The number of American adult smokers is an an all-time low (34 million, or 14% of the population), according to the US Surgeon General’s new report on smoking cessation.

The report, “Smoking Cessation: A Report of the Surgeon General” (2020), encourages greater smoking cessation efforts via approved medications and counseling, taxes on cigarettes, and pictorial health warnings, but does not recommend vaping as a cessation strategy.

More than two-thirds of US adult cigarette smokers report interest in quitting cigarette smoking; and the majority of adult cigarette smokers in the United States have tried to quit during the past year, the report found.

“We know more about the science of quitting than ever before. As a nation, we can and must do more to ensure that evidence-based cessation treatments are reaching the people that need them,” said Surgeon General Vice Admiral Jerome M. Adams. “Today, I’m calling on healthcare professionals, health systems, employers, insurers, public health professionals, and policy makers to take action to put an end to the staggering—and completely preventable—human and financial tolls that smoking takes on our country.”

The major conclusions of the report are as follows:

  1. Smoking cessation is beneficial at any age. Smoking cessation improves health status and enhances quality of life.
  2. Smoking cessation reduces the risk of premature death and can add as much as a decade to life expectancy.
  3. Smoking places a substantial financial burden on smokers, healthcare systems, and society. Smoking cessation reduces this burden, including smoking attributable healthcare expenditures.
  4. Smoking cessation reduces risk for many adverse health effects, including reproductive health outcomes, cardiovascular diseases, COPD, and cancer. Quitting smoking is also beneficial to those who have been diagnosed with heart disease and chronic obstructive pulmonary disease.
  5. More than three out of five US adults who have ever smoked cigarettes have quit. Although a majority of cigarette smokers make a quit attempt each year, less than one-third use cessation medications approved by the FDA or behavioral counseling to support quit attempts.
  6. Considerable disparities exist in the prevalence of smoking across the US population, with higher prevalence in some subgroups. Similarly, the prevalence of key indicators of smoking cessation—quit attempts, receiving advice to quit from a health professional, and using cessation therapies—also varies across the population, with lower prevalence in some subgroups.
  7. Smoking cessation medications approved by the FDA and behavioral counseling are cost-effective cessation strategies. Cessation medications approved by the FDA and behavioral counseling increase the likelihood of successfully quitting smoking, particularly when used in combination. Using combinations of nicotine replacement therapies can further increase the likelihood of quitting.
  8. Insurance coverage for smoking cessation treatment that is comprehensive, barrier-free, and widely promoted increases the use of these treatment services, leads to higher rates of successful quitting, and is cost-effective.
  9. E-cigarettes, a continually changing and heterogeneous group of products, are used in a variety of ways. Consequently, it is difficult to make generalizations about efficacy for cessation based on clinical trials involving a particular e-cigarette, and there is presently inadequate evidence to conclude that e-cigarettes, in general, increase smoking cessation.
  10. Smoking cessation can be increased by raising the price of cigarettes, adopting comprehensive smoke-free policies, implementing mass media campaigns, requiring pictorial health warnings, and maintaining comprehensive statewide tobacco control programs.

“Americans who quit cigarettes can add as much as a decade to their life expectancy. Unfortunately, millions of Americans still smoke cigarettes,” said HHS Secretary Alex Azar. “But the good news is that, as the Surgeon General’s report shows, we know more than ever before about effective ways to help Americans quit. Working together, we can make tobacco-related disease and death a thing of the past.”

View the full report at the Department of Health and Human Services website.