A new CDC report reveals adult cigarette smoking has hit a record low in 2024, while e-cigarette use continues to climb. Separately, an Oxford study suggests nicotine e-cigarettes may be more effective than traditional methods for quitting smoking, though health experts urge caution.
U.S. Smoking and Vaping Trends (CDC)
Cigarette Smoking
According to a 2024 CDC report, approximately 10% of U.S. adults smoked cigarettes in 2024, a decrease from about 11% in 2023. This continues a long-term decline from over 42% of adults in 1964, the year of the first Surgeon General’s report linking smoking to higher mortality rates and serious diseases.
Geographic and demographic differences were observed:
- Adults in rural areas were more likely to smoke, with over 15% reporting cigarette use, compared to urban dwellers.
- Adults aged 45–64 had the highest likelihood of smoking, followed by those aged 25–44.
E-Cigarette Use
The same CDC report found that 7% of U.S. adults used e-cigarettes in 2024, up from 6.5% in 2023 and nearly double the 3.7% reported in 2020.
Geographic and demographic patterns include:
- E-cigarette use was higher in rural areas (9.2%) than in urban areas (6.1%).
- Previous CDC data indicate higher usage among men, individuals identifying as lesbian, gay, or bisexual, and those reporting serious psychological distress.
- The highest prevalence of e-cigarette use was among adults aged 18–24, followed by those aged 25–44.
- Previous CDC data also show that most young adults who use e-cigarettes have not previously smoked cigarettes.
Health Context (CDC)
"While e-cigarettes are considered by some to be a harm reduction option compared to traditional cigarettes, experts state that long-term health effects are not fully understood."
The CDC notes that some adults use e-cigarettes in attempts to quit smoking. However, the U.S. Food and Drug Administration (FDA) has not approved any e-cigarette for smoking cessation. E-cigarettes contain chemicals, including carcinogens, toxins, heavy metals, and respiratory irritants that can cause immediate harm.
Oxford Study on E-Cigarettes and Smoking Cessation
A study published in the journal Addiction by researchers at the University of Oxford analyzed 14 systematic reviews conducted between 2014 and 2023, including a 2024 Cochrane review. The researchers created an 'Evidence and Gap Map' to identify areas requiring further research.
Key findings include:
- The evidence consistently indicates that e-cigarettes are effective in helping people stop smoking, according to lead researcher Angela Difeng Wu.
- The Cochrane review indicated that an additional two to five people per 100 users would quit smoking with nicotine e-cigarettes compared to Nicotine Replacement Therapy (NRT) such as gums and patches.
- Evidence on serious adverse events associated with e-cigarettes was found to be inconclusive. For most other adverse events, the evidence suggested little to no difference compared to other treatments.
International Perspectives and Health Considerations
The role of e-cigarettes in reducing smoking remains subject to uncertainty and controversy, influencing international policy and decision-making. Experts note that evidence on long-term health effects is still evolving due to the products’ recent availability and continuous development.
- A study published in February 2026 reported no current human evidence that e-cigarettes cause cancer, but acknowledged that users are exposed to carcinogenic chemicals. It also found that using e-cigarettes instead of combustible tobacco significantly reduces exposure to cancer-causing chemicals.
- The World Health Organization (WHO) has criticized vapes and e-cigarettes, particularly regarding their impact on children. In 2025, the WHO estimated that over 100 million people worldwide vape, including at least 15 million children aged 13 to 15. The WHO stated that children are, on average, nine times more likely to vape than adults in countries with available data.
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Etienne Krug of the WHO commented that "e-cigarettes are fueling nicotine addiction and risk undermining progress made over decades," although they are marketed as harm reduction.