TABLE. Percentage of adults aged ≥18 years who reported tobacco product use “every day” or “some days,” by tobacco product and selected characteristics — National Health Interview Survey, United States, 2020.
| Characteristic | Tobacco product use,* % (95% CI)† |
|||||||
|---|---|---|---|---|---|---|---|---|
| Any tobacco product§ | Combustible tobacco product¶ | Cigarettes** | Cigars†† | Pipes§§ | E-cigarettes¶¶ | Smokeless tobacco products*** | Two or more tobacco products††† | |
|
Overall
|
19.0 (18.4–19.7)
|
15.2 (14.6–15.8)
|
12.5 (11.9–13.0)
|
3.5 (3.2–3.8)
|
1.1 (0.9–1.3)
|
3.7 (3.4–4.0)
|
2.3 (2.1–2.6)
|
3.3 (3.0–3.6)
|
|
Sex
| ||||||||
| Men |
24.5 (23.5–25.5) |
18.8 (17.9–19.8) |
14.1 (13.3–14.9) |
6.3 (5.8–6.9) |
1.5 (1.2–1.8) |
4.6 (4.2–5.2) |
4.5 (4.0–5.0) |
5.2 (4.7–5.8) |
| Women |
13.9 (13.2–14.7) |
11.7 (11.1–12.4) |
11.0 (10.3–11.6) |
0.8 (0.7–1.0) |
0.7 (0.5–0.9) |
2.8 (2.5–3.2) |
0.3 (0.2–0.5) |
1.5 (1.2–1.8) |
|
Age group, yrs
| ||||||||
| 18–24 |
17.6 (15.5–19.9) |
10.9 (9.2–12.9) |
7.4 (5.9–9.0) |
4.1 (3.1–5.4) |
2.1 (1.3–3.1) |
9.4 (7.8–11.2) |
2.4 (1.6–3.4) |
5.7 (4.4–7.2) |
| 25–44 |
22.9 (21.8–24.0) |
18.0 (16.9–19.1) |
14.1 (13.1–15.1) |
5.0 (4.4–5.6) |
1.7 (1.3–2.1) |
5.2 (4.6–5.7) |
2.8 (2.4–3.3) |
4.9 (4.3–5.6) |
| 45–64 |
20.4 (19.4–21.5) |
16.9 (16.0–17.9) |
14.9 (14.0–15.9) |
2.8 (2.5–3.2) |
0.6 (0.4–0.8) |
2.2 (1.9–2.6) |
2.5 (2.1–3.0) |
2.3 (1.9–2.6) |
| ≥65 |
11.8 (10.9–12.7) |
10.4 (9.6–11.3) |
9.0 (8.2–9.8) |
1.8 (1.5–2.1) |
0.3 (0.2–0.5) |
0.6 (0.4–0.8) |
1.2 (0.9–1.6) |
1.0 (0.8–1.3) |
|
Race and ethnicity
§§§
| ||||||||
| American Indian or Alaska Native, non-Hispanic |
34.9 (24.8–46.2) |
29.3 (18.8–41.7) |
27.1 (17.4–38.6) |
—¶¶¶ |
—¶¶¶ |
—¶¶¶ |
6.8 (3.6–11.5) |
10.9 (6.4–16.9) |
| White, non-Hispanic |
21.1 (20.4–21.9) |
16.3 (15.6–17.0) |
13.3 (12.7–14.0) |
3.8 (3.4–4.2) |
0.9 (0.8–1.2) |
4.2 (3.8–4.7) |
3.2 (2.8–3.5) |
3.6 (3.2–3.9) |
| Black, non-Hispanic |
19.4 (17.4–21.5) |
18.0 (16.2–19.9) |
14.4 (12.6–16.3) |
4.6 (3.7–5.6) |
1.6 (1.1–2.3) |
1.6 (1.0–2.3) |
