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US SummaryAppendixMeasures TableData Source DescriptionsMethodology
Despite national prevention efforts, smoking prevalence has not changed since 2011.
Smoking
Smoking cigarettes is the leading cause of preventable death in the United States. Even among older adults and long-term smokers, smoking cessation has been shown to improve health outcomes.
Between 2011 and 2020
Nationally, the percentage of adults ages 65 and older who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days did not change; the prevalence was 8.9% in both 2011 and 2020. This is in contrast with a significant decrease in smoking prevalence among adults ages 18-44 and 45-64 during the past decade. Smoking among older adults did not notably change in any states during this time.

Some education and income subpopulations experienced significant changes in smoking; changes by race/ethnicity and gender were not notable. Among adults ages 65 and older, smoking decreased 20% among college graduates (5.1% to 4.1%) and increased 20% among those with an annual household income below $25,000 (12.2% to 14.7%).
Disparities in 2020
Smoking among older adults was lowest in Utah (3.4%), California (5.4%) and New Jersey (6.7%); it was highest in Tennessee (14.0%), Nevada (13.4%) and Kentucky (13.0%).
Smoking varied the most by education, income and race/ethnicity, but also significantly varied by gender and metropolitan status. The prevalence in adults ages 65 and older was higher among:
- Those with less than a high school education (13.1%), 3.2 times higher than among college graduates (4.1%).
- Those with an annual household income below $25,000 (14.7%), 3.1 times higher than among those with an income of $75,000 or more (4.7%). The prevalence was significantly higher with each decrease in income level.
- Multiracial adults (15.0%), 1.9 times higher than among Hispanic adults (7.9%). The prevalence was also significantly higher among American Indian/Alaska Native adults (14.5%) than among white (8.5%) and Hispanic adults.
