Young adults lead dramatic decline in smoking rates

Cigarette smoking has been on a steady decline across the United States. New research shows that young adults are driving this shift, especially in states where smoking rates were once the highest. However, there is still a long road ahead for older generations, whose slower progress in quitting may delay broader public health improvements.

Scientists from the University of California San Diego published their findings in the journal JAMA Network Open. The study points to major differences in smoking habits depending on age, region, and background.

Although national smoking rates have dropped sharply, adults over 50 are quitting at a much slower pace. This slower change could keep smoking-related diseases like lung cancer and heart disease high for years to come.

Smoking rates: Progress and persistence

The researchers used data from the Tobacco Use Supplements to the U.S. Census Bureau’s Current Population Survey. This large monthly survey gathers information from about 54,000 households across the country.

The analysis, covering responses from 1.77 million people between June and October 2024, revealed some striking trends. Across the board, smoking has dropped. But the states that once had the highest smoking rates have seen the biggest improvements.

In contrast, places with historically lower rates saw more modest declines. One of the most important findings was the difference between younger and older adults. Young people have quit smoking at much faster rates than those over 50.

Dr. Matthew Stone, the study’s first author, is an assistant professor at the UC San Diego Herbert Wertheim School of Public Health.

“The rapid decline in smoking among young adults is clear evidence that the smoking epidemic will come to an end in our lifetime,” said Dr. Stone.

“Indeed, we project that the national smoking prevalence will be under 5% by 2035. 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.”

How far we have come

Smoking in America has been on a steady decline for decades. In 1955, more than half of U.S. adults – 56.9% – were smokers.

By 2000, that number had fallen by more than half. It dropped again by 50% by 2022. If current trends continue, smoking rates are expected to fall to under 5% by 2035.

Another important pattern has also emerged. States that cut smoking rates the most have seen the biggest drops in lung cancer deaths – though with a delay of about 16 years. This connection shows how public health efforts, policies, and education campaigns can pay off over time.

Decline in smoking, rise in vaping

While cigarette smoking is fading, other problems are taking its place. “The ongoing decline in cigarette smoking is a major public health success story,” said study co-author Dr. John P. Pierce, a professor at the Herbert Wertheim School of Public Health and Human Longevity Science and Moores Cancer Center.

“Recent evidence suggests that the tobacco industry has successfully recruited a new generation of teenagers into e-cigarette use and nicotine addiction. Further research is needed to assess the long-term impact of this shift.”

As vaping and e-cigarette use grow among teens, public health experts are concerned about what the next chapter in tobacco use might look like. Today’s young adults may be turning away from cigarettes, but tomorrow’s teenagers could be facing a different kind of addiction.

Smoking and public health: The future

Public health efforts over the past several decades have made a real difference. Education campaigns, smoking bans, higher tobacco taxes, and smoking cessation programs have all played a role in driving down smoking rates. However, the work isn’t finished.

Addressing the slow decline among older adults will be key to reducing the burden of smoking-related illnesses. At the same time, understanding and managing the rise in e-cigarette use among younger people will be critical.

As smoking habits shift, researchers and policymakers alike will need to adapt to ensure the next generation stays healthy and smoke free.

The full study was published in the journal JAMA Network Open.

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