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Smoking Trend Report

Cigarette smoking is the leading cause of preventable death in the United States, accounting for close to half a million deaths each year. This report presents descriptions, figures, and links to more detailed tables on trends and current patterns of the use of cigarettes and other tobacco products among adults and children.

Overall Smoking Trends

Trends in Cigarette Smoking Rates

Smoking rates have fallen significantly for both youth (from 36.4% in 199 to 10.8% in 2015) and adults (from 42.6% in 1966 to 15.5% in 2016). Data from CDC's NHIS and YRBS.

Long-term, smoking rates have fallen:

  • 64 percent among adults, from 42.6 percent in 1965 to 15.5 percent in 2016. Data table
  • 70 percent among youth, from 36.4 percent in 1997 to 10.8 percent in 2015. Data table

Over the last five years, smoking rates have fallen:

  • 21 percent among adults, from 19.0 percent in 2011. Data table
  • 40 percent among youth, from 18.1 percent in 2011. Data table

Trends in Number of People Who Smoke and Have Quit

There have been more former than current smokers since 2002 (54.3 million former and 37.8 current smokers in 2016), and more than half of ever smokers have quit (59.0% as of 2016). Data from CDC's NHIS.

The 37.8 million current smokers in 2016 marked the second time in a row there were less than 40 million current smokers in the United States since the government began collecting this date in 1997.

Trends in Average Number of Cigarettes Smoked Per Day

The number of cigarettes smoked per day continues to decrease among current smokers. The percent smoking more than 24 cigarettes per day peaked in 1980 at 28.8% and has generally decreased consistently since then to 6.7% in 2016. The percent smoking 15 to 24 cigarettes per day peaked in 1974 at 43.2% and has generally decreased consistently since then to 28.6% in 2016. The percent smoking less than 15 cigarettes per day was lowest in in 1980 at 29.1% and has generally increased consistently since then to 64.6% in 2016. Data from CDC's NHIS.

Between 1974 and 2016, among current smokers: Data table
  • The proportion of people smoking more than 24 cigarettes a day decreased 74 percent from 25 percent to 7 percent.
  • The proportion of people smoking 15-24 cigarettes a day decreased 34 percent from 43 percent to 29 percent.
  • The proportion of people smoking fewer than 15 cigarettes a day increased 104 percent from 32 percent to 65 percent.

Decreases in heavy smoking rates (more than 24 cigarettes a day) from 1974 to 2015 have not been equal across the demographic groups shown in this data table.

Trends in Electronic Cigarette Use

From 2014 to 2016, the number of adults: Data table

  • Who had ever used electronic cigarettes increased 21 percent from 12.6 percent to 15.2 percent.
  • Who were current users of electronic cigarettes decreased 14 percent from 3.7 percent to 3.2 percent.
  • These changes were not consistent across the demographic groups shown in this data table.

From 2011 to 2015, the number of high school students:

  • Who had ever used electronic cigarettes increased 702 percent from 4.7 percent to 37.7 percent.
  • Who were current users of electronic cigarettes increased 967 percent from 1.5 percent to 16.0 percent. Data table

Trends in Adult Use of Other Tobacco Products

Any Tobacco Product

From 2002 to 2015, current use of any tobacco product (cigarettes, cigars, pipe tobacco, and smokeless tobacco): Data table

  • Decreased 27 percent among those ages 18-25, from 45.3 percent to 33.0 percent.
  • Decreased 18 percent among those aged 26 or older, from 29.9 percent to 24.5 percent.
  • Decreased 23 percent among men ages 18-25, from 52.1 percent to 40.0 percent.
  • Decreased 18 percent among men aged 26 or older, from 37.3 percent to 30.7 percent.
  • Decreased 33 percent among women ages 18-25, from 38.4 percent to 25.9 percent.
  • Decreased 19 percent among women aged 26 or older, from 23.2 percent to 18.8 percent.

Smokeless Tobacco

From 2002 to 2015, current use of smokeless tobaccoData table

  • Increased 13 percent among those ages 18-25, from 4.8 percent to 5.4 percent.
  • Remained stable among those aged 26 or older at 3.2 percent.
  • Increased 6 percent among men ages 18-25, from 9.4 percent to 10.0 percent.
  • Decreased 3 percent among men aged 26 or older, from 6.3 percent to 6.1 percent.
  • Increased 167 percent among women ages 18-25, from 0.3 percent to 0.8 percent.
  • Increased 20 percent among women aged 26 or older, from 0.5 percent to 0.6 percent.

