Most U.S. Adults Who Smoke Want to Quit, but Fewer Than 1 in 10 Succeed

Tobacco dependence is a chronic, relapsing condition driven by nicotine addiction, and quitting is hard — but quitting cuts the risk of premature death and smoking-related disease, and clinician help plus evidence-based treatment make success more likely. CDC used the 2022 National Health Interview Survey (27,651 adults) to measure how U.S. adults are doing.

The big picture

In 2022, 11.6% of U.S. adults — about 28.8 million — smoked cigarettes.

*Among those who saw a health professional in the past year — 77.6% of current smokers and 83.1% of recent quitters did.

• Medication (36.3%) was far more common than counseling (7.3%); only 5.3% used both, the most effective combination.
• Most-used medicines: nicotine patch (19.6%), gum or lozenge (18.4%), varenicline (9.6%), bupropion (6.4%), nasal spray or inhaler (1.0%).
• Most-used counseling: one-on-one (4.3%), quitlines (3.7%), classes, groups or clinics (2.4%).

Who quits

• Quit attempts ranged from 74.4% among 18- to 24-year-olds to 47.5% among those 45–64.
• Success ranged from 15.3% (18–24) to 5.6% (45–64 and 65+); from 16.8% with a graduate degree to 4.0% without a high school diploma; and from 11.9% at high income to 7.5% at low income.
• Treatment use was 42.7% among White adults, 33.6% among adults of other races, 32.6% among Black adults, 28.8% among Hispanic adults and 15.9% among Asian adults.
• Uninsured adults had the lowest rates of advice (31.2%), help (27.4%) and treatment (20.4%).
• People with a smoking-related disease, anxiety, depression or a disability were more likely to get advice or help and to use treatment.

Menthol smokers

Quit indicators among adults who usually smoke menthol versus nonmenthol cigarettes, 2022. CDC.

People who smoke menthol were more eager to quit and tried more often, yet were no more successful — possibly because they were less likely to get advice or use treatment. Menthol smoking is especially common among Black adults, partly because of aggressive, targeted marketing, and evidence suggests menthol smokers may find it harder to quit. Policies banning menthol cigarette sales increase quitting and could reduce disparities — and pairing them with better access to treatment matters.

Barriers

• Recalls and shortages have cut prescriptions for quit medicines; the nicotine oral inhaler was recently discontinued.
• Gaps in clinician knowledge and in comprehensive clinical guidelines.
• Limited cessation treatment in behavioral health settings and hospital programs.
• Medicaid barriers — limits on treatment length and number of quit attempts, and prior authorization; only 20 state Medicaid programs offered barrier-free, comprehensive coverage in 2022.
• Pending legal challenges to the Affordable Care Act requirement that most private insurers cover cessation treatment.

What helps

• Population-wide tobacco control: retail strategies, smoke-free policies and mass-media campaigns.
• Expanding quitlines and digital quit services.
• Barrier-free, comprehensive insurance coverage of treatment.
• Health care system changes — treatment protocols and standard workflows — so that everyone who smokes gets help, including the roughly three in four who see a provider each year and those who don't yet have smoking-related disease.
• A "cessation in all tobacco policies" approach, with attention to each group's cultural and language needs and access barriers.

Limitations: the survey excludes institutionalized and military adults, and answers were self-reported and not biochemically verified.

Sources

Based on VanFrank B, Malarcher A, Cornelius ME, Schecter A, Jamal A, Tynan M, "Adult Smoking Cessation — United States, 2022," Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention; a work of the United States government in the public domain.