Young Adults Lead Remarkable Drop in Smoking Rates Across the U.S.

Recent research from the University of California San Diego highlights a significant decline in smoking rates across the United States, primarily driven by reductions among young adults. The newly published study in JAMA Network Open on April 25, 2025, indicates that states with historically high smoking prevalence are witnessing the most dramatic decreases. Despite this encouraging trend, progress among adults aged 50 and older remains slow, suggesting that smoking-related health issues such as lung cancer, heart disease, and chronic obstructive pulmonary disease (COPD) will persist longer into the future.

The study analyzed data from the Tobacco Use Supplements of the U.S. Census Bureau’s Current Population Survey, which surveys about 54,000 households monthly, providing detailed insights into smoking behaviors across the nation. Between June and October 2024, researchers evaluated responses from 1.77 million individuals.

Key findings include persistent disparities in smoking prevalence based on geography, age, sex, race, ethnicity, and education over the years. The most notable decline has been among young adults, which is a promising sign that the smoking epidemic may be nearing its end. However, the decline among adults over 50 has lagged, especially in states with historically high smoking rates.

Since the 1950s, when the link between smoking and lung cancer was first established, the U.S. has seen a dramatic drop in smoking prevalence—from nearly 57% of adults smoking in 1955 to approximately 28% in 2022. Projections now suggest that smoking rates could fall below 5% nationwide by 2035. This reduction correlates with declines in lung cancer mortality, which typically lag about 16 years behind decreases in smoking rates.

Matthew Stone, Ph.D., the study's lead author, emphasizes that the rapid decline in smoking among young adults signals a possible end to the smoking epidemic within our lifetime. Nevertheless, he warns that the tobacco industry’s shift toward e-cigarettes and nicotine products may pose new challenges, particularly in recruiting a new generation of users. Continued research is essential to fully understand and address these evolving trends.

According to the study's senior author, John P. Pierce, Ph.D., ongoing efforts have resulted in a substantial public health victory; however, tackling the slower decline among older populations remains a priority to mitigate the long-term health impacts associated with lifelong smoking.