0.8 (0.4–1.5) |
2.9 (2.2–3.9) |
| Asian, non-Hispanic |
11.5 (9.6–13.7) |
8.7 (7.0–10.7) |
8.0 (6.4–9.9) |
0.9 (0.4–1.6) |
0.4 (0.1–0.9) |
3.4 (2.3–4.7) |
0.4 (0.2–0.9) |
1.4 (0.8–2.3) |
| Other, non-Hispanic |
29.1 (24.1–34.4) |
21.0 (16.3–26.4) |
19.5 (14.9–24.7) |
—¶¶¶ |
—¶¶¶ |
7.8 (5.1–11.2) |
3.7 (1.9–6.4) |
9.2 (5.3–14.8) |
| Hispanic |
11.7 (10.4–13.1) |
9.8 (8.6–11.0) |
8.0 (7.0–9.2) |
2.2 (1.7–2.8) |
0.9 (0.6–1.4) |
2.8 (2.2–3.5) |
0.4 (0.2–0.7) |
2.2 (1.7–2.8) |
|
U.S. Census region**** | ||||||||
| Northeast |
16.6 (15.0–18.3) |
13.4 (12.1–14.8) |
10.4 (9.3–11.5) |
3.1 (2.5–3.8) |
0.8 (0.5–1.2) |
3.0 (2.4–3.8) |
1.6 (1.1–2.3) |
2.1 (1.7–2.6) |
| Midwest |
22.0 (20.6–23.4) |
18.2 (16.8–19.6) |
15.2 (14.0–16.5) |
3.7 (3.1–4.4) |
1.3 (0.9–1.8) |
4.1 (3.4–4.8) |
2.6 (2.1–3.2) |
4.1 (3.3–4.9) |
| South |
21.1 (20.0–22.2) |
16.9 (15.8–18.0) |
14.1 (13.1–15.2) |
4.1 (3.6–4.7) |
1.1 (0.8–1.4) |
3.6 (3.2–4.2) |
2.7 (2.3–3.2) |
3.7 (3.2–4.3) |
| West |
15.0 (13.9–16.1) |
11.1 (10.2–12.0) |
9.0 (8.2–9.8) |
2.5 (2.1–3.0) |
1.1 (0.8–1.5) |
4.0 (3.3–4.7) |
1.9 (1.5–2.4) |
2.8 (2.3–3.3) |
|
Metropolitan statistical area
††††
| ||||||||
| Urban |
17.7 (17.0–18.4) |
14.2 (13.5–14.8) |
11.4 (10.8–12.0) |
3.4 (3.1–3.8) |
1.1 (0.9–1.3) |
3.7 (3.3–4.0) |
1.7 (1.5–2.0) |
3.0 (2.7–3.3) |
| Rural |
27.3 (25.5–29.2) |
21.3 (19.6–23.1) |
19.0 (17.4–20.8) |
3.7 (2.9–4.7) |
1.0 (0.6–1.5) |
3.9 (3.0–5.0) |
5.9 (4.8–7.0) |
5.0 (4.0–6.1) |
|
Education (adults aged ≥25 yrs)
| ||||||||
| 0–12 yrs (no diploma) |
24.8 (22.3–27.4) |
22.7 (20.3–25.2) |
21.5 (19.2–24.0) |
3.1 (2.2–4.2) |
0.7 (0.3–1.3) |
1.4 (0.8–2.2) |
2.4 (1.7–3.4) |
3.6 (2.6–4.9) |
| GED |
40.5 (35.4–45.8) |
34.5 (29.5–39.7) |
32.0 (27.2–37.2) |
5.9 (3.9–8.5) |
1.6 (0.5–3.6) |
5.4 (3.5–7.9) |
3.8 (2.1–6.2) |
6.8 (4.7–9.5) |
| High school diploma |
24.2 (22.9–25.6) |
19.6 (18.3–20.9) |
17.6 (16.4–18.9) |
3.1 (2.5–3.6) |
0.9 (0.6–1.4) |
3.5 (3.0–4.2) |
3.3 (2.7–4.0) |
3.8 (3.1–4.5) |
| Some college, no diploma |
21.7 (20.2–23.3) |
17.3 (15.9–18.7) |
14.4 (13.1–15.7) |
