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(NEW YORK) — Cigarette smoking among U.S. adults continues to fall to record low levels as e-cigarette use rises, according to a report from the Centers for Disease Control and Prevention (CDC) published early Thursday.

Nearly 10% of adults in the U.S. smoked cigarettes in 2024, the report found. This is down from about 11% in 2023, CDC data shows.

Rates of cigarette use have dramatically fallen since a landmark 1964 Surgeon General report warned about the dangers of cigarette smoking and linked it to lung cancer, chronic bronchitis and other serious diseases.

The 1964 report also found a 70% higher mortality rate among smokers and helped launch a nationwide anti-smoking campaign.

At the time, more than 42% of adult Americans were smokers, according to the Surgeon General.

“Decreased cigarette use is certainly in line with decades of trends and really hard work on the part of public health and education folks to get the word out about how awful cigarettes are and how deadly they are,” Dr. Maria Rahmandar, medical director of the substance use & prevention program in the division of adolescent and young adult medicine at Ann & Robert H. Lurie Children’s Hospital of Chicago, told ABC News.

“However, with decreased cigarette use, that means that big tobacco companies are losing money, and so they’re always looking for new ways to capture customers and hook new people on powerfully addictive … nicotine,” she added.

The new CDC report found those living in rural areas were more likely to smoke more than city dwellers. More than 15% of those in non-metropolitan areas smoked cigarettes compared to those living in cities, the report noted.

Meanwhile, the report found that 7% of American adults used e-cigarettes, or vapes, in 2024.

This is a slight uptick from 6.5% of adults reporting e-cigarette use in 2023 and nearly double from the 3.7% of adults who reported using e-cigarettes in 2020, CDC data shows.

“I think we had a shot [at] the first tobacco‑free generation prior to e‑cigarettes coming onto the market. Unfortunately, it’s kind of derailed that progress,” Thomas Carr, director of national policy at the American Lung Association, told ABC News.

The report found that vaping patterns were similar to cigarettes by metro areas, where 6.1% reported using e-cigarettes compared to 9.2% in rural areas. 

Previous CDC data found that men; those who identify as lesbian, gay or bisexual; and those who report serious psychological distress are more likely to report current e-cigarette use.

The CDC has also previously found that some adults use e-cigarettes to try to quit smoking cigarettes. The health agency notes the Food and Drug Administration has not approved any e-cigarette to help people quit smoking.

Rahmandar said e-cigarettes have been marketed as a way for people to get off cigarettes, which she noted can help. But she cautioned that there are still many unknowns about e-cigarette harms.

“Cigarettes are terrible, and it is possible that e‑cigarettes are safer — not safe — safer than cigarettes,” she said. “So could it be better for somebody to switch that in a harm reduction philosophy? Yes, however, we still don’t know long term effects of e‑cigarettes, either … We know that there are immediate effects. There certainly are harmful chemicals, carcinogens, toxins, heavy metals, respiratory irritants and other things inside of there that certainly can cause immediate harm.” 

By age, those between age 45 and 64 were most likely to be smokers followed by those between ages 25 and 44.

Among vapers, those between ages 18 and 24 had the highest prevalence of e-cigarette use followed by those between ages 25 and 44.

Previous CDC data has shown that the majority of young adults who use e-cigarettes have never smoked cigarettes.

“I think this is … the JUUL generation,” Carr said, referencing what was the most popular e-cigarette in the U.S. “From 2017 to 2019, they got teens to get hooked on JUUL, and they’re now adults, and unfortunately, they haven’t been able to quit using e-cigarettes.”

Tiffany Le, MD, is a pediatrics resident at UT Southwestern Medical Center and a member of the ABC News Medical Unit. 

ABC News’ Liz Neporent contributed to this report.

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