Tobacco Use

Cigarette Smoking

In the time since the landmark 1964 United States (US) Surgeon General’s Report concluded that cigarette smoking caused lung cancer,1 adult cigarette smoking prevalence has declined significantly among the general population, with great reductions from 42.4% in 1965 to 10.0% in 2024.2,3 Yet, 60 years later, 25 million adults still smoke. Tobacco use remains the most common preventable cause of death and disease in the US,2,4 and remains disproportionately high in segments of the population, including among those living in the South and Midwest regions of the US (Maps 1.1.1, 1.1.2 and 1.1.3).

Overall youth cigarette smoking prevalence reached an all-time low of 1.4% as of 20255. State-level prevalence estimates of cigarette smoking prevalence among high-school students in 2023, however, demonstrated considerable geographic variation (Map 1.1.4).

The US national prevalence is projected to approach 5%, largely due to higher rate of success in smoking cessation (Figure 1.1.1) and declines in cigarette smoking among younger adults. Although the regional differences in cigarette smoking prevalence are expected to diminish considerably by 2035, projections suggest that only 12 of 50 states have a ≥ 50% chance of reaching public health targets of very low levels of cigarette consumption by 2035 (Figure 1.1.2)6, and only 4 states will likely achieve prevalence significantly below 5%7. Therefore, all states have some opportunities for further progress.

Map 1.1.1

Current cigarette smoking (%) among adults 18 years and older in the United States, 2024

Map 1.1.2

Average number of cigarettes smoked per day by adults 18 years and older who currently smoke in the United States, 2022

Map 1.1.3

State-Level Cigarette Smoking Prevalence Projections to 2035

Map 1.1.4

Current cigarette smoking (%) among high-school students in the United States, 2023

Figure 1.1.1

Past-year quit attempt and recent successful cessation (%) among adults 18 years and older in the United States, 2024

Figure 1.1.2

Cigarette consumption (packs per capita) forecasted to 2035

Up Next Smokeless Tobacco Products Use

Sources

  1. US Department of Health and Human Services. Smoking and Health Report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, DC: Public Health Service, 1964.
  2. US Department of Health and Human Services. The Health Consequences of Smoking-50 Years of Progress. A Report from the Surgeon General. Atlanta, GA; USA: Department of Health and Human Services. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 2014.
  3. American Cancer Society. Cancer Prevention & Early Detection Facts & Figures 2026. Atlanta: American Cancer Society; 2026. Available from https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-prevention-and-early-detection-facts-and-figures/2026-cped-files/cped-2026-tables-and-figures.pdf Accessed February 10, 2026.
  4. Patel AV, Deubler E, Teras LR, et al. Key risk factors for the relative and absolute 5-year risk of cancer to enhance cancer screening and prevention. Cancer. 2022.
  5. Center for Tobacco Products. 2025 National Youth Tobacco Survey: Methodology Report. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration, Center for Tobacco Products, Available from https://www.fda.gov/media/191362/download Accessed March 16, 2026
  6. Leas EC, Trinidad DR, Pierce JP, McMenamin SB, Messer K (2023) Trends in cigarette consumption across the United States, with projections to 2035. PLoS ONE 18(3): e0282893. https://doi.org/10.1371/journal.pone.0282893
  7. Stone MD, Pierce JP, Dang B, et al. State and Sociodemographic Trends in US Cigarette Smoking With Future Projections. JAMA Netw Open. 2025;8(4):e256834. doi:10.1001/jamanetworkopen.2025.6834