Tobacco Product Use Among Adults—United States, 2019

MMWR Introduction

In 2019, about 1 in 5 U.S. adults reported currently using any tobacco product. Cigarettes were the most commonly used tobacco product, followed by e-cigarettes, cigars, smokeless tobacco, and pipes.

To assess recent national estimates of tobacco product use among U.S. adults aged 18 and older, CDC analyzed data from the 2019 National Health Interview Survey. In 2019, an estimated 50.6 million U.S. adults (20.8%) reported currently using any tobacco product, including cigarettes (14.0%), e-cigarettes (4.5%), cigars (3.6%), smokeless tobacco (2.4%), and pipes (1.0%). Most current tobacco-product users (80.5%) reported using combustible products (cigarettes, cigars, or pipes), and 18.6% reported using two or more tobacco products. U.S. adults also report using various non-cigarette tobacco products, with e-cigarettes being the most commonly used non-cigarette tobacco product (4.5%). The implementation of comprehensive, evidence-based, population-level interventions, in coordination with regulation of tobacco products, can reduce the burden of tobacco-related disease and death in the United States.

MMWR Highlights

Percentage of adults aged 18 years old or older who reported current tobacco product use,* by tobacco product type, 2019.

• Cigarettes, 14.0%.
• Electronic cigarettes (e-cigarettes), 4.5%.
• Cigars, cigarillos, or little cigars, 3.6%.
• Smokeless tobacco (chewing tobacco, snuff, dip, snus, or dissolvable tobacco), 2.4%.
• Pipes, water pipes, or hookahs, 1.0%.
• Any combustible tobacco product (cigarettes, cigars, cigarillos, little cigars, pipes, water pipes, or hookahs), 16.7%.
• Used 2 or more tobacco products, 3.9%.

Percentage of adults aged 18 years or older who reported any current tobacco product use,** 2019.

• Overall, 20.8%.
• By sex, 26.2% of men and 7% of women.
• By age group, 2% of adults aged 18 to 24 years, 25.3% of adults aged 25 to 44 years, 23.0% of adults aged 45 to 64 years, and 11.4% of adults aged 65 years or older.
• By race/ethnicity, 29.3% of non-Hispanic American Indian/Alaska Natives, 1% of adults of non-Hispanic other races, 23.3% of non-Hispanic whites, 20.7% of non-Hispanic blacks, and 11.0% of non-Hispanic Asians.
• By U.S. region, 23.7% of adults in the Midwest, 22.9% of adults in the South, 18.5% of adults in the Northeast, and 16.4% of adults in the West.
• By education among adults aged 25 years or older, 43.7% among adults with a General Educational Development certificate (GED),4% among adults with 0-12 years of education (no diploma), 26.4% among adults with a high school diploma, 24.8% among adults with some college (no diploma), 21.2% among adults with an associate degree (academic or technical/vocational), 13.1% among adults with an undergraduate degree, and 8.7% among adults with a graduate degree.
• By marital status, 5% of adults who were divorced, separated, or widowed; 23.0% of adults who were single, never married, or not living with a partner; and 19.2% of adults who were married or living with a partner.
• By annual household income, 0% of adults with an annual household income less than $35,000, 22.0% of adults with an annual household income of $35,000-$74,999, 18.8% of adults with an annual household income of $75,000-$99,999, and 15.1% of adults with an annual household income of $100,000 or more.
• By sexual orientation, 29.9% of lesbian, gay, or bisexual adults and 5% of heterosexual/straight adults.
• By health insurance status, 2% of uninsured adults, 30.0% of adults on Medicaid, 25.6% of adults on other public insurance, 18.0% of adults with private insurance, and 11.4% of adults with Medicare only.
• By disability status, 26.9% of adults with a disability and 20.1% of adults without a disability.
• By generalized anxiety disorder, 45.3% of adults with severe generalized anxiety disorder, 34.2% of adults with moderate generalized anxiety disorder, 30.4% of adults with mild generalized anxiety disorder, and 18.4% of adults with no or minimal generalized anxiety disorder.

* For cigarettes, current use was defined as adults who reported smoking ≥100 cigarettes during their lifetime and reported smoking either “every day” or “some days” at the time of the survey. For all other tobacco products, current use was defined as reported use either “every day” or “some days” at the time of the survey.

** Any tobacco use was defined as current use of at least one tobacco product (cigarettes; e-cigarettes; cigars, cigarillos, little cigars; smokeless tobacco; pipes, waterpipes, hookahs).