question has pragmatic utility in self-report data collection. It is a useful, if somewhat arbitrary, screener for "never regular'' tobacco use among adults, where never smoking needs to be defined in data collection. Use of the criterion may lower prevalence estimates somewhat. Definitions must always be considered when creating time-trends or international comparisons. There are also circumstances where it is inappropriate to exclude individuals who do not meet this criterion from further data collection, or reports. For research in youth, the criterion typically should be used only with more detailed information about experimentation, but it may be a useful additional indicator of established smoking.