4.0 (3.3–4.8) |
0.8 (0.5–1.2) |
4.1 (3.4–5.0) |
2.6 (2.0–3.3) |
3.5 (2.8–4.3) |
| Associate degree (academic or technical/vocational) |
19.4 (17.8–21.1) |
15.3 (13.8–16.8) |
12.7 (11.3–14.1) |
3.6 (2.8–4.5) |
1.0 (0.6–1.6) |
3.7 (2.9–4.5) |
2.6 (2.0–3.4) |
3.3 (2.5–4.2) |
| Bachelor’s degree |
11.7 (10.7–12.6) |
9.0 (8.2–9.9) |
5.6 (5.0–6.3) |
3.3 (2.8–3.9) |
1.0 (0.7–1.4) |
2.4 (2.0–2.9) |
1.3 (1.0–1.7) |
1.7 (1.4–2.1) |
| Graduate degree (master's, professional, or doctoral) |
8.6 (7.6–9.7) |
6.9 (6.0–7.9) |
3.5 (2.9–4.1) |
3.0 (2.5–3.7) |
0.9 (0.5–1.4) |
1.5 (1.1–2.1) |
0.8 (0.6–1.2) |
1.1 (0.8–1.6) |
|
Marital status
| ||||||||
| Married/Living with partner |
17.5 (16.7–18.2) |
13.8 (13.1–14.5) |
10.9 (10.3–11.6) |
3.6 (3.2–4.0) |
0.8 (0.6–1.0) |
3.1 (2.7–3.4) |
2.6 (2.3–2.9) |
2.9 (2.5–3.3) |
| Divorced/Separated/Widowed |
21.6 (20.3–22.9) |
18.9 (17.6–20.1) |
17.3 (16.1–18.5) |
2.3 (1.8–2.8) |
0.8 (0.5–1.1) |
2.6 (2.1–3.1) |
1.6 (1.2–2.1) |
2.6 (2.1–3.2) |
| Single/Never married/Not living with a partner |
21.4 (20.0–23.0) |
16.3 (14.9–17.7) |
13.0 (11.7–14.4) |
4.0 (3.4–4.8) |
2.1 (1.6–2.7) |
6.2 (5.3–7.1) |
2.2 (1.7–2.9) |
4.8 (4.1–5.7) |
|
Annual household income, $
§§§§
| ||||||||
| <35,000 |
25.2 (23.8–26.5) |
22.1 (20.9–23.4) |
20.2 (19.0–21.4) |
3.0 (2.6–3.5) |
1.5 (1.1–2.0) |
3.7 (3.1–4.3) |
1.9 (1.4–2.4) |
4.1 (3.6–4.8) |
| 35,000–74,999 |
20.3 (19.2–21.5) |
16.4 (15.3–17.5) |
14.1 (13.1–15.1) |
3.6 (3.0–4.1) |
0.9 (0.6–1.2) |
3.9 (3.3–4.5) |
2.3 (2.0–2.8) |
3.6 (3.1–4.2) |
| 75,000–99,999 |
18.4 (16.8–20.1) |
13.2 (11.8–14.7) |
10.5 (9.3–11.9) |
3.3 (2.5–4.1) |
1.0 (0.5–1.5) |
4.5 (3.6–5.6) |
3.1 (2.4–4.0) |
3.4 (2.6–4.4) |
| ≥100,000 |
13.7 (12.8–14.7) |
9.9 (9.1–10.7) |
6.2 (5.6–6.9) |
3.8 (3.4–4.3) |
1.0 (0.7–1.4) |
3.2 (2.7–3.7) |
2.3 (1.9–2.7) |
2.3 (1.9–2.8) |
|
Sexual orientation
| ||||||||
| Heterosexual/Straight |
18.8 (18.2–19.5) |
15.0 (14.4–15.6) |
12.3 (11.7–12.8) |
3.5 (3.2–3.8) |
1.0 (0.9–1.2) |
3.5 (3.2–3.8) |
2.4 (2.2–2.7) |
3.2 (2.9–3.5) |
| Lesbian, gay, or bisexual |
