Tobacco Product Use Among Adults—United States, 2015

November 10, 2017 / Vol. 66 / No. 44

MMWR Introduction

Despite declining cigarette smoking prevalence among US adults, shifts in the tobacco product landscape have occurred in recent years. CDC and FDA assessed the most recent national estimates of tobacco product use among adults aged 18 years or older using data from the 2015 National Health Interview Survey. In 2015, approximately 1 in 5 US adults (20.1%, 48.7 million) currently used any tobacco product, with most using combustible tobacco products (17.6%, 42.6 million).

Any tobacco product use was significantly higher among males; adults younger than65 years; non-Hispanic American Indian/Alaska Natives (AI/AN), whites, blacks, and persons of multiple races; adults living in the Midwest; adults with a Graduate Education Development certificate (GED); adults with an annual household income of less than $35,000; adults who were single, never married, not living with a partner, divorced, separated, or widowed; adults who were uninsured or insured through Medicaid; adults with a disability; and adults e who were lesbian, gay, or bisexual (LGB). Adults with serious psychological distress (SPD) had the highest prevalence of any tobacco product use of any subpopulation.

These findings highlight the importance of evidence-based, population-level strategies, including tobacco price increases, high-impact anti-tobacco mass media campaigns, comprehensive smoke-free laws, and enhanced access to help quitting tobacco use to reduce smoking-related death and disease in the United States.

MMWR Highlights

Percentage of adults aged 18 years or older who reported tobacco product use “every day” or “some days,” by tobacco product type, 2015

  • Cigarettes: 15.1%.
  • Electronic cigarettes (E-cigarettes): 3.5%.
  • Cigars, cigarillos, or filtered little cigars: 3.4%.
  • Smokeless tobacco: 2.3%.
  • Pipes, water pipes, or hookahs: 1.2%.
  • Any combustible tobacco product: 17.6%.
  • Used 2 or more tobacco products: 3.9%.

Percentage of adults aged 18 years or older who reported any tobacco product use “every day” or “some days”

  • By sex, 25.2% of men and 15.4% of women used any tobacco product.
  • By age group, 21.4% of adults aged 18 to 24 years; 23.3% of adults aged 25 to 44 years; 21.6% of adults aged 45 to 64 years; and 11.1% of adults aged 65 years or older used any tobacco product.
  • By race or ethnicity, 22.6% of whites, 20.8% of blacks, 9.0% of Asians, 26.6% of American Indian/Alaska Natives, 12.9% of Hispanics, and 25.4% of multi-race adults used any tobacco product.
  • By US region, 24.0% of adults in the Midwest, 20.4% of adults in the South, 18.2% of adults in the Northeast, and 17.4% of adults in the West used any tobacco product.
  • By education level, 37.6% of adults with a GED, 24.4% of adults with a high school diploma, 27.6% of adults with 0 to 12 years of school and no diploma, 23.8% of adults with some college but no degree, 22.2% of adults with an associate degree, 12.6% of adults with an undergraduate degree, and 6.9% of adults with a graduate degree used any tobacco product.
  • By annual household income, 27.8% of adults earning less than $35,000, 21.2% of adults earning $35,000–$74,999, 18.1% of adults earning $75,000–$99,999, and 13.4% of adults earning more than $100,000 used any tobacco product.
  • By marital status, 23.2% of adults who were divorced, separated, or widowed; 23.1% of adults who were single, never married, or not living with a partner; and 18.2% of adults who were married or living with a partner used any tobacco product.
  • By health insurance coverage, 32.3% of adults with no insurance, 31.7% of adults on Medicaid, 25.4% of adults with other public insurance, 16.6% of adults with private insurance, and 11.4% of adults with Medicare only used any tobacco product.
  • By disability status, 25.8% of adults with a disability and 19.7% of adults with no disability used any tobacco product.
  • By sexual orientation, 27.4% of lesbian, gay, or bisexual adults and 20.1% of heterosexual or straight adults used any tobacco product.
  • By serious psychological distress status, 47.2% of adults with serious psychological distress and 19.2% of adults with no serious psychological distress used any tobacco product.