Tobacco Product Use Among Adults - United States, 2019

Abstract

Cigarette smoking remains the leading cause of preventable disease and death in the United States (1). The prevalence of current cigarette smoking among U.S. adults has declined over the past several decades, with a prevalence of 13.7% in 2018 (2). However, a variety of combustible, noncombustible, and electronic tobacco products are available in the United States (1,3). To assess recent national estimates of tobacco product use among U.S. adults aged ≥18 years, CDC analyzed data from the 2019 National Health Interview Survey (NHIS). In 2019, an estimated 50.6 million U.S. adults (20.8%) reported currently using any tobacco product, including cigarettes (14.0%), e-cigarettes (4.5%), cigars (3.6%), smokeless tobacco (2.4%), and pipes* (1.0%).^† Most current tobacco product users (80.5%) reported using combustible products (cigarettes, cigars, or pipes), and 18.6% reported using two or more tobacco products.^§ The prevalence of any current tobacco product use was higher among males; adults aged ≤65 years; non-Hispanic American Indian/Alaska Native (AI/AN) adults; those whose highest level of educational attainment was a General Educational Development (GED) certificate; those with an annual household income <$35,000; lesbian, gay, or bisexual (LGB) adults; uninsured adults and those with Medicaid; those with a disability; or those with mild, moderate, or severe generalized anxiety disorder. E-cigarette use was highest among adults aged 18-24 years (9.3%), with over half (56.0%) of these young adults reporting that they had never smoked cigarettes. Implementing comprehensive, evidence-based, population level interventions (e.g., tobacco price increases, comprehensive smoke-free policies, high-impact antitobacco media campaigns, and barrier-free cessation coverage), in coordination with regulation of the manufacturing, marketing, and sale of all tobacco products, can reduce tobacco-related disease and death in the United States (1,4). As part of a comprehensive approach, targeted interventions are also warranted to reach subpopulations with the highest prevalence of use, which might vary by tobacco product type.

FIGURE 1

Age distribution of adults aged ≥18 years who reported current tobacco product use — National Health Interview Survey, United States, 2019 *Any tobacco use was defined as use either “every day” or “some days” of at least one tobacco product among individuals. For cigarettes, users were defined as adults who reported smoking ≥100 cigarettes during their lifetime, and smoked “every day” or “some days” at the time of interview. Any combustible tobacco use was defined as use either “every day” or “some days” of at least one combustible tobacco product: cigarettes; cigars, cigarillos, filtered little cigars; pipes, water pipes, or hookah. Use of two or more tobacco products was defined as adults who reported use “every day” or “some days” of at least two or more of the following tobacco products: cigarettes; cigars, cigarillos, filtered little cigars; pipes, water pipes, or hookah; e-cigarettes; or smokeless tobacco products.

FIGURE 2

Cigarette smoking status among current adult e-cigarette users, by age group — National Health Interview Survey, United States, 2019 * Adults were asked if they had smoked ≥100 cigarettes in their lifetime and, if yes, whether they currently smoked cigarettes “every day,” “some days,” or “not at all.” Those who smoked “every day” or “some days” were classified as current cigarette smokers. Adults who had not smoked ≥100 cigarettes in their lifetime were classified as never cigarette smokers. Adults who had smoked ≥100 cigarettes in their lifetime but responded to smoking “not at all” at the time of the interview were classified as former cigarette smokers. ^† Current e-cigarette users were defined as adults who reported e-cigarette use at least once during their lifetime and use “every day” or “some days” at the time of the interview. ^§ The prevalence of never cigarette smokers among e-cigarette users aged 65 years and older is not presented because of relative standard error >30% or unweighted denominator <50.