In her session, “Tobacco, Again? Why We Can’t Stop Caring About a Century-Old Problem,” Kristy Marynak of the CDC Foundation challenged CADCA National Leadership Forum attendees to look beyond the headlines around nicotine and tobacco products and focus on what the data continues to show.
Even though the tobacco landscape may look different than it did a decade ago, tobacco use remains the leading preventable cause of death in the United States. According to national data from the 2022 National Health Interview Survey, 28.8 million U.S. adults smoke cigarettes, more than the entire population of Florida. Roughly 38 million adults use at least one type of combustible tobacco product.
Even among young people, cigarette use has not disappeared. Nearly 760,000 middle and high school students report smoking cigarettes or another combustible tobacco product, according to the 2024 National Youth Tobacco Survey. In other words, despite years of progress, tobacco use continues to affect tens of millions of people across the country.
Marynak noted that tobacco use rates vary across the population. Smoking remains more common among adults living in poverty, individuals with disabilities, and people experiencing serious mental health challenges. These trends highlight the need for prevention and cessation strategies targeted to populations with higher smoking rates.
She walked through several narratives shaping public conversation about nicotine, including the idea that the tobacco industry has fundamentally transformed its business and claims that nicotine itself may offer cognitive or performance benefits. She explained that these messages are not accidental. They reflect a broader communications strategy that relies on repetition and marketing to reshape how the public perceives nicotine and tobacco products. This phenomenon, sometimes called the “illusory truth effect,” shows that repeated exposure to misinformation can make false claims feel true over time. That’s why credible and consistent public health messaging remains so important.
Despite the growing visibility of newer nicotine products, more than 80 percent of U.S. tobacco company revenue comes from combustible products. Combustible tobacco accounts for more than three out of every four dollars in tobacco sales in major in convenience and grocery channels, according to the CDC Foundation’s analysis of Circana data.
Marynak addressed the growing effort to rebrand nicotine itself. Increasingly, nicotine is being marketed as something that can enhance focus or improve productivity, particularly through newer products like nicotine pouches. Decades of research tell a different story. Nicotine is a highly addictive stimulant that can harm the developing brain and lead to long-term dependence. For young people in particular, early nicotine exposure can disrupt brain development and increase vulnerability to addiction.
Throughout the session, Marynak emphasized that the fundamentals of tobacco prevention remain as relevant as ever. Strong public health strategies, such as smokefree indoor air laws, education campaigns, and accessible cessation support, have helped people quit smoking and protected communities from secondhand smoke. The CDC Tips From Former Smokers campaign, a federally-funded national tobacco education campaign, helped more than 1 million people successfully quit smoking.
As tobacco products and industry marketing strategies evolve, the need for strong, evidence-based tobacco prevention efforts has not changed.
Interested in leading or attending sessions like this at a CADCA conference? The 25й Annual Mid-Year Training Institute’s call for presentations is open through Monday, April 13, 2026, and registration opens in March 2026.
