- Percentage of population over age 18 that smokes on a regular basis.
- Percentage of adults who are smokers (self-report smoking at least 100 cigarettes in their lifetime and currently smoke).
Smoking is the prevalence of adults who smoke cigarettes regularly. It is defined as the percentage of adults who self-report smoking at least 100 cigarettes in their lifetime and who currently smoke. The 2015 ranks are based on self-report data from CDC’s 2014 Behavioral Risk Factor Surveillance System (BRFSS). Because of the 2011 change in BRFSS methodology, smoking prevalence from the 2012 Edition onward cannot be directly compared to estimates from previous years (see Methodology).
The percentage of adults who currently smoke varies from a low of 9.7% in Utah to 26.7% in West Virginia. In the United States, 18.1% of adults currently smoke, down from 19.0% in 2014. For smoking prevalence by state and age, gender, race/ethnicity, urbanicity, income or education level, see Health Disparities within States.
Public Health Impact
Smoking has a well-documented adverse impact on overall health. It is the leading cause of preventable death in the United States; approximately 14 million major medical conditions among adults are attributed to smoking. Annually, more than 480,000 people die from cigarette smoking with 41,000 deaths caused by exposure to secondhand smoke. Another 10.9 million adults suffer from a serious smoking-related illness. Smoking damages nearly every body organ and causes respiratory disease, heart disease, stroke, cancer, preterm birth, low birthweight, and premature death. Smokers lose an average of 10 years of life because of their smoking. Furthermore, smoking harms not only smokers, but also it affects non-smokers by causing respiratory infections in children and heart disease and lung cancer in adults. Nearly $170 billion in direct medical expenses and $156 billion in lost productivity are attributed to smoking annually in the United States.2
Smoking is a lifestyle behavior that can be influenced by support from the community and clinical intervention. Cessation, even in longtime smokers, can have profound benefits on current health status and long-term outcomes. When smokers quit, the risk of a heart attack drops sharply after just 1 year. Stroke risk can fall to about the same as a nonsmoker’s after 2 to 5 years. Risks for cancer of the mouth, throat, esophagus, and bladder are cut in half after 5 years. And the risk for dying of lung cancer drops by half after 10 years. Those who quit before age 35 reduce their risk of premature death to almost the same level as non-smokers.6
A variety of interventions are effective for prevention and smoking cessation. Over the past several decades, policy efforts such as excise taxes and smoking bans have been effective in increasing cessation, preventing non-smokers from starting and decreasing smoking-related health problems., Due to the widespread negative health effects of secondhand smoke, reducing the prevalence of smoking and creating smoke-free environments can have a profound impact on communities.6 For examples of communities preventing and controlling tobacco use, see CDC’s Division of Community Health resource center. Smokefree.gov provides free, accurate, and evidence-based information and professional assistance to help support the immediate and long-term needs of smokers trying to quit.
 Rostron BL, Chang CM, Pechacek TF. Estimation of cigarette smoking–attributable morbidity in the United States. JAMA Intern Med. October 13, 2014; doi:10.1001/jamainternmed.2014.5219.
 Centers for Disease Control and Prevention (CDC). Smoking and tobacco use: fast facts. April 15, 2015. http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/ . Accessed July 7, 2015.
 Rostron BL, Chang CM, Pechacek TF. Estimation of cigarette smoking-attributable morbidity in the United States. JAMA Intern. Med. 2014. http://archinte.jamanetwork.com/article.aspx?articleid=1915870. Accessed October 16, 2014.
 Centers for Disease Control and Prevention (CDC). Smoking and tobacco use. June 2, 2012. http://www.cdc.gov/tobacco/. Accessed August 3, 2012.
Jha P, Ramasundarahettige C, Landsman V, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N. Engl. J. Med. 2013;368(4):341-50. http://www.ncbi.nlm.nih.gov/pubmed/23343063. Accessed August 11, 2014.
 US Department of Health and Human Services. Atlanta, GA: Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.
 Xu X, Bishop EE, Kennedy SM, Simpson SA, Pechacek TF. Annual healthcare spending attributable to cigarette smoking: an update. Am J Prev Med. 2014. http://www.prevent.org/data/files/actiontoquit/ajpm_annual_healthcare_spending_smoking,%2012-10-14.pdf. Accessed July 7, 2015.
 Chaloupka FJ. Effectiveness of tax and price policies in tobacco control. Tob Control. 2011;20(3):235.
 Naiman A. Association of anti-smoking legislation with rates of hospital admission for cardiovascular and respiratory conditions. CMAJ. 2010;182(8):761.
 Healthy People 2020. 2020 topics & objectives–objectives A-Z. US Department of Health and Human Services. http://www.healthypeople.gov/2020/topicsobjectives2020/default.aspx . Updated March 8, 2013. Accessed October 22, 2013.