Smoking rates hit an all time low for US adults but vaping on the rise

by Jacob Fuller

Lauren Dempsey, MS in Biomedicine and Law, RN, FISM News 

Recently released survey data shows that fewer adults in the U.S. are smoking cigarettes, while an increasing number are using electronic cigarettes, or “vape pens.”

The Centers for Disease Control and Prevention (CDC) released preliminary findings from the National Center for Health Statistics’ (NCHS) National Health Interview Survey (NHIS) which provides estimates for 20 key health indicators based on information collected from more than 27,000 adults.

NHIS is a national household survey conducted throughout the year to gather information on health status, health-related behaviors, and healthcare access and utilization of American families. One of the key health indicators evaluated is current cigarette or electronic cigarette use.

The survey data found that the percentage of adult smokers dropped to about 11%, down from about 12.5% in 2020, while electronic cigarette use jumped to nearly 6% last year, from about 4.5% in the previous year.

According to the American Lung Association, about 8% of adolescents smoke cigarettes and almost 21% reported smoking electronic cigarettes. A 2022 National Youth Tobacco Survey (NYTS) found that more than 2 million middle and high school students reported vaping or using electronic cigarettes. Almost 40% of teen users reported frequent use and about 25% reported vaping daily despite knowing how harmful these products are.


Cigarette smoking rates are not equal across all demographic groups and data suggests that sex, age, race and ethnicity, education, and income, are all contributing factors. Men are more likely than women to smoke. Individuals aged 25-64 have the highest rates of smoking when compared to other age ranges. American Indian/Native Alaskans have the highest rates of smoking when compared to White, Black, Asians, and Hispanics. Other findings show that higher levels of education are linked to lower smoking rates and individuals that fall below the poverty threshold are more likely to smoke.


Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, warns that while vaping or using electronic cigarettes may be less harmful than smoking, they still increase the risk for heart and lung disease and are highly addictive. Also, due to the fact that electronic cigarettes are relatively new to the market, the long-term effects of using them are still mostly unknown.

Nicotine had long been established as the addiction-causing ingredient and cigarettes repeatedly expose users to high levels of the drug as well as other dangerous chemicals. The drug has been linked to impaired brain development, psychiatric disorders, and cognitive impairments, as well as high blood pressure, tremors, sleep disturbances, breathing problems, decreased endurance, appetite suppression, erectile dysfunction, and increased respiratory secretions.

Last year, the Biden administration proposed legislation to limit the effects of tobacco by implementing  “a tobacco product standard that would establish a maximum nicotine level in cigarettes and certain finished tobacco products.” The goal of this proposal is to “to reduce addictiveness to certain tobacco products, thus giving addicted users a greater ability to quit,” and “benefit the population as a whole while also advancing health equity by addressing disparities associated with cigarette smoking, dependence, and cessation.” A final decision by the Food and Drug Administration (FDA) has yet to be made.

The National Institute on Drug Abuse (NIDA) recommends prevention as a critical step in reducing the number of people that smoke. Prevention measures can include increased taxation, stricter laws for who can purchase tobacco products, how and where they can be purchased,  where and when they can be used, and restrictions on advertising and mandatory health warnings on packages.

Cigarette smoking is the leading cause of preventable death in the United States, contributing to more than 480,000 deaths each year and causing more than 90% of lung cancer deaths. Smokers are also more likely to develop heart disease, cancer, COPD, type 2 diabetes, and rheumatoid arthritis, and have an increased risk of stroke.