Why do we measure smoking?

Rates of smoking have declined in recent decades, the significant impact on health remains.(3) Evidence consistently links smoking to a number of adverse health outcomes, including cardiovascular and lung diseases.(2) Smoking is the leading cause of preventable disease and death in the U.S.(1) These deaths include non-smokers who are exposed to secondhand tobacco smoke.(4)

How do we measure smoking?

This metric includes adults, aged 18 or older, who report smoking at least one hundred cigarettes in their lifetime and currently smokes every day or most days.

Strengths of Metric

Limitations of Metric

Smoking is a significant cause of preventable deaths in the U.S.

Smoking does not provide detailed information about the number of people exposed to the negative health effects of secondhand smoke, such as those who live with a smoker.

Smoking does not take into account teenagers who smoke before the age of 18.(5)

The metric is self-reported and depends on the accuracy of the person surveyed.


Smoking is calculated by the following formula:

Smoking Formula

This metric was calculated by aggregating estimates from smaller geographies to the congressional district level. For more information, please refer to the Congressional District Health Dashboard Technical Document.

Data Source

Estimates for this metric are from one year modeled PLACES Project Data (formerly 500 Cities Project) from the Centers for Disease Control and Prevention.

Years of Collection

Calculated by the Dashboard Team using data from 2021, 1 year modeled estimate.


  1. Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults in the United States. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/index.htm. Published December 1, 2016. Accessed July 22, 2017.

  2. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention, Health Promotion Office on Smoking Health. Publications and Reports of the Surgeon General. In: How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2010.

  3. Agaku IT, King BA, Dube SR, Centers for Disease C, Prevention. Current cigarette smoking among adults - United States, 2005-2012. MMWR Morb Mortal Wkly Rep. 2014;63(2):29-34.

  4. National Cancer Institute. Secondhand Tobacco Smoke (Environmental Tobacco Smoke); https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/secondhand-smoke. Updated March 20,2015. Accessed February 15, 2018.

  5. Centers for Disease Control and Prevention. Trends in Current Cigarette Smoking Among High School Students and Adults, United States, 1965–2014; https://www.cdc.gov/tobacco/data_statistics/tables/trends/cig_smoking/index.htm. Updated March 30, 2016. Accessed July 22, 2017.

  6. Health risk behaviors measure definitions. Centers for Disease Control and Prevention. https://www.cdc.gov/places/measure-definitions/unhealthy-behaviors/index.html#smoking. Published October 20, 2021. Accessed November 11, 2022.

Last updated: February 20, 2024