U.S. Smoking Falls Below 10% for the First Time 

Cigarette smoking in the U.S. just hit a historic low. New federal survey data analyzed in NEJM Evidence found that fewer than one in ten adults now smoke cigarettes. This is a historic milestone in the long decline of U.S. cigarette use. In the same data, adult e-cigarette was 7%, signaling that the nicotine landscape continues to shift away from combustible products.  

Cigarette smoking has been steadily declining in the United States for decades. Now it has crossed a historic threshold.

A new study in the journal NEJM Evidence, using data from the National Health Interview Survey (NHIS), found that the national adult smoking rate fell to 9.9% in 2024. At the same time, adult e‑cigarette use rose to 7%, up from 6.5% in 2023—bringing the two figures closer than they’ve ever been before.

This milestone reflects long‑term changes driven by better awareness of smoking’s health risks, public smoking bans, higher cigarette prices, and shifting social norms. But it also points to something broader: many adults are moving away from cigarettes, even if they are not moving away from nicotine altogether. 

The NEJM Evidence analysis draws from the NHIS, the federal government’s main household survey for tracking tobacco use. In 2024, it included nearly 30,000 adults. The results show that cigarettes remain the most commonly used nicotine product, but their dominance continues to weaken as non-combustible products gain ground.

That said, NHIS has limits. It is a self-reported survey covering the civilian, non-institutionalized population with stable household addresses. That means it excludes some groups with historically elevated smoking rates, including active-duty military personnel, people who are incarcerated or living in long-term care institutions, and people without fixed housing. As a result, the 9.9% figure is best understood as a strong estimate, but not necessarily a full count of every population where smoking persists. 

While the NHIS tracks cigarettes and vaping closely, it doesn’t specifically capture numbers on newer products like nicotine pouches. For a closer look at pouches, researchers often turn to other surveys.

Another national survey first asked participants about nicotine pouch use in 2022. Overall, 3.34% of adults reported ever using them, and 0.82% had used them in the last 30 days.  

Nicotine pouches are not approved as smoking cessation products, and research into their long‑term effects is ongoing. But published survey data suggest nicotine pouch use is concentrated among adults with a history of tobacco use, including some adults who recently quit cigarettes or other tobacco products.  

Northerner recently asked more than 1,800 customers why they started using nicotine pouches. Nearly half, 46%, indicated that they did so looking for an alternative to smoking or vaping. This is not a national prevalence estimate, but it is consistent with the broader pattern that many pouch users are previous users of cigarettes, vapes, or other nicotine products.  

A similar shift shows up internationally. A recent analysis of adult purchasing trends in Sweden and Norway describes how nicotine use in the Nordics has shifted from traditional tobacco snus to tobacco leaf-free nicotine pouches. 

Smoking remains a serious public health concern. Still, the long-term movement is hard to miss. Smoking has dropped below 10%, and the broader nicotine market no longer looks the way it did even a few years ago.  

Important Disclaimer: This article is provided for informational and policy commentary purposes only. It does not make any claim that nicotine pouches are safe, safer than cigarettes or other tobacco products, or effective for smoking cessation. Any reduced-risk or modified-risk claim would require separate authorization from the U.S. Food and Drug Administration for the specific product.

Nicotine is addictive and intended only for adults age 21 and over who currently use tobacco or nicotine. Adults considering changes to their tobacco or nicotine use should consult a qualified healthcare professional.