Cigarette smoking among U.S. adults has dropped to 9.9% in 2024, marking the first time the rate has reached single digits, according to a new public health alerts report published by Public Health Alerts, a collaboration between NEJM Evidence and CIDRAP. The decline follows a 10.8% rate in 2023, signaling progress toward national health goals, while use of other tobacco products like cigars and e-cigarettes remained steady.

Decline in Cigarette Use, Flat Trends in Other Products

The report, based on data from the National Health Interview Survey, shows that 18.8% of U.S. adults — or about 48 million people — used at least one tobacco product in 2024. This includes 9.9% who smoked cigarettes, 7.0% who used e-cigarettes, and 3.7% who smoked cigars. Despite the decline in cigarette use, the rates for cigars and e-cigarettes have not changed significantly.

The National Health Interview Survey, conducted in 50 states and Washington, D.C., collected responses from 29,522 adults in 2023 and 32,629 adults in 2024. The data provides a nationally representative snapshot of tobacco use patterns across the country.

“For more than a decade, prevalence of cigarette smoking has been tracked continuously to monitor progress toward national objectives,” the report states. “Recently, however, routine public reporting of adult smoking prevalence has been interrupted, creating gaps in the continuity of federal tobacco surveillance.”

Public Health Concerns Over E-Cigarette and Cigar Use

While the decline in cigarette smoking is a positive development, the report highlights growing concerns about the use of e-cigarettes and cigars. Among adults aged 18 to 24, e-cigarette use outpaced cigarette smoking by 14.8% to 3.4%. This trend raises questions about the long-term health impacts of these products, particularly among younger populations.

“The lack of change in cigar and e-cigarette use calls for intensified implementation of thorough tobacco control policies addressing all products,” the authors emphasize. They argue that current strategies focused on reducing cigarette use may not be sufficient if other tobacco products continue to remain stable or increase in popularity.

Among cigarette smokers, 74.1% smoked daily, averaging 21 packs in the past 30 days, while some-day smokers averaged 3.2 packs in the same period. These figures underscore the continued high levels of nicotine dependence among regular smokers.

Progress Toward National Health Goals

The decline in cigarette smoking is a key step toward the Healthy People 2030 goal of reducing cigarette use to 6.1% by 2030. If the current trend continues, the report suggests that the target might be met or even exceeded by 2030.

“The decline in cigarette smoking from 10.8% in 2023 to 9.9% in 2024 marked the first time that prevalence of cigarette smoking among U.S. adults reached single digits,” the authors note. “This aligns with progress toward the Healthy People 2030 goal of 6.1% if this decline continues.”

The report also points out that thorough tobacco control policies are needed to address all forms of tobacco use. These policies could include measures such as increasing taxes on all tobacco products, implementing stricter advertising regulations, and expanding access to cessation programs.

Public Health Alerts, as a new initiative, aims to fill gaps in reliable data by providing expert-reviewed reports that translate frontline observations into actionable public health evidence. An NEJM Evidence editorial explains that the initiative seeks to enhance the coordination and reliability of tobacco surveillance efforts in the United States.

“The lack of change in cigar and e-cigarette use calls for intensified implementation of thorough tobacco control policies addressing all products,” the authors conclude. They warn that without targeted interventions, the overall impact of tobacco use on public health may not improve significantly.

The findings of this report are particularly significant for public health officials, healthcare providers, and policymakers who are working to reduce the burden of tobacco-related diseases. The report provides a clear roadmap for future actions and highlights the importance of maintaining surveillance and data collection efforts to monitor progress over time.

As the U.S. continues to work toward reducing tobacco use, the findings from this report will be crucial in shaping future public health strategies. The data highlights the need for a more complete approach to tobacco control that addresses all forms of tobacco products, not just cigarettes.