Dramatic drop in tobacco use stalls, reports finds

Despite dramatic drops in smoking over the last 60 years, tobacco use among middle-aged and older people remains relatively steady and e-cigarettes are still relatively popular, according to a report released Monday by the American Cancer Society.

Additionally, only 18% of eligible adults were up to date on lung cancer screening, which can detect the disease in its early stages, the nonprofit said in its first U.S. Tobacco Atlas.

The digital report contains recent data on tobacco use, including who is using tobacco, the burden on health and the economy as well as advances in tobacco control.

For example, while teen smoking is down overall, the lure of flavored e-cigarettes remains. Among high schoolers, use grew to a peak of nearly 28% in 2019 and dropped in 2024 to less than 8%. On the other hand, 1.7% of students reported smoking cigarettes in 2024, down from just under 16% in 2011.

The report emphasizes that tobacco use remains the "leading preventable cause of cancer death in the United States, with over 80% of lung cancer deaths attributed to tobacco."

In 2025, an estimated 12,770 residents in New York will be diagnosed with lung cancer and 6,060 New Yorkers will die from it.

Experts said smoking declines have been dramatic when compared with the 1960s but it remains an issue.

In 1965, 42% of adults in the United States smoked. In 2022, it had dropped to 12%, aided by factors such as legislative smoking bans, the higher cost of cigarettes and improved smoking cessation tools.

On Long Island, the most recent state data available showed 9.4% of Suffolk adults smoked in 2021, down from 11.2% in 2018. In Nassau County, 7.5% of adults smoked in 2021 — the second lowest percentage in the state after Westchester County's 5.6%. Nassau's rate in 2018 was 7.2%. 

But the number of people who quit smoking "is not progressing as expected," said Dr. Nigar Nargis, senior scientific director, tobacco control and research at the American Cancer Society. "It’s kind of stalled."

Smoking rates among adults between the ages of 40 and 64 "are leveling off" and are "stagnant" for people 65 and older, according to the report.

Between 2011 and 2022, the percentage of people smoking between the ages of 40 and 64 declined from 21% to 15%. And people 65 and over remained roughly around 9% during that time.

The drop was much greater among younger smokers — 19% to 4% for 18-to-24-year-olds and 23% to 12% for 25-to-39-year-olds.

"Whatever reduction we have seen recently in tobacco use is coming from a dramatic reduction among the youth and young adults," said Nargis. "But that's for conventional tobacco. We are simultaneously seeing a rise in electronic nicotine delivery products used among this population which has somewhat tamed the last couple of years but it’s still high."

Even though lung cancer screening through a low-dose CT scan is a key way to make an early diagnosis, only about 18% of eligible adults were up-to-date. Screening is generally recommended for people who have smoked a pack a day for at least 20 years, smoke currently or have quit within the past 15 years and are between 50 and 80 years of age, according to the U.S. Preventive Services Task Force.

"It’s an underutilized resource," said Nargis. "Some people are not aware that they are eligible or they can’t access it because they don't have the insurance to cover it."

Gina Battaglia, 61, of East Moriches was stunned when she was diagnosed with Stage 4 lung cancer in 2022. Not only had she stopped smoking after her 20s, she was also active.

"I was running 3.5 miles a couple of times a week and riding my bike on the other days," she said.

Battaglia had been losing weight but doctors told her that her blood work was fine. It was a pop in her shoulder as she vacuumed that led to the diagnosis. She thought she had torn her rotator cuff until the orthopedist found tumors on her MRI.

She’s currently undergoing chemotherapy and other treatments. Battaglia encouraged people to advocate for themselves.

"We know our own bodies and we know when something is wrong ," she said. "Find another doctor if you need to and be your own best advocate."

By Lisa L. Colangelo

lisa.colangelo@newsday.com@lisalcolangelo

Lisa joined Newsday as a staff writer in 2019. She previously worked at amNewYork, the New York Daily News and the Asbury Park Press covering politics, government and general assignment.