Tobacco Product Use and Cessation Indicators Among Adults — United States, 2018

MMWR Introduction

Cigarette smoking is the leading cause of preventable disease and death in the United States. To assess recent national estimates of tobacco product use among U.S. adults aged ≥18 years, CDC, the Food and Drug Administration, and the National Cancer Institute analyzed data from the 2018 National Health Interview Survey.

Coordinated efforts at the local, state, and national levels are needed to continue progress toward reducing tobacco-related disease and death in the United States. Proven strategies include implementation of tobacco price increases, comprehensive smoke-free policies, high-impact antitobacco media campaigns, barrier-free cessation coverage, and comprehensive state tobacco control programs, combined with regulation of the manufacturing, marketing, and distribution of all tobacco products.

MMWR Highlights

Percentage of adults aged 18 years or older who reported tobacco product use “every day” or “some days,” by tobacco product type, 2018*

• Cigarettes: 13.7%.
• Cigars, cigarillos, or filtered little cigars: 3.9%.
• Electronic cigarettes (E-cigarettes): 3.2%
• Smokeless tobacco (chewing tobacco, snuff, dip, snus, or dissolvable tobacco): 2.4%.
• Pipes, water pipes, or hookahs: 1.0%.
• Any combustible tobacco product: 16.5%.
• Used 2 or more tobacco products: 3.7%.

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

• Overall use, 19.7%.
• By sex, 25.8 % of men and 14.1% of women used any tobacco product.
• By age group, 17.1% of adults aged 18 to 24 years, 23.8% of adults aged 25 to 44 years, 21.3% of adults aged 45 to 64 years, and 11.9% of adults aged 65 years or older used any tobacco product.
• By race or ethnicity, 32.3% of non-Hispanic American Indian/Alaska Natives, 25.4% of non-Hispanic multiracial adults, 21.9% of non-Hispanic whites, 19.3% of non-Hispanic blacks, 13.8% of Hispanics, and 10.0% of non-Hispanic Asians used any tobacco product.
• By U.S. region, 23.6% of adults in the Midwest, 21.4% of adults in the South, 17.5% of adults in the Northeast, and 15.3% of adults in the West used any tobacco product.
• By education level (adults age 25 and older), 41.4% of adults with a GED, 25.9% of adults with 12 years of education or less and no diploma, 25.2% of adults with a high school diploma, 24.7% of adults with some college but no degree, 21.3% of adults with an associate degree, 13.0% of adults with an undergraduate degree, and 8.2% of adults with a graduate degree used any tobacco product.
• By annual household income, 26.2% of adults with an annual household income of less than $35,000, 21.0% of adults with an annual household income of $35,000–$74,999, 20.2% of adults with an annual household income of $75,000–$99,999, and 14.3% of adults with an annual household income of more than $100,000 used any tobacco product.
• By marital status, 22.6% of adults who were divorced, separated, or widowed; 21.1% of adults who were single, never married, or not living with a partner; and 18.4% of adults who were married or living with a partner used any tobacco product.
• By health insurance coverage, 29.9% of uninsured adults, 27.8% of adults on Medicaid, 23.0% of adults with other public insurance, 17.2% of adults with private insurance, and 12.6% of adults with Medicare only used any tobacco product.
• By disability status, 24.3% of adults with a disability and 19.3% of adults with no disability used any tobacco product.
• By sexual orientation, 29.2% of lesbian, gay, or bisexual adults and 19.5% of heterosexual or straight adults used any tobacco product.
• By serious psychological distress status, 36.7% of adults with serious psychological distress and 19.1% of adults with no serious psychological distress used any tobacco product.