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Background
Quitting smoking has major and immediate health benefits for men and women of all ages. Quitting smoking dramatically reduces the risk of lung and other cancers caused by smoking, coronary heart disease, stroke, and chronic obstructive pulmonary disease (COPD). For example, 10-15 years after quitting, the risk of lung cancer decreases to about one-half that of a person who continues to smoke; with continued abstinence from smoking, the risk of lung cancer decreases even further.
Although quitting smoking is beneficial at any age, the earlier in life a person quits, the more likely it is that he or she will avoid the devastating health effects of continued tobacco use. Few smokers can quit successfully on their first attempt; most people will require many attempts before they are able to permanently quit. This emphasizes the need for smokers to begin trying to quit as early in life as possible.
A number of strategies can increase the likelihood of successful smoking cessation, including comprehensive, barrier-free, and widely promoted access to insurance coverage for smoking cessation treatment, and the use of FDA approved smoking cessation medications together with behavioral counseling to support quit attempts. Behavioral counseling and support can be delivered using individual or group counseling, or by quitlines, web and internet, or text-messaging platforms. Cessation rates can also be improved by adopting population-level policies, such as tobacco product price increases or comprehensive smokefree policies, implementing anti-tobacco mass media campaigns, requiring pictorial health warnings on tobacco products, and maintaining comprehensive statewide tobacco control programs.
Measure
Attempt to quit: The percentage of adult smokers aged 18 years and older who attempted smoking cessation within the past 12 months. The attempt-to-quit measure includes both current smokers who smoke every day or some days and who, at the time of the survey, had quit smoking for at least 1 day during the past 12 months, as well as recent former smokers, who quit smoking less than or equal to 1 year ago.
Successful quitting: The percentage of recent smoking cessation success for adult smokers (aged 18 years and older) includes recent former smokers who quit 6-12 months prior to the survey interview among those who met any of the three conditions:
- Former smokers who had quit smoking 6-12 months prior to the survey interview.
- Former smokers who had quit smoking less than 6 months prior to the survey interview.
- Current smokers at the time of the survey interview who initiated smoking at least 2 years prior to the survey interview.
Healthy People 2030 Target
- Increase to 65.7 percent the proportion of adult current smokers (aged 18 years and older) who stopped smoking for a day or longer because they were trying to quit.
- Increase to 10.2 percent the proportion of adult smokers (aged 18 years and older) who successfully quit smoking.
Healthy People 2030 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey 1998-2020.
In 2019 the NHIS questionnaire was redesigned to increase relevance, enhance data quality, and minimize respondent burden. In addition, the COVID-19 pandemic created challenges conducting in-person interviews for the 2020 NHIS, requiring changes to field procedures to conduct most surveys by telephone, which impacted survey response rates. For details related to the potential impacts of these issues, please refer to Potential Impact of NHIS Redesign and COVID-19 on the Cancer Trends Progress Report.
Trends and Most Recent Estimates
Attempted to Quit Smoking
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
Both Sexes
|
53.9 | 51.6 - 56.1 |
Male
|
53.5 | 50.6 - 56.5 | |
Female
|
54.1 | 50.8 - 57.4 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
All Races
|
53.9 | 51.6 - 56.1 |
Non-Hispanic White
|
51.1 | 48.4 - 53.8 | |
Non-Hispanic Black
|
60.4 | 52.8 - 67.5 | |
Hispanic
|
55.4 | 48.6 - 61.9 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
Ages 18-24
|
63.4 | 50.4 - 74.7 |
Ages 25 and older
|
52.2 | 50.1 - 54.3 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
55.0 | 51.4 - 58.6 |
>=200% of federal poverty level
|
53.0 | 50.0 - 55.9 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
Less than High School
|
51.8 | 46.0 - 57.5 |
High School
|
51.7 | 48.2 - 55.2 | |
Greater than High School
|
52.6 | 49.7 - 55.4 | |
Successfully Quit Smoking
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
Both Sexes
|
8.5 | 7.3 - 9.8 |
Male
|
8.1 | 6.7 - 9.9 | |
Female
|
8.8 | 6.9 - 11.2 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
All Races
|
8.5 | 7.3 - 9.8 |
Non-Hispanic White
|
9.6 | 8.1 - 11.4 | |
Non-Hispanic Black
|
7.8 | 4.8 - 12.5 | |
Hispanic
|
5.2 | 3.2 - 8.3 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
Ages 18-24
|
15.8 | 8.6 - 27.3 |
Ages 25 and older
|
7.6 | 6.6 - 8.7 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
6.2 | 4.6 - 8.4 |
>=200% of federal poverty level
|
10.0 | 8.4 - 11.9 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2020) | |
|---|---|---|---|
| Percent of adult smokers | 95% Confidence Interval | ||
|
Less than High School
|
5.8 | 3.7 - 9.1 |
High School
|
6.3 | 4.8 - 8.1 | |
Greater than High School
|
9.4 | 7.9 - 11.0 | |
Additional Information on Quitting Smoking
- Tobacco. National Cancer Institute.
- How to Quit Using Tobacco. American Cancer Society.
- Smoking & Tobacco Use – Quit Smoking. Centers for Disease Control and Prevention.
