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Cigarette Smoking

Alabama’s #14 Health Indicator

Tobacco usage  and vaping was ranked AL’s fourteenth and has consistently been a public health concern since the 1960s. Smoking is the leading cause of preventable disease and death (CDC Smoking and Tobacco). While the 67 percent national decrease in current cigarette smokers since 1965 is considered a great public health achievement, tobacco-related disparities persist (CDC News Release). 

Emerging vaping tobacco products, such as JUUL, led to increased youth initiation and exposure to harmful chemicals, such as heavy metals, volatile organic compounds, diacetyl, and nicotine (CDC Electronic Cigarettes). Electronic cigarettes or vaping products can also contain tetrahydrocannabinol and other drugs.  The long-term effects of e-cigarettes are still unknown.

In August 2019, ADPH began receiving reports from healthcare providers of suspected lung injury cases related to e-cigarette, or vaping products. ADPH began working with CDC and the Food and Drug Administration (FDA) as part of a multistate outbreak investigation related to e-cigarette or vaping use-associated lung injury (EVALI) (CDC EVALI Outbreak).

Disproportionately Affected Populations

According to CDC, nicotine can harm adolescent and young adult brain development. Minority populations suffer disproportionally from smoke-related diseases such as CVDs, cancer, diabetes, and pulmonary diseases. Nicotine is also a health danger for pregnant adults and their developing infants.

Geographic Variation

In the U.S., current cigarette smoking is the highest in the Midwest (16.4 percent) and the South (15.4 percent). Smoking is banned in many public settings in major cities, but vaping may still be allowed. The full impact of secondhand smoke effects remains unknown.

Alabama Tobacco Usage and Vaping Highlights

Data are retrieved from BRFSS, the AL Adult Tobacco Survey, and the Youth Risk Behavioral Surveillance System (YRBSS): 

  • Individuals who have less than a high school education and individuals who have an income less than $15,000 per year are more likely to be current smokers.
  • Currently, the prevalence of AL high school students using cigarettes is 7.1 percent, and the prevalence of those using smokeless tobacco products is 8.9 percent.
  • According to YRBSS, over half of AL high school students tried using a vaping device in 2019.
  • The percentage of AL high school students who ever used electronic vapor products was higher among whites and Hispanics students than AA/black students.

Health Indicators


Page last updated: April 22, 2022