Trends in the Age of Cigarette Smoking Initiation Among Young Adults in the US From 2002 to 2018

Key Points Question Has the proportion of cigarette smokers initiating smoking in early adulthood (ages 18-23 years) vs adolescence (age <18 years) increased from 2002 to 2018? Findings In this repeated cross-sectional study including 71 756 young adults aged 22 to 23 years, the proportion of ever smokers who initiated cigarette smoking in early adulthood more than doubled between 2002 and 2018, and the proportion of daily cigarette smokers who transitioned to daily smoking in early adulthood also increased from 38.7% in 2002 to 55.9% in 2018. Meaning These findings suggest that smoking prevention efforts typically targeting adolescents should be expanded to address young adults, who account for an increasing and substantial proportion of new smokers.