Tobacco and Alcohol Use Trends in the United States, 2011-2024: Comparing Three National Surveys.

Abstract

<b>Objectives.</b> To quantify the prevalence of and trends in tobacco and alcohol use and key social inequities among US adults across 3 nationally representative health surveys over time. <b>Methods.</b> We analyzed repeated cross-sectional data among US adults in 3 nationally representative surveys (2011-2024). We estimated annual prevalence of, absolute change over time, and temporal trends in current cigarette, electronic nicotine delivery systems (ENDS), and past-30-day binge alcohol use, and frequency of alcohol use, by year-overall and by subgroup (i.e., age, sex, race/ethnicity, education, income)-incorporating survey weights. <b>Results.</b> Cigarette smoking prevalence decreased and ENDS use prevalence increased across the study period in all surveys. Alcohol use showed more heterogeneous patterns across surveys and over time. In subgroup analyses, inequities in tobacco and alcohol use exhibited dynamic patterns over time. <b>Conclusions.</b> Further research is needed to understand mechanisms underlying these trends, as well as policy and clinical interventions to promote equitable delivery of evidence-based treatment. Differences by survey highlight the benefits of corroborating findings across data sets. (<i>Am J Public Health</i>. Published online ahead of print August 6, 2026:e1-e10. https://doi.org/10.2105/AJPH.2026.308612).