The study also shows states with historically high smoking rates have seen the most dramatic declines, while adults over 50 have slower declines.

Researchers at UC San Diego found that cigarette smoking continues to decline across the US, largely driven by young adults. Their study, published April 25 in JAMA Network Open, reveals that the states with historically high smoking rates have seen the most dramatic declines.

The study also indicates, however, that smoking cessation progress among adults over 50 has been much slower, which could prolong the public health burden of smoking-related diseases and death.

“The rapid decline in smoking among young adults is clear evidence that the smoking epidemic will come to an end in our lifetime,” Matthew Stone, first author and assistant professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science and Moores Cancer Center member said in a press release.

Stone’s team projects the national smoking prevalence will be under 5 percent by 2035.

Researchers used the Tobacco Use Supplements to the US Census Bureau’s Current Population Survey. The survey is a large, monthly, representative survey of about 54,000 households that provides information on employment and economic wellbeing. For this study, all analyses were conducted between June and October 2024, with a total of 1.77 million respondents.

The study found large differences in smoking prevalence existed across the US in both the 1990s and in 2022, when the study authors obtained smoking prevalence estimates, with the most significant decline in smoking happening in states with historically high smoking rates. 

Since the 1950s, when researchers first linked smoking to lung cancer, national smoking rates have dropped dramatically. In 1955, 56.9 percent of US adults smoked. By 2000, that figure had fallen by more than half, and by 2022, it had halved again.

The trend is expected to continue, with smoking rates projected to halve again by 2035. Recent evidence indicates that states that have made the greatest progress in reducing smoking have also seen the largest declines in lung cancer mortality, typically with a 16-year lag.

The researchers warn, however, that though the ongoing decline in cigarette smoking is a major public health success, the impact of the rise of e-cigarettes still needs to be studied. 

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