Cigarette smoking rates across the United States are plummeting, driven largely by young adults, according to a new study by researchers at the University of California San Diego. The significant findings, published in JAMA Network Open, highlight how states with historically high smoking rates have seen the most dramatic declines in recent years.
First author Matthew Stone, an assistant professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science and member of the Moores Cancer Center, underscored the significance of the findings.
“The rapid decline in smoking among young adults is clear evidence that the smoking epidemic will come to an end in our lifetime,” he said in a news release. “Indeed, we project that the national smoking prevalence will be under 5% by 2035.”
Generational Divide in Quitting
While the data points to an optimistic future, the study also revealed a slower decline in smoking rates among adults over 50. This delay in smoking cessation could prolong the public health burden related to smoking-induced diseases, such as lung cancer, heart disease and chronic obstructive pulmonary disease (COPD).
“However, the much slower decline in smokers over the age of 50, particularly in previously high smoking states, will mean that the high rates of lung cancer, heart disease and chronic obstructive pulmonary disease that are caused by lifelong smoking will take longer to decrease,” Stone added.
Methodology and Findings
The research utilized data from the Tobacco Use Supplements to the U.S. Census Bureau’s Current Population Survey, a comprehensive dataset encompassing approximately 54,000 households.
Conducted between June and October 2024, the study examined responses from 1.77 million participants to assess smoking prevalence across various demographics and states.
Key findings included:
- Persistent disparities in smoking rates across states, with the highest reductions seen in states with historically high smoking rates.
- Significant reductions in smoking among young adults, contrasted with a much slower decline among those aged 50 and older.
- Evidence linking declines in smoking rates with subsequent drops in lung cancer mortality, typically with a 16-year lag.
Since the 1950s, when the link between smoking and lung cancer was first established, national smoking rates have seen a dramatic decline. In 1955, a staggering 56.9% of U.S. adults smoked. By 2022, that figure had fallen significantly, and projections indicate that smoking rates could drop below 5% by 2035.
Corresponding author John P. Pierce, a distinguished professor at the Herbert Wertheim School of Public Health and Human Longevity Science and Moores Cancer Center, emphasized the positive public health implications but also raised concerns about emerging trends.
“While the ongoing decline in cigarette smoking is a major public health success story, recent evidence suggests that the tobacco industry has successfully recruited a new generation of teenagers into e-cigarette use and nicotine addiction,” he said in the news release. “Further research is needed to assess the long-term impact of this shift.”
The study involved several co-authors from UC San Diego, including Brian Dang, Sara B. McMenamin, David R. Strong, Yuyan Shi, Karen Messer and and Dennis R. Trinidad, as well as contributors from the California Department of Public Health.