CDC report shows public health benefit of reduced-risk nicotine products

NOTE: This post was originally published by the author on March 10, 2025.

The U.S. Centers for Disease Control and Prevention recently reported that since 2017 the number of American adults who exclusively smoke cigarettes dropped dramatically from 26.6 million to 19.8 million, translating to roughly 6.8 million fewer adults who exclusively smoke cigarettes. During this same time period, there was a statistically insignificant change in the number of adults reporting dual use of both combustible cigarettes and e-cigarettes (1.4% in 2017 and 1.8% in 2023).

Cigarette smoking remains the leading cause of preventable death and disease in the U.S. and around the globe. However, with recent reductions in smoking, the U.S. is now likely to meet or exceed its Healthy People 2030 national objective for adult smoking to reach 6.1% or lower. Clearly, the recent decrease in the number of Americans who smoke cigarettes is a huge win and should be celebrated by the public health community.

However, the CDC’s report emphasizes that amid the estimated decrease in the number of people who smoke, more adults have begun to exclusively use e-cigarettes. Some 10.1 million adults exclusively use e-cigarettes, up from 2.9 million adults in 2017. This finding leads the agency to state that “continued surveillance and use of comprehensive tobacco control strategies … are important for preventing and reducing tobacco product use, nicotine addiction, and their associated adverse health outcomes.”

But the CDC’s declaration lacks context: the U.S. Surgeon General stresses that 490,000 Americans die annually from use and exposure to traditional cigarettes.  In addition, the U.S. Food and Drug Administration, a sister agency to the CDC in the Department of Health and Human Services, made it clear that generally, e-cigarettes pose significantly lower risks to health than cigarettes, and any adult who switches entirely will enjoy health benefits.

Notably, the CDC report illustrates that most of the progress reducing cigarette smoking has been seen among younger Americans (ages of 18-44) who now have higher rates of exclusive e-cigarette use. Unfortunately, significantly less progress has been seen reducing smoking among older Americans (ages 45+) who are much less likely to use e-cigarettes.

To finally end the cigarette epidemic, federal health agencies and tobacco control groups need to be clearly aligned on the relative risks of different forms of nicotine. It is a massive success for the U.S. to have the lowest cigarette smoking rate ever seen, and that achievement is likely associated with increased e-cigarette usage. Tobacco control groups need to acknowledge this and also focus greater attention on older adults who continue to smoke cigarettes.

The CDC missed an opportunity to celebrate a massive win in public health. Reduced-risk nicotine products, including e-cigarettes and other reduced-risk nicotine products, are clearly helping move us closer to our shared goal of ending the global cigarette smoking epidemic.