Demographic Trends and Disparities in Cigarette Consumption Among U.S. Older Adults, 2006-2022

Cigarette smoking remains a significant public health concern in the U.S. There is limited research on cigarette consumption among older adults, a population with increased vulnerability to smoking-related morbidities. This study examines demographic trends in cigarette smoking among U.S. adults aged 50 and older.

Data from the Health and Retirement Study (2006-2022), a nationally representative longitudinal survey, were analyzed. Current smoking prevalence and average daily cigarette consumption were calculated. Joinpoint regression analysis was used to identify significant shifts in trends over time, stratified by sex, race/ethnicity, and age cohorts.

The overall prevalence of current smoking among older adults significantly decreased from 14.77% in 2006 to 6.99% in 2022, with a steeper decline after 2018 (Biennial Percent Change [BPC] = -12.15%). This decline was consistent across several demographics. A notable counterintuitive trend emerged in average daily cigarette consumption among those who continued to smoke. This consumption initially declined significantly from 18.03 cigarettes per day in 2006 to 10.91 cigarettes per day in 2016 (Biennial Average Change [BAC] = -4.93), but then significantly increased to 12.86 cigarettes per day by 2022 (BAC = 2.74). This pattern of initial decrease followed by a subsequent increase in daily consumption was observed across most demographic subgroups.

Cigarette smoking among older adults in the U.S. has significantly declined, but the increasing cigarette consumption among adults who smoked in the later part of the study period highlights a potential hardening of smoking behavior, warranting that tailored cessation efforts are needed.