Cigarette smoking continues to decline across the United States, with the most dramatic declines coming in states with historically high smoking rates.


RT’s Three Key Takeaways:

  1. Historic Smoking Declines Led by Young Adults: Smoking rates in the US have dropped dramatically, especially among young adults, with projections suggesting national smoking prevalence could fall below 5% by 2035.
  2. Older Adults Show Slower Progress: Despite overall declines, adults over 50—particularly in states with historically high smoking rates—have been slower to quit, potentially prolonging the public health burden of smoking-related diseases like lung cancer and heart disease.
  3. New Threat from E-Cigarettes: While cigarette smoking declines, researchers warn that e-cigarette use among teenagers is rising, suggesting the tobacco industry may be shifting addiction patterns to a new generation, raising concerns for future public health.


Cigarette smoking continues to decline across the United States, with the most dramatic declines coming in states with historically high smoking rates, according to a study published in JAMA Network Open.

The decline has largely driven by young adults, while smoking cessation progress among adults over 50 has been much slower, which could prolong the public health burden of smoking-related diseases and death, according ton researchers at University of California San Diego.

US adult cigarette smoking prevalence 1992-2035
US adult cigarette smoking prevalence 1992-2035. Credit: Matthew Stone/John Pierce, UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science

“The rapid decline in smoking among young adults is clear evidence that the smoking epidemic will come to an end in our lifetime,” said Matthew Stone, PhD, first author and assistant professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science and Moores Cancer Center member. “Indeed, we project that the national smoking prevalence will be under 5% by 2035. However, the much slower decline in smokers over the age of 50, particularly in previously high smoking states, will mean that the high rates of lung cancer, heart disease and chronic obstructive pulmonary disease that are caused by lifelong smoking will take longer to decrease.”

Researchers used the publicly available Tobacco Use Supplements to the U.S. Census Bureau’s Current Population Survey. The survey is a large — approximately 54,000 households — monthly representative survey that provides information on employment and economic well-being. For this study, all analyses were conducted between June and October 2024. A total of 1.77 million respondents were analyzed.

The study found:

  • Large differences in smoking prevalence existed across U.S. states in both the 1990s and in 2022, when the study authors obtained smoking prevalence estimates. The most significant decline in smoking happened in states with historically high smoking rates.
  • Differences in prevalence across age, sex, race and ethnicity, and education persisted across the years. There was a larger decline in young adult smoking compared with other states with lower historical rates of smoking. However, the gain was offset by a much slower decline among adults 50 and older.

Since the 1950s, when researchers first linked smoking to lung cancer, national smoking rates have dropped dramatically. In 1955, 56.9% of U.S. adults smoked. By the turn of the century, that figure had fallen by more than half, and by 2022, it had dropped again by 50%. The trend is expected to continue, with smoking rates projected to halve again by 2035. Recent evidence indicates that states that have made the greatest progress in reducing smoking have also seen the largest declines in lung cancer mortality — typically with a 16-year lag.

“While the ongoing decline in cigarette smoking is a major public health success story,” said John P. Pierce, Ph.D., corresponding author and Distinguished Professor at the Herbert Wertheim School of Public Health and Human Longevity Science and Moores Cancer Center. “Recent evidence suggests that the tobacco industry has successfully recruited a new generation of teenagers into e-cigarette use and nicotine addiction. Further research is needed to assess the long-term impact of this shift.”