Behaviors

As the leading cause of preventable death

in the U.S., cigarette smoking is responsible for the deaths of more than 470,000 Americans every year, including 196,200 women.⁵⁹ Smoking affects nearly every organ

and can cause cancer, heart disease, stroke, diabetes and respiratory conditions such as chronic obstructive pulmonary disease (COPD).⁶⁰

Changes over the last decade. Nationally, the prevalence of cigarette smoking — the percentage of women ages 18-44 who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days — decreased 52% from 17.4% to 8.4% between 2013-2014 and 2023-2024. The current rate remains above the Healthy People 2030 target to reduce current cigarette smoking in adults to 6.1%.

⁶¹ Reducing current cigarette smoking in adults is a Healthy People 2030 Leading Health Indicator.

⁵ In 2023-2024, nearly 4.5 million women reported smoking, a decrease of 4.8 million women compared with 2013-2014.

In the decade between 2013-2014 and 2023-2024, cigarette smoking significantly decreased: 

During the same time period, the prevalence significantly decreased in 49 states and the District of Columbia. The largest decreases were 69% in the District of Columbia (14.0% to 4.3%), 65% in Connecticut (15.6% to 5.5%) and 64% in Rhode Island (18.1% to 6.6%).

Recent differences. The prevalence of cigarette smoking significantly varied by race/ethnicity, geography, income, educational attainment, disability status, age, metropolitan status and sexual orientation. In 2023-2024, the prevalence among women ages 18-44 was:

Note: No data were available for Tennessee in 2024 or for Kentucky and Pennsylvania in 2023. Differences highlight the groups with the highest and lowest values. However, the values for certain race/ethnicity, education and disability groups may not differ significantly based on overlapping 95% confidence intervals. For more information, view cigarette smoking data for women.

Related Measure: Household Smoke
Nationally, the prevalence of household smoke — the percentage of children ages 0-17 who live in households where someone uses cigarettes, cigars or pipe tobacco — decreased 34% from 15.5% to 10.3% between 2016-2017 and 2023-2024. In 2023-2024, 7.2 million children ages 0-17 lived in a household with smoke, a decrease of 3.9 million children compared with 2016-2017.

Between 2016-2017 and 2023-2024, the prevalence of household smoke among children ages 0-17 significantly decreased in 26 states. The largest decreases were 47% in California (11.0% to 5.8%), 46% in Colorado (14.3% to 7.7%) and 45% in Nebraska (18.4% to 10.2%). In 2023-2024, the prevalence was 4.7 times higher in West Virginia (21.9%) than in Utah (4.7%). The prevalence of household smoke also significantly varied by education, race/ethnicity and children with special health care needs. For more information, view household smoke data for children.

Electronic cigarettes, also called e-cigarettes,

vapes or vape pens, are electronic devices that use heat to make an aerosol that the user inhales.⁶² The aerosol produced by e-cigarettes contains toxic substances

that can cause cancer and serious lung disease.⁶²  

Changes over time. Nationally, the prevalence of e-cigarette use — the percentage of women ages 18-44 who reported using e-cigarettes or other electronic vaping products at least once in their lifetime and now use daily or some days — increased 121% from 5.3% to 11.7% between 2018 and 2023-2024. In 2023-2024, 6.2 million women reported using e-cigarettes, an increase of nearly 4.1 million women compared with 2018. 

Between 2018 and 2023-2024, e-cigarette use among women ages 18-44 significantly increased:

During the same time period, the prevalence significantly increased in 48 states. The largest increases were 218% in Pennsylvania (3.9% to 12.4%), 216% in Louisiana (5.6% to 17.7%) and 209% in Kansas (4.7% to 14.5%).

Recent differences. The prevalence of e-cigarette use significantly varied by race/ethnicity, educational attainment, disability status, geography, income, age, sexual orientation, metropolitan status, and veteran status. In 2023-2024, the prevalence among women ages 18-44 was:

Note: No data were available for Tennessee in 2024 or for Kentucky and Pennsylvania in 2023. Differences highlight the groups with the highest and lowest values. However, the values for certain race/ethnicity, educational attainment, disability and income groups may not differ significantly based on overlapping 95% confidence intervals. For more information, view e-cigarette use data for women.

Related Measure: Electronic Vapor Product Use Among Youth
Nationally, the prevalence of electronic vapor product use — the percentage of high school students who reported using an electronic vapor product in the past 30 days — decreased 49% from 32.7% to 16.8% between 2019 and 2023. During the same time period, electronic vapor product use decreased in 15 states. The largest decreases were 60% in Nebraska (17.1% to 6.9%), 59% in Virginia (19.9% to 8.1%) and 57% in Hawaii (30.6% to 13.2%). In 2023, the prevalence among high school students was 4.3 times higher in Montana (24.3%) than in Utah (5.7%).