A Public Health Alerts report today notes that cigarette smoking in US adults dropped from 10.8% in 2023 to 9.9% in 2024, while the use of other tobacco products, such as cigars and e-cigarettes, stayed flat, and 18.8% of US adults—or about 48 million—used at least one tobacco product in 2024.

Public Health Alerts, a new collaboration between NEJM Evidence and CIDRAP, fills a gap in reliable data, offering expert-reviewed reports that translate frontline observations into actionable public health evidence. An NEJM Evidence editorial explains the initiative further.

E-cigarettes much more common in young adults

The authors of the report, from Atlanta-based Chisquares and the University of California, San Francisco, analyzed data from the National Health Interview Survey, which is a nationally representative, in-person household survey conducted in 50 states and Washington, DC. It included 29,522 adults in 2023 and 32,629 adults in 2024.

“For more than a decade, prevalence of cigarette smoking has been tracked continuously to monitor progress toward national objectives, with reporting historically coordinated through the Centers for Disease Control and Prevention (CDC) Office on Smoking and Health,” the authors note. “Recently, however, routine public reporting of adult smoking prevalence has been interrupted, creating gaps in the continuity of federal tobacco surveillance.”

The researchers found that, in 2024, 18.8% (47.7 million) of US adults reported using any tobacco product, including 12.6% (31.8 million) who reported using any cigarettes or cigars, 9.9% (25.2 million) who reported smoking cigarettes, 7.0% (17.8 million) who reported using e-cigarettes, 3.7% (9.3 million) who reported smoking cigars, and 2.6% (6.6 million) who reported using smokeless tobacco.

The lack of change in cigar and e-cigarette use calls for intensified implementation of comprehensive tobacco control policies addressing all products.

Cigarette smoking declined from 10.8% in 2023, while use of the other products remained unchanged. In adults 18 to 24 years old, however, e-cigarette use outpaced cigarette smoking by 14.8% to 3.4%. Among cigarette smokers, 74.1% smoked daily, averaging 21 packs in the past 30 days, whereas some-day smokers averaged 3.2 packs in 30 days.

The authors conclude, “The decline in cigarette smoking from 10.8% in 2023 to 9.9% in 2024 marked the first time that prevalence of cigarette smoking among U.S. adults reached single digits, aligning with progress toward the Healthy People 2030 goal of 6.1%. If this decline continues, the target might be met or exceeded by 2030. 

“However, the lack of change in cigar and e-cigarette use calls for intensified implementation of comprehensive tobacco control policies addressing all products.”