Adult cigarette smoking drops to all-time low as student vaping heats up

"It’s dizzying.” That’s the assessment of tobacco researcher Matthew Carpenter at the Medical University of South Carolina, referring to all of the changes occurring in his field. Today, there’s word that adult cigarette smoking in the U.S. has dropped to an all-time low of 13.9 percent. “We knew that the prevalence of smoking was coming down, but this is the first we've seen it this low,” Carpenter says. “That’s great news.”  

A bar graph released by the Centers for Disease Control and Prevention shows the dramatic decline of cigarette use from 2006 to 2017. 

But Carpenter says it doesn’t tell the whole story. He points to a second graph in the CDC’s report on the National Health Interview Survey results. It shows a smoldering discrepancy between the smoking rate in rural areas versus cities.

“In rural areas, 21.5 percent of adults are still smoking, versus 11.4 percent for urban areas. It shows that smoking is becoming more concentrated in places where access to smoking cessation help is very limited, apart from the South Carolina Tobacco Quitline that’s open to everyone.”

Carpenter says experts in the MUSC Health Tobacco Treatment Program and elsewhere are working on ways to make sure rural South Carolinians aren’t left behind. They’re focusing on science-based methods shown to help people quit. “We need to get more smokers using better treatments sooner.”

Smoking was once so common that people even smoked in hospitals. Anti-smoking programs and high cigarette taxes have helped change that. So have electronic cigarettes, Carpenter believes. “Vaping can help smokers quit. The data show e-cigarettes and other electronic devices can make a difference.”

But is the U.S. making a transition away from one problem and toward another, as the number of young adults who were not tobacco cigarette smokers but do use e-cigarettes soars? News reports call student vaping an epidemic.

E-cigarettes heat liquid nicotine to produce a vapor the user can inhale. They come in a range of flavors including fruit medley, crème brulee and mint. Carpenter says there is concern that the devices, including the widely popular Juul, will be a gateway to regular cigarettes, but the evidence for that is mixed.

“The report from the CDC is good, but you have to see it in the context of all these alternative products proliferating on the market, Juul being the latest but not the last, offering alternatives for smoking. That’s good for smokers who want to stop using combustible cigarettes. That’s bad for non-smokers who have many more ways to use nicotine.”

Read more about Carpenter’s thoughts on e-cigarettes in this report: Juuling, hot teen trend, fascinates and worries researcher.

Tobacco cessation experts at MUSC Health have some suggestions for smokers who want to quit.

• Pick a quit date
• Think about your reasons for quitting, such as being healthier and saving money
• Get rid of things that will make you want to start smoking again such as ashtrays and lighters
• Let family and friends know so they can support you

You can find more information on how to quit smoking through the MUSC Health Tobacco Treatment Program.