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Adult cigarette smoking hits record low

In 2018, cigarette smoking among U.S. adults reached a low of 13.7% — the lowest prevalence recorded since 1965, according to new data published in Morbidity and Mortality Weekly Report.

“This marked decline in cigarette smoking is the achievement of a consistent and coordinated effort by the public health community and our many partners,” Robert R. Redfield, MD, CDC director, said in a press release. “Yet, our work is far from over. The health benefits of quitting smoking are significant, and we are committed to educating Americans about the steps they can take to become tobacco-free.”

To evaluate further trends in tobacco product use among U.S. adults, researchers analyzed data from the 2018 National Health Interview Survey, which polled 25,417 aged 18 years and older about current cigarette smoking and current use of other tobacco products.

Cigarettes most commonly used tobacco product

According to the data, an estimated 49.1 million adults (19.7%) reported current use of a tobacco product in 2018. Cigarettes were still the most commonly used tobacco product (13.7%), followed by cigars, cigarillos or filtered little cigars (3.9%), electronic cigarettes (3.2%), smokeless tobacco (2.4%) and pipes, water pipes or hookahs (1%).

The majority of current tobacco product users (83.8%) reported using combustible products and 18.8% reported using at least two tobacco products.

The researchers also found an increase in e-cigarette use from 2.8% to 3.2% during 2017-2018, which was mostly attributable to an increase in use among young adults aged 18 to 24 years. There was also an increase from 2.1% to 2.4% in smokeless tobacco use during this period.

In 2018, cigarette smoking among U.S. adults reached a low of 13.7% — the lowest prevalence recorded since 1965, according to new data published in Morbidity and Mortality Weekly Report.

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Current cigarette smokers reported having smoked at least 100 cigarettes during their lifetime and smoking every day or some days at the time of the survey.

“The sustained drop in adult smoking is encouraging as we work to reduce tobacco-related disease and death in the U.S. through science-driven policy, compliance and enforcement in addition to public education,” Adm. Brett Giroir, MD, assistant secretary of health and acting FDA commissioner, said in the release. “We remain dedicated to keeping pace with the evolving tobacco product landscape to ensure strong regulatory oversight in light of the increases in youth use of e-cigarette products in the U.S.”

Cigarette smoking by subgroup

Results also revealed several differences among users of tobacco products. In 2018, the prevalence of use of any product was highest among the following groups:

• adults aged 25 to 44 years (23.8%);

• adults with a general education development certificate (41.4%);

• adults without insurance (9%) or with Medicaid (27.8%) or other public insurance (23%);

• adults who were non-Hispanic American Indian/Alaska Native (32.3%), multiracial (25.4%) or black (19.3%);

• lesbian, gay or bisexual adults (29.2%);

• adults with an annual household income less than $35,000 (26.2%);

• adults with a disability (24.3%);

• adults living in the Midwest (23.6%) or the South (21.4%);

• adults who were divorced, separated or widowed (22.6%) or adults who were single, never married or not living with a partner (21.1%); and

• adults who reported serious psychological distress (36.7%).

The researchers also evaluated smoking cessation behaviors among U.S. adult cigarette smokers. They found an increase from 52.8% in 2009 to 55.1% in 2018 in the percentage of adults who made a recent attempt to quit in the past 12 months (P < .001). Similarly, recent successful smoking cessation increased from 6.3% in 2009 to 7.5% in 2018. Further, the percentage of adults who ever smoked 100 cigarettes or more during their lifetime and successfully quit increased from 57.1% in 2009 to 61.7% in 2018.

“Coordinated efforts at the local, state and national levels are needed to continue progress toward reducing tobacco-related disease and death in the United States,” the researchers wrote in MMWR. “Proven strategies include implementation of tobacco price increases, comprehensive smoke-free policies, high-impact anti-tobacco media campaigns, barrier-free cessation coverage and comprehensive state tobacco control programs, combined with regulation of the manufacturing, marketing and distribution of all tobacco products.” – by Melissa Foster

Disclosures: The authors report no relevant financial disclosures.