Top 5 Takeaways

1. Prevalence of Tobacco Use: In 2020, 19.0% of U.S. adults (47.1 million) used any tobacco product, with cigarettes being the most commonly used (12.5%).
2. Decrease in Tobacco Use: From 2019 to 2020, the prevalence of overall tobacco product use, combustible tobacco product use, cigarettes, e-cigarettes, and use of two or more tobacco products decreased.
3. Demographic Disparities: Higher prevalence of tobacco use was observed among men, younger adults, certain racial and ethnic groups, those in rural areas, and individuals with lower socioeconomic status.
4. Combustible Products Dominance: Among current tobacco users, 79.6% used combustible products like cigarettes, cigars, or pipes.
5. Public Health Implications: Continued monitoring and tailored strategies are essential to reduce disparities and overall tobacco use.

Original Article Author and Citation

Corresponding Author

Monica E. Cornelius, yex8@cdc.gov

Suggested Citation

Cornelius ME, Loretan CG, Wang TW, Jamal A, Homa DM. Tobacco Product Use Among Adults — United States, 2020. MMWR Morb Mortal Wkly Rep 2022;71:397–405. DOI: http://dx.doi.org/10.15585/mmwr.mm7111a1

Summary

In 2020, 19.0% of U.S. adults reported using any tobacco product, with cigarettes being the most common. The prevalence of tobacco use decreased from 2019 to 2020. Higher usage rates were found among men, younger adults, certain racial and ethnic groups, rural residents, and those with lower socioeconomic status. Combustible products were the most used among tobacco users. Continued monitoring and tailored public health strategies are needed to address disparities and reduce overall tobacco use.

Methods

The study used data from the 2020 National Health Interview Survey (NHIS), which included 31,568 adults aged ≥18 years. Data were weighted to provide nationally representative estimates. The survey assessed the use of five tobacco products: cigarettes, cigars, pipes, e-cigarettes, and smokeless tobacco. Prevalence estimates were calculated overall and by various demographic factors. Statistical analyses were conducted using SAS-callable SUDAAN software.

Discussion

Despite a decrease in tobacco use from 2019 to 2020, nearly one in five adults continued to use tobacco products, predominantly combustible ones. Sociodemographic disparities in tobacco use were evident, with higher prevalence among men, younger adults, certain racial and ethnic groups, rural residents, and those with lower socioeconomic status. Public health interventions, such as raising tobacco prices, implementing smoke-free policies, and increasing access to cessation services, are crucial for reducing tobacco use and related health disparities.

Conclusion

Continued monitoring and tailored public health strategies are essential to address disparities and reduce overall tobacco use. Equitable implementation of comprehensive tobacco control interventions is necessary to further reduce tobacco-related morbidity and mortality in the United States.

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