25.1 (21.4–29.1) |
18.9 (15.3–22.8) |
16.1 (12.7–19.9) |
4.3 (2.4–7.1) |
2.6 (1.2–4.9) |
8.7 (6.5–11.4) |
0.8 (0.3–1.6) |
6.2 (3.9–9.4) |
|
Health insurance coverage
¶¶¶¶
| ||||||||
| Private insurance |
16.4 (15.7–17.2) |
12.3 (11.7–12.9) |
9.2 (8.6–9.7) |
3.5 (3.2–3.9) |
0.9 (0.8–1.2) |
3.8 (3.4–4.2) |
2.4 (2.1–2.7) |
2.8 (2.5–3.1) |
| Medicaid |
28.6 (26.5–30.8) |
24.6 (22.6–26.6) |
22.7 (20.8–24.8) |
3.0 (2.3–3.8) |
1.9 (1.3–2.8) |
4.4 (3.4–5.6) |
2.4 (1.7–3.3) |
5.0 (3.9–6.2) |
| Medicare only (aged ≥65 yrs) |
12.5 (11.0–14.2) |
11.3 (9.8–12.9) |
10.2 (8.7–11.8) |
1.6 (1.1–2.2) |
0.1 (0.0–0.3) |
0.7 (0.4–1.0) |
1.1 (0.7–1.6) |
1.0 (0.6–1.6) |
| Other public insurance |
21.3 (18.9–24.0) |
17.7 (15.3–20.3) |
14.8 (12.6–17.4) |
4.2 (3.1–5.6) |
1.0 (0.5–1.7) |
2.7 (1.9–3.8) |
2.4 (1.6–3.4) |
3.1 (2.1–4.2) |
| Uninsured |
27.3 (25.0–29.8) |
23.3 (21.1–25.6) |
21.2 (19.1–23.4) |
4.8 (3.7–6.1) |
1.6 (1.0–2.3) |
5.1 (4.0–6.4) |
2.5 (1.8–3.4) |
6.0 (4.8–7.4) |
|
Disability ***** | ||||||||
| Yes |
25.4 (23.3–27.6) |
21.6 (19.6–23.8) |
19.8 (17.8–22.0) |
3.4 (2.5–4.6) |
1.2 (0.8–1.7) |
3.5 (2.7–4.5) |
2.9 (2.1–4.1) |
4.8 (3.6–6.1) |
| No |
18.4 (17.8–19.1) |
14.6 (14.0–15.2) |
11.8 (11.2–12.3) |
3.5 (3.2–3.8) |
1.1 (0.9–1.3) |
3.7 (3.4–4.1) |
2.3 (2.0–2.5) |
3.2 (2.8–3.5) |
|
Regularly having feelings of anxiety
†††††
| ||||||||
| Yes |
29.6 (27.7–31.5) |
24.1 (22.2–26.0) |
21.4 (19.6–23.2) |
4.1 (3.3–5.0) |
1.8 (1.3–2.6) |
7.1 (5.9–8.4) |
2.1 (1.5–2.9) |
5.6 (4.6–6.6) |
| No |
17.7 (17.0–18.4) |
14.0 (13.4–14.7) |
11.3 (10.8–11.9) |
3.4 (3.1–3.7) |
1.0 (0.8–1.2) |
3.3 (3.0–3.6) |
2.3 (2.1–2.6) |
3.0 (2.7–3.3) |
|
Regularly having feelings of depression
§§§§§
| ||||||||
| Yes |
35.6 (32.4–39.0) |
29.6 (26.6–32.8) |
26.9 (23.9–30.0) |
3.7 (2.6–5.1) |
2.8 (1.6–4.6) |
8.3 (6.4–10.6) |
2.6 (1.5–4.3) |
6.7 (4.9–9.0) |
| No | 18.3 (17.6–18.9) | 14.5 (13.9–15.1) | 11.8 (11.2–12.3) | 3.5 (3.2–3.8) | 1.0 (0.8–1.2) | 3.5 (3.2–3.8) | 2.3 (2.1–2.6) | 3.1 (2.8–3.4) |
Abbreviation: GED = general educational development certificate.
