Adult Cigarette Smoking


Smoking rates have fallen dramatically since 2000 in the county as a whole. However, disparities across race, place, and sexual orientation remain.


Cigarette smoking is the leading preventable cause of death in the US, accounting for almost 1 in 5 deaths each year. Deaths from tobacco use exceed the total deaths from HIV, alcohol use, illegal drug use, motor vehicle injury, suicide, and murder. On average, from 2013-2017, 11% of King County adults were smokers, who currently smoke cigarettes every day or some days.

  • Trends: Adult smoking rates declined from 21% in 2000-2002 to 11% in 2015-2017. However, not all groups had the same amount of decline, and some disparities even grew. For example, smoking did not decline among American Indian/Alaska Natives. The gap between smoking rates among Black/African American and White residents increased: While 21% of White residents and 24% of Black residents smoked in 2000-2002 (a difference of 3%), in 2015-2017, only 10% of White residents smoked compared to 17% of Black residents (a difference of 7%).

  • Region and city/neighborhood: From our latest data, the smoking rate in South Region (15%) exceeded rates in Seattle (11%), North Region (9%), and East Region (8%).  7 of the 8 cities or neighborhoods with smoking rates above the county average—Auburn-North, Auburn-South, Burien, Des Moines/Normandy Park, Federal Way-Central/Military Rd, Kent-West, and North Highline—are located in South Region. Smoking rates in Downtown Seattle were elevated as well.

  • Income: Smoking rates decreased as income increased. Adults with household income less than $15,000 were over 4 times more likely than those with income at or above $75,000 to be current smokers.

  • Age: People age 65 and older (6%) were less likely than the county average to smoke.  Smoking rates peaked in those aged 25 to 64.

  • Gender: Men were slightly more likely than women to smoke (13% and 10%, respectively).

  • Sexual orientation: One in five lesbian, gay, and bisexual adults smoked, about twice as high as the King County average.

  • Race and ethnicity: 3 out of 10 American Indian/Alaska Native residents were cigarette smokers. Black/African American residents were also more likely than average to smoke at 17%, while Asian residents were less likely at 7%.


Notes & Sources

Source: Washington State Department of Health, Center for Health Statistics, Behavioral Risk Factor Surveillance System, supported in part by the Centers for Disease Control and Prevention, Cooperative Agreement NU58/DP006066-03-00 (2017).

The Behavioral Risk Factor Surveillance System collects information on the health and safety of Washington residents aged 18 and older. Every year, the Washington State Department of Health and the Centers for Disease Control and Prevention conduct the survey primarily through telephone interviews, including landline and cellphone numbers. To learn more about the survey, please go to

Numerator: People who responded “every day” or “some days” to the question: “Do you now smoke cigarettes every day, some days, or not at all?”

Denominator: All respondents who answered the question.

For more information about adult use of smokeless tobacco, see here