Cigarette smoking in the United States has reached one of its lowest levels ever recorded, a dramatic change from a time when lighting up was a routine part of daily life for millions of Americans.
Today, about 11% of U.S. adults smoke cigarettes, according to federal health data. That’s a fraction of the roughly 42% of adults who smoked in 1965, when the nation was just beginning to confront evidence linking cigarettes to lung cancer and other serious diseases.
The decline represents one of the most significant public health transformations in modern American history.
For younger Americans, it may be difficult to imagine how common smoking once was. Cigarettes were smoked in offices, restaurants, airplanes, hospitals, schools and homes. Tobacco companies sponsored television programs, sporting events and some of the most recognizable advertising campaigns in the country.
The turning point came in 1964, when U.S. Surgeon General Luther Terry released a landmark report concluding that cigarette smoking caused lung cancer and other serious health problems. The report fundamentally changed the national conversation about smoking and is widely considered the beginning of America’s long campaign to reduce tobacco use.
Congress followed with the Federal Cigarette Labeling and Advertising Act of 1965, requiring warning labels on cigarette packages. The first warnings were relatively simple, cautioning consumers that smoking could be hazardous to their health. Over time, those warnings became stronger and more direct.
Another major change came in 1971, when cigarette advertising was banned from television and radio. For decades before the ban, tobacco companies had used popular television shows and sports broadcasts to market their products to millions of Americans.
As research continued, attention expanded beyond smokers themselves. Scientists found that secondhand smoke could also cause health problems, leading to a new wave of restrictions on where people could smoke.
One of the most visible changes came on airplanes. Smoking was gradually restricted on domestic flights beginning in the late 1980s and eventually prohibited on virtually all flights to and from the United States.
Cities and states also began adopting smoke-free laws for restaurants, workplaces and public buildings. In Kansas, the Kansas Indoor Clean Air Act took effect in 2010, prohibiting smoking in most indoor public spaces.
Missouri took a different approach. Unlike Kansas, which enacted a statewide indoor smoking ban, Missouri relies largely on a patchwork of local smoke-free ordinances. The state adopted its Indoor Clean Air Act in 1992, requiring nonsmoking sections in many public places, but stopped short of a comprehensive statewide ban. As a result, smoking regulations can vary from one Missouri community to another.
Health officials also focused on preventing young people from becoming smokers. Age restrictions, identification requirements, limits on youth-focused advertising and other measures were designed to keep cigarettes out of the hands of minors. In 2019, the federal minimum age to purchase tobacco products was raised from 18 to 21.
Researchers say no single law or policy caused smoking rates to fall. Instead, the decline resulted from decades of public education campaigns, warning labels, advertising restrictions, smoke-free laws, higher tobacco taxes and changing social attitudes.
Part of the decline also reflects generational change. Many of the Americans who came of age when smoking was most common are now in their late 70s, 80s and 90s. But public health experts say the larger story is not that older smokers have died. It is that younger generations have been far less likely to start smoking in the first place.
That may be the clearest sign of how much America has changed.
What began with a surgeon general’s warning more than 60 years ago has gradually transformed smoking from a widely accepted part of everyday life into a habit practiced by a shrinking share of the population. Today, many Americans have never experienced the smoke-filled restaurants, offices and airplanes that once seemed perfectly normal—a reminder of just how far the country has come.