Tobacco Use Trends: A Substantial Change Over Time. By Tyler Watson, Research Specialist - Washington Alcohol Server Classes | Alcohol Server Training (MAST) Permits WA

1. Between 1965 and 2022, cigarette use has decreased by 73%

The recognition of tobacco use as a health hazard, and subsequent decrease in use, is often credited as one of the 10 greatest public health achievements of the 20th century. Efforts such as anti-smoking campaigns, smoking bans, tobacco taxes, and cessation support have all contributed to this decrease.

Cigarette Smoking in the U.S. by Age Group, 1965–2021. Source: American Lung Association

2. As of 2021, tobacco use in the U.S. remains the third leading risk factor for early death and disability

People with lower household income, lower education levels, and those who are male, Black, African American and/or multiracial experience the most disparities from tobacco use. These trends exist across the U.S. as well as in Washington and have been similar over time.

Cigarette Smoking in the Past Month Among Adults Aged 18 or Older in the U.S. and Washington, 2002–2022. Source: National Survey on Drug Use and Health (NSDUH)

3. It is not just about cigarettes

E-cigarettes and smokeless tobacco are gaining popularity. In Washington, about 8% of individuals vape e-cigarettes and about 3% of individuals use smokeless tobacco. E-cigarettes have been shown to help with smoking cessation and may be less harmful than cigarettes; however, e-cigarettes are still linked to various health issues such as addiction and respiratory problems.

Prevalence of Nicotine/Tobacco Use in Washington, 2022. Source: Washington State Department of Health

4. It is critical to prevent young people from using any type of nicotine products

Nicotine/tobacco use in adolescence has been linked to numerous harmful outcomes, such as inattention, impulsivity, psychosis, and increased risk of substance use and other mental health disorders.

Importantly, the use of cigarettes, smokeless tobacco, and e-cigarettes dropped substantially among adolescents during the COVID-19 pandemic.

However, as of 2023, about 2% of 10th graders in Washington smoke cigarettes, 3% use smokeless tobacco, and about 8% vape nicotine. That means four times as many adolescents vape nicotine compared to smoking cigarettes (8% vs. 2%).

Among adolescents, demographic groups at higher risk of tobacco use include those who identify as sexually or gender diverse, have one or more disabilities, or are part of a migratory working family.

Current (30-day) Tobacco Product Use Among 10th Graders in Washington State, 2010–2023.* Source: Washington Healthy Youth Survey

*Trend lines are not continued after 2018 due to methodology changes related to the COVID-19 pandemic. The definition of “smokeless tobacco” was expanded in 2023 to include other smokeless nicotine products such as pouches, lozenges, gum, or toothpicks.

5. Continued focus on tobacco/nicotine prevention and reduction remain essential to public health efforts

Check out the Department of Health Commercial Tobacco Prevention Program for more information and resources.

For more information provided by the LCB Research Program, visit our website.