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Notes from the Field, CDC's Morbidity and Mortality Weekly Report*, 2025.*
Cigarette smoking among U.S. adults fell from 42.4% in 1965 to 11.6% in 2022, its lowest level in 60 years. Yet tobacco use is still the leading cause of preventable death in the United States, and how adults use other commercial tobacco products shapes the overall picture. Youth e-cigarette use rose sharply in 2017–2018 before falling again, and some of those young people are now old enough to be counted in adult surveys.
The headline
From 2017 to 2023, the number of adults who smoked only cigarettes fell by about 6.8 million. Over the same years, the number who used only e-cigarettes rose by about 7.2 million. The two changes cancelled out: overall current tobacco use among adults did not change.
| Adults, 2017 → 2023 | Share of adults | Number of adults |
|---|---|---|
| Smoke cigarettes only | 10.8% → 7.9% | 26.6 million → 19.8 million |
| Use e-cigarettes only | 1.2% → 4.1% | 2.9 million → 10.1 million |
By age
The rise in e-cigarette-only use came mainly from younger adults — about 2.3 million more aged 18 to 24, and about 3.9 million more aged 25 to 44.
| Age group | What changed, 2017 → 2023 |
|---|---|
| 18–24 | cigarettes only fell from 6.5% to 1.2% (1.9 million to 350,000 people); pipe only from 1.0% to 0.1% (290,000 to 40,000); e-cigarettes only rose from 2.7% to 10.3% (800,000 to 3.1 million) |
| 25–44 | cigarettes only fell from 12.0% to 7.6% (10.1 million to 6.5 million); e-cigarettes only rose from 1.5% to 6.1% (1.3 million to 5.2 million) |
| 45–64 | the number using only e-cigarettes rose from 690,000 to 1.6 million |
| 65 and over | pipe only fell from 0.4% to 0.1% (190,000 to 80,000); the number smoking only cigarettes rose from 3.6 million to 4.2 million |
How it was measured
CDC analysed National Health Interview Survey data for adults aged 18 and over, 2017–2023. The survey is an annual household survey of the U.S. civilian noninstitutionalized population; yearly samples ranged from 21,153 people (2020) to 31,997 (2019).
- Current use means using a product "every day" or "some days" at the time of the survey (for cigarettes, also having smoked at least 100 in one's life).
- Exclusive use means using that product and no other tobacco product.
- Commercial tobacco means cigarettes, cigars, e-cigarettes, pipes and smokeless tobacco made and sold by companies — not traditional tobacco used by some Indigenous groups for religious or ceremonial purposes. E-cigarettes meet the federal definition of a tobacco product.
- A caution: the survey's weighting and design changed in 2019, so comparisons between 2019–2023 and earlier years need care.
What it means
Cigarette smoking is at a 60-year low, but adult tobacco use overall has not fallen since 2017, because e-cigarettes have taken cigarettes' place. The authors call for continued surveillance and for comprehensive strategies — higher prices, smoke-free policies, high-impact media campaigns and help to quit — to prevent and reduce tobacco use, nicotine addiction and the harm they cause.
Sources
- René A. Arrazola, Corinne G. Husten, Monica E. Cornelius and Brian S. Armour, "Notes from the Field: Tobacco Product Use Among Adults — United States, 2017–2023", MMWR, vol. 74, no. 7, 2025. https://www.cdc.gov/mmwr/volumes/74/wr/mm7407a3.htm
- Rewritten in hubnx's own words.
Licens: CC0 1.0 (allmän egendom) · Bearbetat efter www.cdc.gov
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