Smoking Cessation Prevalence and Inequalities in the United States: 2014-2019

Abstract

Background: Smoking is a leading cause of premature death and health inequities in the United States.

Methods: We estimated cross-sectional prevalence of smoking cessation indicators among US adult recent smokers (n = 43 602) overall and by sociodemographic subgroups in the Current Population Survey Tobacco Use Supplement 2014-2015 and 2018-2019 timepoints. Respondents reported past-year quit smoking interest, attempts, sustained (successful) cessation for 6 or more months and use of e-cigarettes or behavioral or pharmacological cessation treatments to quit smoking.

Results: Past-year quit smoking attempts declined slightly from 2014-2015 (52.9%) to 2018-2019 (51.3%) overall. Quit interest (pooled = 77.1%) and sustained cessation (pooled = 7.5%) did not change across timepoints. Among smokers making past-year quit attempts, 34.4% reported using cessation treatments in 2018-2019, and using e-cigarettes to quit smoking declined from 2014-2015 (33.3%) to 2018-2019 (25.0%). Several non-White (vs White) racial and ethnic groups had higher prevalence of quit interest and attempts but lower prevalence of sustained cessation or using e-cigarettes or treatments to quit. Income, education, employment, and metropolitan residence were positively associated with sustained cessation. Sociodemographic inequalities in sustained cessation and most other outcomes did not change across timepoints.

Conclusions: Although about half of US adult smokers made past-year quit attempts from 2014 to 2019, only 7.5% reported sustained cessation, and most who made quit attempts did not report using cessation treatments. Sociodemographic inequalities in cessation were pervasive and not entirely correspondent with sociodemographic variation in motivation to quit. Smoking cessation prevalence and inequalities did not improve from 2014 to 2019. Encouraging quit attempts and equitable access to smoking cessation aids are public health priorities.