Atlanta–Cigarette smoking among U.S. adults has reached an all-time low of 13.7% in 2018 — a decline of approximately two-thirds in the more than 50 years since the first Surgeon General’s report warned of the health consequences of smoking. Yet, new data released in today’s Morbidity and Mortality Weekly Report show that nearly 1 in 7 U.S. adults smoke cigarettes. Many use other tobacco products.
The study found that an estimated 49.1 million (19.7%) U.S. adults currently used a tobacco product in 2018. Cigarettes remained the most commonly used tobacco product (13.7%), followed by cigars, cigarillos, or filtered little cigars (3.9%); e-cigarettes (3.2%); smokeless tobacco (2.4%); and pipes, water pipes, or hookahs (1.0%). Most tobacco current product users (83.8%) reported using combustible products (cigarettes, cigars, pipes, water pipes, or hookahs), and 18.8% reported using two or more tobacco products.
During 2017–2018, e-cigarette use among adults increased from 2.8% to 3.2%, a reversal from the decline observed among adults during 2014-2017. The increase during 2017-2018 was primarily driven by an increase in e-cigarette use among young adults (18-24 years old), which rose from 5.2% in 2017 to 7.6% in 2018. Smokeless tobacco use also increased from 2.1% to 2.4% among adults during the same time period. No significant changes occurred in the use of the other tobacco products included in the study.
Cigarettes remain the most commonly used tobacco product among adults. The study found that disparities exist. By subgroups, use of any tobacco product in 2018 was highest among:
- Adults 25-44 years old (23.8%).
- Adults with a General Education Development (GED) certificate (41.4%).
- Adults who were uninsured (29.9%), insured by Medicaid (27.8%), or received some other public insurance (23.0%).
- Non-Hispanic American Indian/Alaska Native (32.3%), multiracial (25.4%), white (21.9%), or black adults (19.3%).
- Lesbian, gay, or bisexual adults (29.2%).
- Adults with an annual household income under $35,000 (26.2%).
- Adults living with a disability (24.3%).
- Adults living in the Midwest (23.6%) or the South (21.4%).
- Adults divorced, separated, or widowed (22.6%), or adults who were single, never married, or not living with a partner (21.1%).
- Adults who reported serious psychological distress (36.7%).
Among adult cigarette smokers, those making a quit attempt in the past 12 months increased from 52.8% in 2009 to 55.1% in 2018. Recent successful smoking cessation increased from 6.3% in 2009 to 7.5% in 2018, and the quit ratio, or the percent of adults who ever smoked 100 cigarettes or more during their lifetime who have quit smoking, increased from 51.7% in 2009 to 61.7% in 2018.