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Tobacco products are bad for pretty much every aspect of human health. Smoking tobacco regularly increases the chances of developing heart disease or lung cancer.1 Tobacco products also contain nicotine, which is an addictive substance that makes it difficult for people to stop smoking.2 A nicotine addiction makes people smoke more, which leads people to spend more money on tobacco, and makes the health risks of smoking tobacco more likely to occur. Sadly, there was a time many decades ago when society did not know that smoking tobacco was harmful. Tobacco companies even falsely advertised that it was healthy! However, in recent decades the fields of medicine and public health have identified the risks of smoking tobacco. Since then, these fields have made impressive efforts to help people either quit smoking or avoid starting altogether. Getting people to stop smoking has been one of public health’s most successful endeavors. While there is still work to be done, new research shows that each new generation is smoking less than the previous one.3  

A recent study looked at data collected through the National Health Interview Survey (NHIS) from 1997 to 2018. The NHIS asks people about their health, including questions about smoking habits. The NHIS is a nationally representative survey, which means it gets responses from adults of all ages, races/ethnicities, and education levels from each region of the US. The goal of a nationally representative survey is to get a picture of the health trends in the US as a whole without having to survey each person in the US. Because the NHIS is sent out each year, the researchers were also able to look for any changes in smoking behavior over time. 

The study revealed some hopeful trends related to smoking in the US. First, it found that the percentage of adults with a smoking habit decreased over the years. There were also fewer people who started smoking each year. The biggest decreases in smoking were among teenagers and young adults. This is important because most people start smoking when they are young due to targeting from tobacco companies or social pressure.4,5 Preventing teenagers from smoking will lead to less people taking up smoking in the long run. Even when looking at adults who did smoke, the number who were heavy smokers decreased over time too. Lastly, adults who did start smoking in recent years were less likely to have started before the age of 18.  

Altogether, this study shows that public health’s efforts to reduce smoking in the US have been working. With health education, people have been waking up more and more to the fact that smoking tobacco causes permanent harm over time. Of course, the researchers point out a limit of their study: they don’t look at the use of nicotine vapes or electronic cigarettes. Vapes and e-cigarettes are highly addictive and pose health risks. Unfortunately, they are being sneakily marketed towards teenagers and have flavors that are appealing to kids. Even if there is more work to do with vaping, the fact that people are smoking less cigarettes is a welcome finding and a victory for public health. 

If you or anyone you know is trying to quit smoking or vaping, follow the links or phone numbers below for more information and assistance.  


Nationally Representative Survey – this is a survey that collects responses from people of all different ages, racial or ethnic backgrounds, education levels, and regions of the country. The goal of a nationally representative sample is to get an idea of the trends that are going on in the whole country. If the sample of people surveyed has the same make-up as the country, then the survey is representative. For example, if 36% of the US population is from the South, then 36% of the people you survey need to be from the South.  


  1. Food and Drug Administration. Health Effects of Tobacco Use. Accessed January 31, 2024.…
  2. Food and Drug Administration. Nicotine Is Why Tobacco Products Are Addictive. FDA. Published online November 13, 2023. Accessed January 31, 2024.… 
  3. Cheng YJ, Cornelius ME, Wang TW, Homa DM. Trends and Demographic Differences in the Incidence and Mean Age of Starting to Smoke Cigarettes Regularly, National Health Interview Survey, 1997-2018. Public Health Rep. 2023;138(6):908-915. doi:10.1177/00333549221138295 
  4. Soneji S, Ambrose BK, Lee W, Sargent J, Tanski S. Direct-To-Consumer Tobacco Marketing and Its Association With Tobacco Use Among Adolescents and Young Adults. Journal of Adolescent Health. 2014;55(2):209-215. doi:10.1016/j.jadohealth.2014.01.019 
  5. U.S. Department of Health and Human Services. Preventing Tobacco Use among Youth and young Adults: A Report of the Surgeon General: (603152012-001). Published online 2012. doi:10.1037/e603152012-001

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