Cigars

From 2002 to 2015, current use of cigarsData table

  • Decreased 19 percent among those ages 18-25, from 11.0 percent to 8.9 percent.
  • Decreased 7 percent among those aged 26 or older, from 4.6 percent to 4.3 percent.
  • Decreased 25 percent among men ages 18-25, from 16.8 percent to 12.6 percent.
  • Decreased 14 percent among men aged 26 or older, from 8.5 percent to 7.3 percent.
  • Decreased 2 percent among women ages 18-25, from 5.2 percent to 5.1 percent.
  • Increased 50 percent among women aged 26 or older, from 1.0 percent to 1.5 percent.

Pipe Tobacco

From 2002 to 2015, current use of pipe tobaccoData table

  • Increased 64 percent among those ages 18-25, from 1.1 percent to 1.8 percent.
  • Remained stable among those aged 26 or older at 0.8 percent.

Trends in Youth Use of Other Tobacco Products

Any Tobacco Product

From 2002 to 2015, current use of any tobacco productData table

  • Decreased 41 percent among middle school students, from 13.3 percent to 7.9 percent.
  • Decreased 7 percent among high school students, from 28.2 percent to 26.3 percent.

Cigarettes

From 2002 to 2015, current use of cigarettesData table

  • Decreased 77 percent among middle school students, from 9.8 percent to 2.3 percent.
  • Decreased 59 percent among high school students, from 22.5 percent to 9.3 percent.

Cigars

From 2002 to 2015, current use of cigarsData table

  • Decreased 73 percent among middle school students, from 6.0 percent to 1.6 percent.
  • Decreased 26 percent among high school students, from 11.6 percent to 8.6 percent.

Hookah

From 2011 to 2015, current use of hookahsData table

  • Doubled among middle school students, from 1.0 percent to 2.0 percent.
  • Increased 80 percent among high school students, from 4.0 percent to 7.2 percent.

Smokeless Tobacco

From 2002 to 2015, current use of smokeless tobaccoData table

  • Decreased 61 percent among middle school students, from 3.6 percent to 1.4 percent.
  • Decreased 5 percent among high school students, from 5.9 percent to 5.6 percent.

Snus

From 2011 to 2015, current use of snusData table

  • Remained the same at less than 1 percent among middle school students.
  • Decreased 57 percent among high school students, from 2.8 percent to 1.2 percent.

Dissolvable Tobacco

From 2011 to 2015, current use of dissolvable tobaccoData table

  • Remained the same at less than 1 percent among middle school students.
  • Remained the same at less than 2 percent among high school students.

Pipes

From 2002 to 2015, current use of pipesData table

  • Decreased 89 percent among middle school students, from 3.5 percent to 0.4 percent.
  • Decreased 69 percent among high school students, from 3.2 percent to 1.0 percent.

Current Smoking Comparisons and Disparities

Smoking Rates by Sex

In 2016, the smoking rate of 17.5% among men was significantly greater than the rate of 13.5% among women. Data from CDC's NHIS, 2016.

Smoking Rates by Age

Smoking rates increase with age until around middle age, then decrease. In 2016, 13.1% of those ages 18 to 24 were current smokers, 17.6% of those 25 to 44, 18.0% of those 45 to 64, and 8.8% of those 65 and older. Data from CDC's NHIS 2016.

Smoking Rates by Race/Ethnicity

In 2016, smoking rates were highest among American Indian and Alaska Natives at 34.1%, followed by blacks at 16.9%, whites at 16.7%, Hispanics at 10.7%, and Asians at 9.4%. Data from CDC's NHIS, 2016.

Smoking Rates by Education

In 2016, smoking rates were lowest for those with a bachelor degree or higher at 6.5%, followed by 16.8% for those with some college, 21.4% for those with a high school diploma or GED, and 23.2% for those who did not complete high school. Data from CDC's NHIS 2016.

Smoking Rates by Income

In 2016, smoking rates were highest for those with a ratio of family income to the poverty threshold of less than one at 25.3%, followed by those with a ratio of one to two at 21.2%, and those with a ratio of two or greater at 12.7%. Data from CDC's NHIS 2016.

Based on 2014 poverty thresholds from the Census Bureau, which depend on size and age composition of family.

