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Smoking
Smoking in United States
United States

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United States Value:

14.4%

Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days

Smoking in depth:

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Smoking by State

Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days




Smoking Trends

Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days

Trend: Smoking in United States, 2022 Annual Report

Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days

United States
Sources:
  • CDC, Behavioral Risk Factor Surveillance System
  • Office of the Surgeon General, Department of Health and Human Services
  • National Heart, Lung and Blood Institute, US Department of Health and Human Services
View All Populations

Smoking

Trend: Smoking in United States, 2022 Annual Report

Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days

United States
Sources:
  • CDC, Behavioral Risk Factor Surveillance System
  • Office of the Surgeon General, Department of Health and Human Services
  • National Heart, Lung and Blood Institute, US Department of Health and Human Services






About Smoking

US Value: 14.4%

Top State(s): Utah: 7.2%

Bottom State(s): West Virginia: 22.0%

Definition: Percentage of adults who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days

Data Source and Years: CDC, Behavioral Risk Factor Surveillance System, 2021

Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2023.

Smoking cigarettes harms health. As the leading cause of preventable death and disease in the United States, cigarette smoking is responsible for more than 480,000 deaths yearly. Smokers live 10 years less than non-smokers, on average. Currently, more than 16 million Americans live with a disease caused by smoking. 

Smoking damages nearly every organ and is associated with multiple types of cancer, heart disease, stroke, respiratory diseases such as chronic obstructive pulmonary disease and diabetes. Smoking can affect non-smokers as well. Exposure to secondhand smoke is responsible for 41,000 deaths among U.S. adults every year. The annual cost of smoking to the U.S. is around $132.5-$175.9 billion in medical expenses and $151 billion in lost productivity due to premature death. 

In recent years, there has been an increase in the popularity of e-cigarettes, especially among youth. E-cigarettes often contain nicotine and other cancer-causing chemicals and have been linked to lung injuries, hospitalizations and death. In October 2021, the U.S. Food and Drug Administration (FDA) authorized the marketing of certain electronic nicotine delivery system devices as a tool to help addicted adults smoke fewer cigarettes.

The prevalence of smoking in adults is higher among: 

  • Men compared with women.
  • Adults ages 45-64 compared with adults ages 65 and older and ages 18-44.
  • American Indian/Alaska Native adults, who have a prevalence nearly 5 times higher than Asian adults.
  • Adults with less than a high school education, who have a prevalence nearly 5 times higher than college graduates; the prevalence was significantly lower with each increase in education level.
  • Adults with an income less than $25,000, who have a prevalence 3 times higher than those with an income of $75,000 or more; the prevalence was significantly lower with each increase in income level.
  • Adults living in non-metropolitan areas compared with those living in metropolitan areas.

Additional populations with high prevalences of smoking include:

  • Adults with a disability or self-reported limitation.
  • Adults who report serious psychological distress, such as feelings of sadness, nervousness and worthlessness.
  • Lesbian, gay and bisexual adults.
  • Adults living in states with a high prevalence of e-cigarette use.

Quitting smoking can have profound benefits on current and long-term health at any age, even among heavy and lifelong smokers. A variety of interventions are effective for smoking prevention and cessation.

Over several decades, excise taxes and smoking bans have effectively prevented non-smokers from starting, increasing cessation and decreasing smoking-related health problems. Raising the legal tobacco purchase age is one way to decrease the number of teens who become smokers. In December 2019, the Federal Food, Drug and Cosmetic Act was changed to raise the legal tobacco age from 18 to 21. 

County Health Rankings & Roadmaps provides a list of evidence-based strategies to address health issues. Smokefree.gov provides free, accurate and evidence-based information as well as professional assistance to support the immediate and long-term needs of smokers trying to quit.

Healthy People 2030 has multiple goals regarding tobacco use, including reducing current use of cigarettes among adults to 5% and increasing successful quit attempts in adults who smoke to 10.2%.

Chaloupka, Frank J., Kurt Straif, and Maria E. Leon. “Effectiveness of Tax and Price Policies in Tobacco Control.” Tobacco Control 20, no. 3 (May 1, 2011): 235–38. https://doi.org/10.1136/tc.2010.039982.

Committee on the Public Health Implications of Raising the Minimum Age for Purchasing Tobacco Products, Board on Population Health and Public Health Practice, and Institute of Medicine. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Edited by Richard J. Bonnie, Kathleen Stratton, and Leslie Y. Kwan. Washington, D.C.: National Academies Press, 2015. https://doi.org/10.17226/18997.

Cornelius, Monica E., Caitlin G. Loretan, Teresa W. Wang, Ahmed Jamal, and David M. Homa. “Tobacco Product Use Among Adults — United States, 2020.” MMWR. Morbidity and Mortality Weekly Report 71, no. 11 (March 18, 2022): 397–405. https://doi.org/10.15585/mmwr.mm7111a1.

Gallaway, M. Shayne, S. Jane Henley, C. Brooke Steele, Behnoosh Momin, Ahmed Jamal, Katrina F. Trivers, Cheryll C. Thomas, Simple D. Singh, and Sherri L. Stewart. “Surveillance for Cancers Associated with Tobacco Use — United States, 2010–2014.” MMWR. Surveillance Summaries 67, no. 12 (November 2, 2018): 1–42. https://doi.org/10.15585/mmwr.ss6712a1.

Hu, S. Sean, David M. Homa, Teresa Wang, Yessica Gomez, Kimp Walton, Hua Lu, and Linda Neff. “State-Specific Patterns of Cigarette Smoking, Smokeless Tobacco Use, and E-Cigarette Use Among Adults — United States, 2016.” Preventing Chronic Disease 16 (February 7, 2019): 180362. https://doi.org/10.5888/pcd16.180362.

Patnode, Carrie D., Jillian T. Henderson, Jamie H. Thompson, Caitlyn A. Senger, Stephen P. Fortmann, and Evelyn P. Whitlock. “Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Review of Reviews for the U.S. Preventive Services Task Force.” Annals of Internal Medicine 163, no. 8 (October 20, 2015): 608. https://doi.org/10.7326/M15-0171.

U.S. Department of Health and Human Services. “The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.” Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. https://pubmed.ncbi.nlm.nih.gov/24455788/.

Zulfiqar, Hassam, and Omar Rahman. “Vaping Associated Pulmonary Injury.” In StatPearls. Treasure Island (FL): StatPearls Publishing, 2022. http://www.ncbi.nlm.nih.gov/books/NBK560656/.

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