Tobacco Product Use Among Adults—United States, 2021

MMWR Introduction

Cigarette smoking declined from 12.5% in 2020 to 11.5% in 2021, the lowest prevalence recorded since 1965. This study also found that in 2021, nearly 1 in 5, or an estimated 46.0 million, U.S. adults currently used any commercial tobacco product.* This includes 35.6 million adults who reported using a smoked tobacco product (e.g., cigarettes, cigars, pipes), and 8.3 million who used two or more tobacco products. In 2021, cigarettes remained the most commonly used tobacco product, followed by e-cigarettes, cigars, smokeless tobacco, and pipes.

Despite a decline in cigarette smoking, nearly 1 in 7 U.S. adults used smoked products in 2021. To reduce commercial tobacco use and tobacco-related disparities, we must continue to use evidence-based tobacco control strategies and ensure they reach all population groups equitably.

MMWR Highlights

Current Use, 2021

Any Tobacco Product Use, 2021

  • In 2021, an estimated 46.0 million (18.7%), or nearly 1 in 5 U.S. adults, currently used any tobacco product.

Smoked Tobacco Products, 2021

  • Among U.S. adults overall, 35.6 million (14.5%) used smoked tobacco products (e.g., cigarettes, cigars, pipes).

Two or More Tobacco Products, 2021

  • Among U.S. adults overall, 3 million (3.4%) used two or more products. Among these adults:
    • Nearly one-third (31.4%) reported use of both cigarettes and e-cigarettes.
    • 0% reported use of both cigarettes and cigars.
    • 9% reported use of both cigarettes and smokeless tobacco products.
    • 0% reported use of both e-cigarettes and cigars.
    • 7% reported use of both cigarettes and pipes.
  • Additionally, 29% of adults who currently used two or more tobacco products reported use of some other combination, including use of three or more products (14%).

Cigarettes/E-Cigarettes, 2021

  • In 2021, more than 1 in 9 (11.5%) U.S. adults aged 18 years or older currently smoked cigarettes—the lowest percentage recorded since 1965.
  • Cigarettes were the most commonly used tobacco product (11.5%) in 2021, followed by e-cigarettes (4.5%). Use of other products:
    • cigars (3.5%).
    • smokeless tobacco products (2.1%).
    • pipes (0.9%).
  • Among U.S. adults overall, use of cigarettes declined to 11.5% in 2021 (down from 12.5% in 2020).
  • Among U.S. adults overall, use of e-cigarettes increased to 4.5% in 2021 (up from 3.7% in 2020), with prevalence highest among 18–24-year-olds (11.0%).

Sociodemographics, 2021

  • Current use of any commercial tobacco product in 2021, by subgroup, was highest among:
    • Males (24.1%).
    • Adults 25–44 (22.1%) and 45–64 (21.1%) years of age.
    • Adults in the “non-Hispanic, Other” race category (25.6%).
    • Adults living in the Midwest (22.1%).
    • Adults living in rural areas (26.2%).
    • Adults whose highest level of educational attainment was a General Educational
      Development certificate (GED) (39.0%).
    • Adults divorced/separated/widowed (21.3%).
    • Adults with low incomes (24.7%).
    • Adults identifying as lesbian, gay, or bisexual (27.4%).
    • Uninsured adults (28.4%) and those insured by Medicaid (28.1%).
    • Adults with a disability (24.2%).
    • Adults experiencing serious psychological distress (37.6%).

Ever Use, 2021

  • The percentage of adults who ever smoked cigarettes who reported having quit was 66.5%.

 

*Any commercial smoked tobacco product use is defined as current use of one or more of the following tobacco products on ≥1 day during the past 30 days: cigarettes, cigars, hookah, pipe tobacco, or bidis. The term, “tobacco,” as used in this report, refers to commercial tobacco products and not to sacred and traditional use of tobacco by some American Indian communities.