The Shrinking Use of Tobacco

By Jane Farrell

Good news: Cigarette smoking has reached the lowest level ever recorded among U.S. adults.

Only 14 percent of Americans  smoke, according to the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the National Cancer Institute (NCI).

Still, about 47 million (one in five) Americans used a tobacco product in 2017, including smoked, smokeless and electronic tobacco products, the statistics showed.

The estimated 14 percent of U.S. adults (34 million) who are current (“every day” or “some days”) cigarette smokers in 2017 are down from 15.5 percent in 2016,and represent a 67 percent decline since 1965, the year after the landmark Surgeon General’s report on the dangers of  smoking.

“This new all-time low in cigarette smoking is a tremendous public-health accomplishment.”

A particularly notable decline occurred among young adults between 2016 and 2017: About 10 percent of young adults aged 18 to 24 years smoked cigarettes in 2017, down from 13 percent in 2016.

“This new all-time low in cigarette smoking among U.S. adults is a tremendous public health accomplishment – and it demonstrates the importance of continued proven strategies to reduce smoking,” said CDC Director Robert Redfield. “Despite this progress, work remains to reduce the harmful health effects of tobacco use.”

Data from the 2017 National Health Interview Survey (NHIS), released in the CDC’s Morbidity and Mortality Weekly Report (MMWR), describe the range and scale of tobacco-product use among U.S. adults. These products include cigarettes, cigars, e-cigarettes, hookah/water pipes/pipes, and smokeless tobacco. The survey has been used to assess current cigarette smoking among U.S. adults since 1965, but ongoing surveillance of other tobacco products began more recently.

The tobacco field has changed in the past several years to include newly developed products. In 2017, cigarettes were the most commonly used product (14 percent) among U.S. adults, followed by cigars, cigarillos, or filtered little cigars (3.8 percent); e-cigarettes (2.8 percent); smokeless tobacco (2.1 percent); and pipes, water pipes, or hookahs (1 percent). Of the 47 million adults who currently use any tobacco products, about 9 million (19 percent) reported use of two or more tobacco products. The most common product tobacco combinations were cigarettes and e-cigarettes.

By subgroups, use of any tobacco product was highest among:

People with a General Education Development (GED) certificate (42.6%).

People who were uninsured (31.0%), insured by Medicaid (28.2%), or received some other public insurance (26.8%).

Non-Hispanic American Indian/Alaska Native (29.8%), multiracial (27.4%), white (21.4%), or black adults (20.1%)

Lesbian, gay, or bisexual adults (27.3%).

People with an annual household income under $35,000 (26.0%).

People living with a disability (25.0%).

Adults living in the Midwest (23.5%) or the South (20.8%).

People divorced, separated, or widowed (23.1%), or people who were single, never married, or not living with a partner (21.0%).

Among adults who reported serious psychological distress, about 2 in 5 adults (40.8 percent) used any tobacco product, one of the most marked disparities in tobacco use, compared with about 1 in 5 (18.5 percent) of those without serious psychological distress. Such strategies and interventions include CDC’s Tips From Former Smokers® campaign, the FDA’s “Every Try Counts” campaign and toll-free national quitline (1-800-QUIT-NOW). These coordinated efforts, in combination with strategies that address the diversity of tobacco products, can reduce tobacco-related disease and death in the United States.

Cigarette smoking remains the leading preventable cause of death and disease in the United States, and is responsible for the overwhelming burden of death and disease from tobacco use. Cigarette smoking kills an estimated 480,000 Americans each year, and about 16 million Americans suffer from a smoking-related illness. However, no form of tobacco use is risk-free. For more information or for free help quitting, click here to visit the NCI’s’s “Smokefree” website.