From cigarettes to e-cigarettes: The evolution of tobacco use in the United States
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EmailA historical journey through the evolution of smoking, public health policies and the rise of e-cigarettes in America.
In the United States, cigarette smoking remains the leading cause of preventable disease and death, responsible for over 480,000 fatalities annually. In Michigan, 15.2% of adults are smokers, exceeding the national average of 13.5% as of 2022. Electronic-cigarette (e-cigarette) usage among Michigan adults is also higher, at 8.4%, compared to the U.S. average of 7.6%. Additionally, the Michigan Department of Health and Human Services reported in 2023 that 16.5% of Michigan high school students currently use tobacco, while 13.7% use e-cigarettes, reflecting the rising prevalence of vaping among youth.
Tobacco use in North America has a long history, dating back approximately 12,000 to 12,500 years, when it was traditionally smoked in pipes. In 1880, James Albert Bonsack revolutionized the tobacco industry by inventing the cigarette-rolling machine, which enabled mass production and contributed to the rapid growth in cigarette consumption. By the 1930s and 1940s, cigarette marketing had surged, leading to widespread promotion. U.S. per capita cigarette consumption rose dramatically from 54 cigarettes in 1900 to a peak of 4,345 in 1963. However, in 1969, Congress took a major step by banning cigarette advertising on radio and television.
Public health efforts began in 1950 when studies first linked cigarette smoking to lung cancer. This evidence prompted significant action, including the passage of the Federal Cigarette Labeling and Advertising Act in 1965, which mandated warning labels on cigarette packages and required annual reports from the Department of Health, Education and Welfare detailing the health risks of smoking. Beyond lung cancer, smoking has also been strongly associated with oral cavity and pharynx cancer, as well as heart disease. These initiatives contributed to a steady decline in cigarette consumption, with per capita rates dropping to 2,261 by 1998. Reducing tobacco use was also identified as a national health objective in Healthy People 2000 and remains a priority in contemporary public health initiatives.
While the first e-cigarette was patented by Joseph Robinson in 1930, commercial success of e-cigarettes did not begin until 2003 in China. They were introduced to the U.S. market in 2006 and vaping and e-cigarette use have surged in popularity, especially among youth. By 2024, the Centers for Disease Control and Prevention reported that e-cigarettes had become the most popular tobacco product among middle and high school students, with approximately 410,000 middle schoolers and 1.21 million high schoolers—totaling 1.63 million youth—using e-cigarettes. Of these, 87.6% reported using flavored e-cigarettes, 38.8% had used them on at least 20 of the previous 30 days, and 26.3% reported daily usage.
Both tobacco and vaping carry serious health risks, particularly for youth, as nicotine is highly addictive. Vaping can interfere with brain development, impair learning, increase the risk of future drug addiction, and contribute to long-term health issues, including cancer. The CDC strongly encourages parents and guardians to educate themselves and their children about the dangers of e-cigarette use. Recommended resources include:
- E-cigarettes and Youth: What Parents Need to Know
- Talk With Your Teen About E-Cigarettes Tip Sheet
- 1-800-QUIT-NOW and Teen.smokefree.gov
Michigan State University Extension is dedicated to educating Michigan’s youth about the risks associated with substance use and vaping. MSU Extension was awarded a $450,000 three-year Health Rocks! grant from National 4-H Council to provide substance use prevention education to youth ages 8-14 across Michigan. More information on this important initiative can be found in a recent article.
To contact someone about the Health Rocks! program, email piconeal@msu.edu. Connect with MSU Extension in your community by contacting your county MSU Extension office. Visit the 4-H Healthy Youth website to learn more about 4-H healthy living programs for youth.
