US Smoking Rate Falls Below 10% for First Time—Despite CDC Cuts

For the first time on record, cigarette smoking among U.S. Adults has fallen below 10%, a significant public health milestone. The news, but, didn’t originate from the Centers for Disease Control and Prevention (CDC), the agency typically responsible for tracking and reporting these figures. Instead, the finding emerged from an independent analysis conducted by Israel Agaku, founder and CEO of research technology company Chisquares and published in the digital journal NEJM Evidence.

This shift in how crucial public health data is disseminated underscores a growing concern: the erosion of government capacity in vital areas like tobacco control. Federal funding cuts have decimated the Office of Smoking and Health at the CDC, leaving a gap that researchers like Agaku are now working to fill. The situation highlights a broader trend where independent organizations are stepping in to address critical data analysis and public health alerts.

A Symbolic Threshold and Persistent Disparities

The analysis revealed that 9.9% of U.S. Adults reported smoking cigarettes in 2024, down from 10.8% in 2023. While this decline is cause for optimism, it’s crucial to remember that 9.9% still represents approximately 25 million Americans. Cigarette smoking rates remain disproportionately higher among specific populations, including those with lower educational attainment, individuals with disabilities, and people living in rural areas. The CDC’s National Health Interview Survey, conducted annually, provided the underlying data for this analysis.

As Agaku, who previously served as a senior scientist at the CDC’s Office of Smoking and Health, explained, “In public health, the number 10% is very symbolic to us. Things below 10% are considered rare events or unusual events.” He suggests that, by this definition, smoking could now be considered rare in the U.S. However, he emphasizes that data requires interpretation. “People have to make sense of data, because data cannot speak for itself,” he stated.

The CDC’s Evolving Role and Alternative Data Channels

The CDC maintains its commitment to tobacco prevention and control through outreach, education, and surveillance, according to a statement from agency spokesperson Andrew Nixon. However, the agency’s diminished capacity has led to a reliance on alternative channels for disseminating critical findings. NEJM Evidence, in collaboration with the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, launched a “public health alert” initiative last year as a response to this gap, offering a platform for independent researchers to publish timely analyses. CIDRAP also launched the Vaccine Integrity Project, focused on protecting vaccine use amid concerns about weakening immunization policies.

The situation mirrors a similar trend unfolding with youth tobacco use data. The Food and Drug Administration (FDA) recently released raw data from its National Youth Tobacco Survey without accompanying analysis, prompting researchers at Yale University and Duke University to independently analyze the findings. This underscores the growing need for external expertise to fill the void left by reduced government resources.

Beyond Cigarettes: A Broader Seem at Tobacco Use

While cigarette smoking rates are declining, the overall picture of tobacco use in the U.S. Is more complex. The survey data also revealed that e-cigarette use remained stable at 7%, while 2.6% of adults reported using smokeless tobacco, including nicotine pouches. However, comparisons for smokeless tobacco use were limited due to changes in the survey’s definition of which products fall into that category.

18.8% of U.S. Adults – roughly 48 million people – use at least one tobacco product. Kathy Crosby, CEO and president of the tobacco control nonprofit Truth Initiative, emphasized the importance of addressing persistent disparities in tobacco use among racial, economic, geographic, and LGBTQ+ communities. She also called for restoring and maintaining federal infrastructure to support tobacco use prevention, cessation, research, and public education.

The Path Forward: Restoring Public Health Infrastructure

The CDC released the raw data from its National Health Interview Survey last fall, but without the customary accompanying analysis published in its Morbidity and Mortality Weekly Report (MMWR). Dorothy Hatsukami, a professor at the University of Minnesota who studies tobacco addiction, highlighted the importance of a consistently available government source for national tobacco use trends. “A government agency that can consistently provide us with the results from the survey is vital to understand national trends in tobacco use,” she said.

Agaku’s experience attempting to publish his analysis through the MMWR further illustrates the challenges. He was informed that the MMWR could no longer publish external contributions related to smoking due to the lack of in-house expertise at the CDC following the dismantling of the Office of Smoking and Health. He questioned how a health agency could lack experts on the leading cause of preventable death in the U.S. – smoking, responsible for over 480,000 deaths annually.

Looking ahead, the U.S. Appears to be on track to meet its government goal of reducing smoking prevalence to 6.1% by 2030, as part of the broader Healthy People initiative. However, achieving this goal will require a renewed commitment to public health infrastructure and data analysis, ensuring that critical information reaches policymakers and the public in a timely and effective manner. The current situation underscores the vital role independent researchers and organizations play in safeguarding public health when government resources are constrained.

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