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The percentage of American adults who smoke cigarettes has dropped to the lowest level ever recorded, according to a new study.
About 9.9% of U.S. adults reported smoking cigarettes in 2024, a drop from 10.8% in 2023, according to an analysis of National Health Interview Survey data published Tuesday in the journal NEJM Evidence.
The findings mark the first time the adult smoking rate in the U.S. has fallen to the single digits, a milestone public health officials have pursued for decades. The decline suggests the U.S. may be moving closer to the Healthy People 2030 goal — a national public health target — of reducing adult smoking to 6.1%.
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“If this decline continues, the target might be met or exceeded by 2030,” the researchers, led by Israel Agaku, Ph.D., an Atlanta-based public health researcher and professor, wrote in the paper.
The percentage of U.S. adults who smoke cigarettes fell to 9.9% in 2024, the lowest level ever recorded, according to a new study. (iStock)
But the milestone does not mean tobacco use has disappeared. About 25.2 million adults still smoke cigarettes — the most commonly used tobacco product in the United States — while nearly 47.7 million adults, or 18.8% of the population, use at least one tobacco product, including cigarettes, cigars or e-cigarettes, according to the researchers.
The study analyzed responses from more than 29,500 adults in 2023 and 32,600 adults in 2024 who participated in the National Health Interview Survey, a nationally representative household survey and the most recent national data available on adult tobacco use.
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The drop in cigarette smoking helped drive a decline in overall combustible tobacco use, which includes cigarettes and cigars. About 12.6% of adults used combustible tobacco in 2024, down from 13.5% the year prior, according to the study.
The use of other tobacco products such as e-cigarettes remained largely unchanged. (iStock)
However, the prevalence of other tobacco products — including e-cigarettes and cigars — did not significantly change between 2023 and 2024, according to the study.
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“The lack of change in cigar and e-cigarette use calls for intensified implementation of comprehensive tobacco control policies addressing all products,” the researchers wrote.
The study also found that tobacco use was not evenly distributed across the population.
Tobacco use was higher among certain occupational groups, including adults working in agriculture, construction and manufacturing. (iStock)
Men reported significantly higher tobacco use than women, with just over 24% of men using at least one tobacco product compared with nearly 14% of women, according to the study.
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Tobacco use was also higher among certain demographic and occupational groups, particularly adults in industries such as agriculture, construction and manufacturing.
The highest tobacco use was reported among people with a General Educational Development certificate at 42.8%, as well as rural residents, low-income individuals and people with disabilities.
Young adults were more likely to use e-cigarettes than traditional cigarettes. Nearly 15% of adults ages 18 to 24 reported using e-cigarettes, compared with 3.4% who smoked cigarettes, according to the study.
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Some experts note the findings reflect a shift in nicotine use rather than a disappearance of addiction.
Young adults were more likely to use e-cigarettes than traditional cigarettes, according to the study. (iStock)
John Puls, a psychotherapist and addiction specialist who runs Full Life Comprehensive Care in Boca Raton, Florida, said the trend away from cigarettes but continued use of tobacco and e-cigarettes mirrors what he sees with patients.
“Most of my patients use e-cigarettes and various vape products,” Puls, who was not involved in the study, told Digital. “They’re easier to conceal, can be used almost anywhere and deliver a much more powerful nicotine dose.”
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Cigarette smoking, on the other hand, is “more socially unacceptable than it has ever been,” he added. “I work with many patients who are addicted to nicotine, and the vast majority have never smoked a cigarette.”
Public health officials emphasize that no tobacco product is considered safe. (iStock)
Puls said this pattern is especially common among adolescents and young adults and is concerning because cigarettes typically deliver about 1 to 2 milligrams of nicotine, while some vape products can contain 20 to 60 milligrams.
“There’s also a perception that e-cigarettes are a safer form of smoking, which is contributing to the decline in cigarette smoking,” Puls added.
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Health officials stress that no tobacco product is safe, including e-cigarettes, according to the Centers for Disease Control and Prevention.
Cigarette smoking is the leading cause of preventable disease and death in the U.S. and is responsible for about one in three cancer deaths, the agency says.
Public health officials say quitting support, smoke-free laws and tobacco taxes are key tools for reducing smoking rates. (iStock)
Overall, sustained public health measures — including smoke-free laws, tobacco taxes and access to quitting support — remain critical to further reducing tobacco use, the researchers noted.
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The study had several limitations, including changes to how smokeless tobacco has been defined over the survey years, reliance on self-reported data and less reliable estimates for some smaller subgroups.
Digital has reached out to Agaku for comment.
