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Who are America’s Biggest Smokers? CDC Report Breaks Down the Numbers

November 25, 2020

Picking up a cigarette and becoming a chronic smoker is a surefire way to suffer long-term health damage. Cigarette smoking, after after all these years, is still the leading cause of preventable disease and death in the United States.

The clearest snapshot of who smokes what, and where, surfaced in a study released quietly several days ago in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. The CDC, after reviewing responses of U.S. adults in the 2019 National Health Interview Survey, says 1 in 5 adults reported using tobacco products. About 80 percent said they used combustible products, such as cigarettes, but the survey also included cigars, pipes, e-cigarettes and smokeless tobacco.

Here are a few stat-grabs from the study:

By Region (Percentage of Adults Who Smoke)

  • Midwest (23.7 percent).
  • South (22.9 percent).
  • Northeast (18.5 percent).
  • West (16.4 percent).

By Subpopulation Groups

  • Adults 25-44 years old (25.3 percent).
  • Non-Hispanic American Indian/Alaska Natives (29.3 percent).
  • Lesbian, gay, or bisexual adults (29.9 percent).
  • Adults 25 years old or older with a General Educational Development (GED) certificate (43.7 percent).
  • Adults with an annual household income less than $35,000 (27 percent).
  • Uninsured adults (30.2 percent) or those with Medicaid (30 percent).
  • Adults with a disability (26.9 percent).
  • Adults divorced, separated or widowed (23.5 percent), or adults who were single, never married or not living with a partner (23 percent).
  • Adults with mild (30.4 percent), moderate (34.2 percent) or severe generalized anxiety disorder (45.3 percent).

By Sex

  • Male: 26.2 percent.
  • Female: 15.7 percent.

By Age

  • 65 and older: 11.4 percent.
  • 18-24: 18.2 percent.
  • 45-64: 23 percent.
  • 25-44: 25.3 percent.


The highest concentration of e-cigarette use was among smokers 18 to 24 years old (9.3 percent). More than half (56 percent) reported they had never smoked cigarettes. During COVID-19, the health risks are even greater for this age group.

“We believe that younger people who vape, or use e-cigarettes, run an even higher risk of contracting COVID-19, and more severely, than other people,” said Dr. J. Craig Allen, medical director of Rushford, part of the Hartford HealthCare Behavioral Health Network. “Vaping leaves the lungs more vulnerable to severe infection and we know that COVID-19 attacks the lungs.”

Quitting Smoking

In Connecticut, at least, smokers want to quit. About 58 percent of daily adult smokers in the state quit smoking for one or more days in 2017, according to the CDC. Unfortunately, cold-turkey efforts typically fail.

“Quitting is only half the battle,” says Ellen Anderson Dornelas, a psychologist and Director of Cancer Care Delivery and Disparities Research
for the Hartford Healthcare Cancer Institute. “Maintaining abstinence is difficult.  Many people relapse to smoking. Relapse is often accompanied by feelings of depression, guilt, frustration and demoralization.

You’ll need a cessation program — the Cancer Institute provides smoking cessation services to any patient in active treatment — the right medication and support from family and friends.

Ask your doctor about the medications that can help you quit smoking. Three types are approved by the Food and Drug Administration: nicotine-replacement therapies, Zyban (bupropion) and Chantix (varenicline). The replacement therapies are available with an inhaler, nasal spray, patch, gum or lozenge.

Try the CT Qutline (1.800.784.8669) or 1-800-Quit-Now, a free telephone helpline staffed by trained Quit Coaches 24 hours a day in English, Spanish and other languages.  Callers receive a personal quit plan and educational quit guides.

For online support, try CommitToQuitCt.com, an online resource available in English and Spanish with individual assistance from a trained Quit Coach accessible by phone or text message. This program help people to quit cigarettes, cigars, chew, dip, vaping or other tobacco products.