Smoking Rates by Sexual Identity

In 2016, smoking rates were lowest among straight females at 13.5%, followed by straight males at 17.3%, gay, lesbian, or bisexual females at 17.9%, and gay or bisexual males at 23.85%. Data from CDC's 2016 NHIS.

Smoking Rates by Health Insurance Coverage

In 2016, among adults ages 18 to 65, 12.7% of those with private health insurance smoked, compared to 28.6% who were uninsured, and 26.8% with Medicaid. Data from CDC's 2016 NHIS.

Smoking Rates by Urban vs Rural Residency

Dual Use of Cigarettes and E-Cigarettes by Adults

Current smokers have the highest rates of ever (42%) and current (11%) use of e-cigarettes, followed by former smokers (11% ever, 5% current), with the lowest e-cigarette rates (5% ever, 1% current) among never smokers.

In 2016, among current smokers, 11% were current e-cigarette users, 42% had ever used e-cigarettes, and 47% had never used e-cigarettes. Among ever smokers, 5% were current e-cigarette users, 11% had ever used e-cigarettes, and 84% have never used e-cigarettes. Among never smokers, 1% were current e-cigarette users, 5% had ever used e-cigarettes, and 94% had never used e-cigarettes. Overall, 3% were current e-cigarette users, 12% had ever used e-cigarettes, and 85% had never used e-cigarettes. Data from CDC's 2016 NHIS.

Among current users of e-cigarettes, 52 percent also currently smoke, and 34 percent formerly smoked.

In 2016, among current e-cigarette users, 52% were current smokers, 34% were former smokers, and 14% were never smokers. Among ever e-cigarette users, 53% were current smokers, 21% were former smokers, and 26% were never smokers. Among never e-cigarette users, 9% were current smokers, 22% were former smokers, and 69% were never smokers. Overall, 15% were current smokers, 22% were former smokers, and 62% were never smokers. Data from CDC's 2016 NHIS.

Various Rates by State

Adult Smoking Rates by State

In 2016, smoking rates among adults ranged by state from a low of 8.8 percent in Utah to a high of 24.8 percent in West Virginia. Data table

Adult Smokers Who Made a Quit Attempt by State

In 2016, the percent of adult current smokers who stopped smoking for one day or more in the past year because they were trying to quit ranged from a low of 49.9 percent in Vermont to a high of 64.1 percent in South Carolina. Data table

Adult E-Cigarette Use by State

In 2016, current use of e-cigarettes among adults ranged from a low of 2.4 percent in the District of Columbia to a high of 6.7 percent in Oklahoma. Data table

Youth Smoking and Tobacco Use by State

In 2015, smoking rates among high school students from the 41 states with comparable data ranged from 4.8 percent in Rhode Island to 16.9 percent in Kentucky. The most recent data available was from prior to 2015 for eight states and the District of Columbia, and three states only survey a single grade of high school students. Data table

In 2015, use of any tobacco product among high school students from the 37 states with comparable data ranged from 12.5 percent in Wisconsin to 40.8 percent in West Virginia. The most recent data available was from prior to 2015 for one state, data was not available for eleven states and the District of Columbia, and one state only surveys a single grade of high school students. Data table

In 2015, smoking rates among middle school students from the 21 states with comparable data ranged from 0.8 percent in Connecticut to 5.2 percent in Louisiana. The most recent data available was from prior to 2015 for 27 states and the District of Columbia, data was not available for one state, and six states only survey a single grade of middle school students. Data table

Economic Cost of Smoking

The total economic cost of smoking is estimated to be over $332 billion each year, including close to $176 billion in health care expenditures in 2013, $151 billion in lost productivity annually from 2005-2009, and $5.7 billion in lost productivity from exposure to secondhand smoke in 2006.

The total economic cost from smoking is over $332 billion each year. This includes $175.9 billion in health care expenditures in 2013, $150.73 billion in lost productivity from 2005 to 209, and 5.68 billion in lost productivity in 2006.

Sources

  • Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 1965-2016. Analysis performed by the American Lung Association Epidemiology and Statistics Unit using SPSS software.
  • Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance Survey, 2015-2016. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.
  • Substance Abuse and Mental Health Services Administration. Office of Applied Studies. National Survey on Drug Use and Health, 2002-2015.
  • U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. 2014.
  • Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2011-2015. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software. 2002-2009 from MMWRs.
  • Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2015. Morbidity and Mortality Weekly Report. June 10, 2016; 65(SS-06).

    Page Last Updated: April 27, 2018

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