* Smoking and tobacco use here refer to use of commercial tobacco products and not to tobacco used for medicinal and spiritual purposes by some American Indian communities.
† 95% Korn-Graubard CIs. National Center for Health Statistics data presentation standards. https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf
§ Any tobacco use was defined as use either “every day” or “some days” of at least one tobacco product. (For cigarettes, users were defined as adults who reported use either “every day” or “some days” and had smoked 100 or more cigarettes during their lifetime).
¶ Any combustible tobacco use was defined as use either “every day” or “some days” of at least one combustible tobacco product: cigarettes; cigars, cigarillos, filtered little cigars; pipes, water pipes, or hookah. (For cigarettes, users were defined as adults who reported use either “every day” or “some days” and had smoked 100 or more times during their lifetime).
** Current cigarette smoking was defined as smoking 100 or more cigarettes during a person’s lifetime and now smoking cigarettes “every day” or “some days.”
†† Current cigar smoking was defined as smoking cigars, cigarillos, or little filtered cigars at least once during a person’s lifetime and now smoking at least one of these products “every day” or “some days.”
§§ Current pipe smoking was defined as smoking tobacco in a regular pipe, water pipe, or hookah at least once during a person’s lifetime and now smoking at least one of these products “every day” or “some days.”
¶¶ Current e-cigarette use was defined as using e-cigarettes at least once during a person’s lifetime and now using e-cigarettes “every day” or “some days.”
*** Current smokeless tobacco product use was defined as using chewing tobacco, snuff, dip, snus, or dissolvable tobacco at least once during a person’s lifetime and now using at least one of these products “every day” or “some days.”
††† Current multiple tobacco product use was defined as use “every day” or “some days” for at least two or more of the following tobacco products: cigarettes (100 or more cigarettes during lifetime); cigars, cigarillos, filtered little cigars; pipes, water pipes, or hookahs; e-cigarettes; or smokeless tobacco products.
§§§ Hispanic persons could be of any race. All other groups were non-Hispanic. The following four non-Hispanic single-race categories were available for sample adults in the 2020 National Health Interview Survey public use files: 1) White; 2) Black or African American; 3) Asian, and 4) American Indian or Alaska Native. Exclusive from these groups, the “Other, non-Hispanic” category includes those adults who were categorized as “non-Hispanic American Indian or Alaska Native and any other group” or “other single and multiple races.”
¶¶¶ Based on National Center for Health Statistics data presentation standards, estimates were statistically unreliable (https://www.cdc.gov/nchs/data/series/sr_02/sr02_175.pdf). SAS MACRO used for suppression criteria check. https://www.sas.com/content/dam/SAS/support/en/sas-global-forum-proceedings/2019/3659-2019.pdf
**** Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont; Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin; South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia; West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.
†††† Urban = large central metropolitan, large fringe metropolitan, medium metropolitan, and small metropolitan; rural = nonmetropolitan. Metropolitan statistical areas are based on the 2013 National Center for Health Statistics Urban-Rural Classification Scheme for Counties. https://www.cdc.gov/nchs/data/series/sr_02/sr02_166.pdf
§§§§ Based on the imputed sample adult family income (grouped) variable.
¶¶¶¶ Private insurance coverage includes adults who had any comprehensive private insurance plan (including health maintenance organizations and preferred provider organizations). Medicaid for adults aged <65 years includes adults who do not have private coverage, but who have Medicaid or other state-sponsored health plans including Children’s Health Insurance Program; for adults aged ≥65 years, includes adults aged ≥65 years who do not have any private coverage but have Medicare and Medicaid or other state-sponsored health plans. Medicare coverage only includes adults aged ≥65 years who only have Medicare coverage. Other public insurance includes adults who do not have private insurance, Medicaid, or other public coverage but have any type of military coverage, coverage from other government programs, or Medicare (adults aged <65 years). Uninsured includes adults who have not indicated that they are covered under private health insurance, Medicare, Medicaid, a state-sponsored health plan, other government programs, or military coverage. Insurance coverage is as of time of survey.