- Public Health Education. U.S. Food and Drug Administration.
Quitting Smoking Resources
- Smokefree.gov. National Cancer Institute.
- Cigarette Smoking: Health Risks and How to Quit (PDQ®)–Patient Version. National Cancer Institute.
- How to Quit Using Tobacco. American Cancer Society.
- North American Quitline Consortium. North American Quitline Consortium.
- Tips From Former Smokers-Media Campaign. Centers for Disease Control and Prevention.
- A Socioecological Approach to Addressing Tobacco-Related Health Disparities. U.S. National Cancer Institute. National Cancer Institute Tobacco Control Monograph 22. NIH Publication No. 17-CA-8035A. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2017.
- The Economics of Tobacco and Tobacco Control. U.S. National Cancer Institute and World Health Organization. National Cancer Institute Tobacco Control Monograph 21. NIH Publication No. 16-CA-8029A. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; and Geneva, CH: World Health Organization; 2016.
- Tobacco Control Evidence-Based Programs Listing. National Cancer Institute.
- Smoking Cessation: A Report of the Surgeon General. Centers for Disease Control and Prevention.
- Surgeon General’s Reports on Smoking and Tobacco Use. Centers for Disease Control and Prevention.
- Best Practices for Comprehensive Tobacco Control Programs – 2014. Centers for Disease Control and Prevention.
- Healthcare Provider Resources: Smoking and Tobacco Use. Centers for Disease Control and Prevention.
- Tobacco Use. Million Hearts.
- Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons. U.S. Preventive Services Task Force.
- Prevalence and determinants of cigarette smoking relapse among US adult smokers: a longitudinal study. Alboksmaty A, Agaku IT, Odani S, Filippidis FT. BMJ Open. 2019;9(11):e031676.
- Anti-Smoking Media Campaigns and Disparities in Smoking Cessation in the United States, 2001-2015. Colston DC, Cho B, Thrasher JF, et al. Am J Health Promot. 2021 Jan 8:890117120985818.
- Tobacco Product Use and Cessation Indicators Among Adults - United States, 2018. Creamer MR, Wang TW, Babb S, et al. MMWR Morb Mortal Wkly Rep. 2019;68(45):1013-1019.
- State Tobacco Excise Taxation, Comprehensive Smoke-free Air Laws, and Tobacco Control Appropriations as Predictors of Smoking Cessation Success in the United States. Dahne J, Nahhas GJ, Wahlquist AE, Cummings KM, Carpenter MJ. J Public Health Manag Pract. 2020;26(5):E1-E4.
- Relapse Prevention Interventions for Smoking Cessation. Livingstone-Banks J, Norris E, Hartmann-Boyce J, et al. Cochrane Database Syst Rev. 2019;2019(10).
- Targeted smoking cessation for dual users of combustible and electronic cigarettes: a randomised controlled trial. Martinez U, Simmons VN, Sutton SK, et al. Lancet Public Health. 2021;6(7):e500-e509.
- Paying Low-Income Smokers to Quit? The Cost-Effectiveness of Incentivizing Tobacco Quit Line Engagement for Medicaid Recipients Who Smoke. Mundt MP, Baker TB, Fraser DL, Smith SS, Piper ME, Fiore MC. Value Health. 2019;22(2):177-184.
- Heterogeneity in Past-Year Smoking, Current Tobacco Use, and Smoking Cessation Behaviors Among Light and/or Non-Daily Smokers. Omole T, McNeel T, Choi K. Tob Induc Dis. 2020;18:74.
- Enhancing employer coverage of smoking cessation treatment: A randomized trial of the Partners in Helping You Quit (PiHQ) program. Rigotti NA, Kelley JHK, Regan S, et al. Prev Med. 2020;140:106216.
- Income disparities in smoking cessation and the diffusion of smoke-free homes among U.S. smokers: Results from two longitudinal surveys. Vijayaraghavan M, Benmarhnia T, Pierce JP, et al. PLoS One. 2018;13(7):e0201467.
- Smoking-Cessation Interventions for U.S. Young Adults: Updated Systematic Review. Villanti AC, West JC, Klemperer EM, et al. Am J Prev Med. 2020;59(1):123-136.
- Associations between marijuana use and tobacco cessation outcomes in young adults. Vogel EA, Rubinstein ML, Prochaska JJ, Ramo DE. J Subst Abuse Treat. 2018;94:69-73.
- Characteristics and Correlates of Recent Successful Cessation Among Adult Cigarette Smokers, United States, 2018. Walton K, Wang TW, Prutzman Y, Jamal A, Babb SD. Prev Chronic Dis. 2020;17:E154.
- State-Specific Cessation Behaviors Among Adult Cigarette Smokers - United States, 2014-2015. Wang TW, Walton K, Jamal A, et al. Prev Chronic Dis. 2019;16:E26.
- The Tobacco Use Supplement to the Current Population Survey. National Cancer Institute.
- The National Health Interview Survey Cancer Control Supplements. National Center for Health Statistics, co-sponsored by the National Cancer institute/DCCPS and the Centers for Disease Control and Prevention/OSH and DCPC.
- Population Assessment of Tobacco and Health (PATH) Study Series. National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, Food and Drug Administration.