CDC Reports Welcome Declines in Adult Smoking and E-Cigarette Use in U.S., but Bold Action Needed to Address Large Disparities in Who Still Uses Tobacco

WASHINGTON, D.C. – In good news for our nation’s health, the CDC reported today that the adult cigarette smoking rate fell to a record-low 12.5% in 2020, down from 14% in 2019. Adult use of commercial tobacco products overall and of e-cigarettes also fell, with e-cigarette use decreasing from 4.5% to 3.7%. E-cigarette use remains highest among young adults (ages 18-24) at 9.4%. Following the previously reported high rates of e-cigarette use among high school students (11.3% in 2021), these results add to the evidence that, in the U.S., the primary impact of e-cigarettes to date has been in attracting young people.

Despite the progress shown in this report, tobacco use remains an enormous public health problem in the United States. Nearly 1 in 5 adults (19%) used at least one tobacco product – a total of 47.1 million adults, including 30.8 million who smoked cigarettes.

The CDC report also shows once again that there are large and unacceptable disparities in who still smokes and uses tobacco in the U.S. Groups with high rates of smoking include people with lower income and less education; American Indians/Alaska Natives; residents of the Midwest and South; residents of rural areas; lesbian, gay or bisexual adults; and adults who regularly had feelings of anxiety or depression. Adults who are uninsured or enrolled in Medicaid smoke at more than double the rates of those with private health insurance or Medicare. We also know that Black Americans die from smoking-caused diseases at high rates due in part to the tobacco industry’s predatory targeting of Black communities with marketing for menthol cigarettes.

These results underscore the importance of the FDA moving forward quickly with its plans to prohibit menthol cigarettes and flavored cigars, as well as continued state and local efforts to eliminate flavored tobacco products. The tobacco industry has long targeted Black, LGBTQ+ and other communities with marketing for menthol cigarettes, contributing significantly to tobacco-related health disparities.

Policy makers at all levels must also fully implement other proven strategies and ensure they benefit all Americans, especially those with high rates of tobacco use. These policies include significant tobacco tax increases, comprehensive smoke-free laws, well-funded tobacco prevention and cessation programs, hard-hitting mass media campaigns, and comprehensive, barrier-free health insurance coverage for smoking cessation treatments under Medicaid and private health plans.

Today’s CDC report reminds us that, despite enormous progress, the fight against tobacco use – the nation’s No. 1 cause of preventable death – is far from over and must remain a national priority. This is a winnable battle, but only if policy makers at all levels fully implement proven solutions.