Adult smoking declines in 2020 in the United States

The latest report from the Centers for Disease Control and Prevention (CDC)[1], published on March 18, 2022, indicates that the smoking rate among adults (18 years and older) has declined and represented 12.5 % of the population in 2020, compared to 14 % in 2019. Despite this progress, nicotine use as a whole remains a huge public health problem in the United States. Nearly one in five adults (19 %) used at least one nicotine product in 2020, a total of 47.1 million adults.

The 2020 figures, whose release was delayed due to the COVID-19 pandemic, are based on a survey of nearly 32,000 adults aged 18 and older, representative of the general population, across the United States. The CDC assessed the use of five nicotine products: cigarettes, cigars (cigars, cigarillos, or little filtered cigars), pipes (regular pipes, shisha, or hookahs), e-cigarettes, and chewing tobacco.

Decline in traditional smoking and vaping product use

Among US adults in 2020, 19% (47.1 million) were currently using a tobacco or nicotine product. Cigarettes were the most commonly used tobacco product (12.5%; 30.8 million), followed by e-cigarettes (3.7%; 9.1 million), cigars (3.5%; 8.6 million), chewing tobacco (2.3%; 5.7 million), and pipes (1.1%; 2.6 million).

From 2019 to 2020, statistically significant decreases were observed in the prevalence of consumption of any tobacco product and other nicotine products. This decrease was reflected in the following data: from 20.8 % to 19.0 %, with a decrease in cigarette consumption, the prevalence of which fell from 14.0 % to 12.5 %, and also that of electronic cigarettes, which decreased from 4.5 % to 3.7 %. The use of electronic cigarettes remains significantly higher among young adults, aged 18 to 24, and concerns 9.4 % of this category of the population.

Disparities according to population categories

The CDC report highlights that there are still large disparities in the use of nicotine products across population groups in the United States. Differences concern age, gender, race, income levels, sexual orientation, etc.). These differences are explained in part by targeted marketing by the tobacco industry, which helps normalize consumption among these populations. Approximately 25% of men and 14% of women were regular users of tobacco and nicotine products in 2020, and use was more common among adults aged 25 to 44 (23% of men) than among those aged 18 to 24 (18% of men) or those aged 65 and older (12% of women).

Nearly 351% of adults who identified as American Indian or Alaska Native were regular users, compared to 211% of adults who identified as white and 191% of African Americans. Just under 121% of Hispanic Americans included in the survey were current users.

Adults without health insurance (27.31%) or enrolled in Medicaid (28.61%) use tobacco at significantly higher rates than those with private health insurance (16.41%). More than a quarter of LGBT people report regular use of tobacco and nicotine products, compared to 18.1% of people who identify as heterosexual.

For the organization Tobacco-Free kids (CTFK)[2], these findings underscore the importance of the Food and Drug Administration (FDA) moving quickly on its plans to ban menthol cigarettes and flavored cigars. It also underscores the need for continued state and local efforts to eliminate flavored tobacco products. The tobacco industry has long targeted Black, LGBTQ+, and other communities with menthol cigarette marketing, contributing significantly to tobacco-related health disparities.

Keywords: CDC, Nicotine, tobacco, vaping, adults, United States,

©Generation Without Tobacco

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[1] Monica E. Cornelius, PhD1; Caitlin G. Loretan, MPH; Teresa W. Wang, PhD; Ahmed Jamal, MBBS; David M. Homa, PhD, Tobacco Product Use Among Adults — United States, 2020, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report / Vol. 71 / No. 11 March 18, 2022, accessed same day

[2] Press release, CDC Reports Welcome Declines in Adult Smoking and E-Cigarette Use in US, but Bold Action Needed to Address Large Disparities in Who Still Uses Tobacco, Campaign for Tobacco-Free Kids, March 17, 2022, accessed March 18, 2022