U.S. Cigarette Smoking Drops Below 10%, Marking 'Landmark Moment'

Prevalence of cigarette smoking among U.S. adults fell from 10.8% in 2023 to 9.9% in 2024, signaling a major milestone in tobacco control.

Apr. 3, 2026 at 11:53am by Ben Kaplan

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A ghostly, translucent X-ray photograph showing the intricate structure of a human lung against a dark background, conceptually illustrating the health impacts of smoking.An X-ray view of the human lung reveals the internal damage caused by years of cigarette smoking, a public health crisis that is now on the decline.San Francisco Today

Cigarette smoking among U.S. adults fell from 10.8% in 2023 to 9.9% in 2024, signaling a 'landmark moment' with a prevalence below 10%, according to findings published in NEJM Evidence. The use of other tobacco products like cigars and e-cigarettes did not change much during this period. Experts say this represents a major milestone in tobacco control and reflects decades of sustained public health and clinical efforts.

Why it matters

Reaching a cigarette smoking prevalence below 10% is considered a significant public health achievement, as conditions affecting fewer than 10% of the population are often considered relatively uncommon. This milestone marks the success of long-term tobacco control efforts and reinforces the important role of clinicians in tobacco prevention and cessation.

The details

The analysis, conducted by Israel Agaku, DMD, MPH, MBA, PhD, of the University of California, San Francisco, evaluated responses from over 29,000 U.S. adults in 2023 and 32,000 in 2024. It found that 18.8% of adults in 2024 reported use of any tobacco product, with combustible tobacco (cigarettes and/or cigars) being the most common at 12.6%. Cigarette smoking specifically fell from 10.8% in 2023 to 9.9% in 2024, while the prevalence of cigar smoking and e-cigarette use did not change much.

  • In 2023, 10.8% of adults reported smoking cigarettes.
  • In 2024, the cigarette smoking prevalence dropped to 9.9%.

The players

Israel Agaku

An adjunct clinical professor at the University of California, San Francisco, who conducted the analysis on tobacco use trends.

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What they’re saying

“These findings reinforce that clinicians remain central to tobacco prevention and cessation. Even brief conversations about tobacco use during routine visits can help patients quit and contribute to continued declines in smoking.”

— Israel Agaku, Adjunct Clinical Professor, University of California, San Francisco

What’s next

Future studies will need to monitor not only cigarettes but the full range of tobacco products, including e-cigarettes and cigars. Continued surveillance is essential to ensure that progress in reducing smoking is sustained and that emerging products do not offset these gains.

The takeaway

The decline in U.S. cigarette smoking prevalence below 10% represents a major public health milestone, reflecting the success of long-term tobacco control efforts. However, vigilance is still required to ensure these gains are maintained and that the use of other tobacco products does not undermine the progress made.