***** Disability was defined based on self-reported presence of selected limitations including vision, hearing, mobility, remembering or concentrating, self-care, and communication. Respondents had to answer, “A lot of difficulty” or “Cannot do at all/unable to do” to one of the following questions: “Do you have difficulty seeing, even when wearing glasses?,” “Do you have difficulty hearing, even when using a hearing aid?,” “Do you have any difficulty walking or climbing steps?,” “Using your usual language, do you have difficulty communicating, for example, understanding or being understood?,” “Do you have difficulty remembering or concentrating?,” “Do you have difficulty with self-care, such as washing all over or dressing?” to be coded as living with a disability; those who responded “no difficulty” or “some difficulty” to all six questions were coded as having no disability. Classifications are based on the 2020 National Health Interview Survey Washington Group Short Set Composite Disability Indicator recode, as based on the short set of questions recommended by the Washington Group on Disability Statistics. https://www.cdc.gov/nchs/washington_group/index.htm
††††† Regularly having feelings of anxiety was assessed by the questions, “How often do you feel worried, nervous or anxious? Would you say daily, weekly, monthly, a few times a year, or never?” and “Thinking about the last time you felt worried, nervous or anxious, how would you describe the level of these feelings? Would you say a little, a lot, or somewhere in between?” Respondents indicating 1) feeling worried, nervous, or anxious daily and describing the level of those feelings as “somewhere in between a little and a lot” or “a lot” or 2) feeling worried, nervous, or anxious weekly and describing the level of those feelings as “a lot” were considered as regularly having feelings of anxiety. Those who answered 1) “never” feeling worried, nervous or anxious and who did not answer the question on the level of the feelings, 2) feeling worried, nervous or anxious and daily and described the level of those feelings as “a little,” 3) feeling worried, nervous, or anxious weekly and described the level of those feelings as “a little” or “somewhere in between a little and a lot,” or 4) feeling worried, nervous, or anxious “monthly” or “a few times a year” and described the level of those feelings as “a little”, “a lot” or “somewhere in between a little and a lot” were considered as not regularly having feelings of anxiety. Others not falling within those combinations were excluded. More information on the definition is available at https://wwwn.cdc.gov/NHISDataQueryTool/ER_Quarterly/index_quarterly.html, and more information on the question source is available at https://www.washingtongroup-disability.com/fileadmin/uploads/wg/Documents/Questions/WG_Implementation_Document__4C_-_WG-SS_Enhanced_Question_Specifications.pdf.
§§§§§ Regularly having feelings of depression was assessed by the questions, “How often do you feel depressed? Would you say daily, weekly, monthly, a few times a year, or never?” and “Thinking about the last time you felt depressed, how would you describe the level of these feelings? Would you say a little, a lot, or somewhere in between?” Respondents indicating 1) feeling depressed daily and describing the level of those feelings as “somewhere in between a little and a lot” or “a lot” or 2) feeling depressed weekly and describing the level of those feelings as “a lot” were considered as regularly having feelings of depression. Those who answered 1) “never” feeling depressed and who did not answer the question on the level of the feelings, 2) feeling depressed daily and described the level of those feelings as “a little,” 3) feeling depressed weekly and described the level of those feelings as “a little” or “somewhere in between a little and a lot,” or 4) feeling depressed “monthly” or “a few times a year” and described the level of those feelings as “a little,” “a lot” or “somewhere in between a little and a lot” were considered as not having feelings of depression. Others not falling within those combinations were excluded. More information on the definition is available at https://wwwn.cdc.gov/NHISDataQueryTool/ER_Quarterly/index_quarterly.html, and more information on the question source is available at https://www.washingtongroup-disability.com/fileadmin/uploads/wg/Documents/Washington_Group_Questionnaire__3_-_WG_Short_Set_on_Functioning_-_Enhanced.pdf.