Smoking, Vaping, and Tobacco Use and Native Hawaiians/Pacific Islanders

Note: The information and data on this page focus on commercial tobacco products sold by tobacco companies. It does include information on traditional tobacco used by some American Indians for ceremonial, prayer, or medicinal purposes.

Tobacco products encompass a wide range of products, including cigarettes, smokeless tobacco, electronic cigarettes or vapes, cigars, hookahs, and pipe tobacco. Tobacco products are addictive because they contain nicotine. Nicotine is a highly addictive chemical compound present in a tobacco plant. Using any tobacco product can lead to nicotine addiction. This is because nicotine can change the way the brain works, causing cravings for more of it. Some tobacco products, like cigarettes, are designed to deliver nicotine to the brain within seconds, making it easier to become dependent on nicotine and more difficult to quit. While nicotine naturally occurs in the tobacco plant itself, some tobacco products contain additives that may make it easier for your body to absorb more nicotine.

No tobacco products, including e-cigarettes, are safe. Tobacco products contain many substances that can be harmful to the body and cause a range of health problems, such as cancer, heart disease, lung disease, type 2 diabetes, and problems with the immune system. Quitting tobacco use is one of the most important actions people can take to improve their health.

From 2022 to 2024, Native Hawaiian/Pacific Islander (NHPI) adults were 3% less likely than U.S. adults overall to be current cigarette smokers.

In 2023, NHPI high school students were 54% less likely than students nationwide to be current cigarette smokers.

In 2023, NHPI high school students were 87% more likely than students nationwide to use smokeless tobacco.

From 2022 to 2024, NHPI adults were 61% less likely than U.S. adults overall to have COPD, emphysema, or chronic bronchitis.

Additional Resources

MedlinePlus

Smoking (in multiple languages)
Smoking and Youth

Smoking Cessation

Related Data

Further Reading

HHS OMH Knowledge Center Topic Guide: Smoking, Vaping, and Tobacco Use

Occurrence

Adults

Nicotine dependence in past month among adults ages 18 and older, percentage, 2024
NHPI*	Total Population	Ratio (NHPI* / Total)
5.5	8.7	0.63

Source: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2025). Results from the 2024 National Survey on Drug Use and Health: Detailed Tables (Table 8.3B). U.S. Department of Health and Human Services.

Adults ages 18 and over who were current cigarette smokers, percentage, 2022-2024
NHPI*	Total Population	Ratio (NHPI* / Total)
10.5	10.8	0.97

Source: U.S. Centers for Disease Control and Prevention, National Center for Health Statistics. (2025). Interactive summary health statistics for adults: Percentage of current cigarette smoking for adults aged 18 and over, United States, 2022-2024. U.S. Department of Health and Human Services.

Adults ages 18 and over who were current e-cigarette users, percentage, 2022-2024
NHPI*	Total Population	Ratio (NHPI* / Total)
15.8	6.5	2.43

Source: U.S. Centers for Disease Control and Prevention, National Center for Health Statistics. (2025). Interactive summary health statistics for adults: Percentage of current electronic cigarette use for adults aged 18 and over, United States, 2022-2024. U.S. Department of Health and Human Services.

Adolescents

Students in grades 9-12 who currently smoked cigarettes, 2023
	NHPI*	Total Population	Ratio (NHPI* / Total)
Male	3.1	3.7	0.84
Female	0.6	3.2	0.19
Both Sexes	1.6	3.5	0.46

Source: U.S. Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance System. (2024). 1991-2023 High School Youth Risk Behavior Survey Data: High school students who currently smoked cigarettes. U.S. Department of Health and Human Services.

Students in grades 9-12 who currently used smokeless tobacco, percentages, 2023
	NHPI*	Total Population	Ratio (NHPI* / Total)
Male	2.1	2.9	0.72
Female	5.5	1.5	3.67
Both Sexes	4.3	2.3	1.87

Source: U.S. Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance System. (2024). 1991-2023 High School Youth Risk Behavior Survey Data: High school students who currently used smokeless tobacco. U.S. Department of Health and Human Services.

Students in grades 9-12 who currently used electronic vapor products, 2023
	NHPI*	Total Population	Ratio (NHPI* / Total)
Male	11.1	14.2	0.78
Female	16.0	19.5	0.82
Both Sexes	14.1	16.8	0.84

Source: U.S. Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance System. (2024). 1991-2023 High School Youth Risk Behavior Survey Data: High school students who currently used smokeless tobacco. U.S. Department of Health and Human Services.

Students in grades 9-12 who have ever used electronic vapor products, 2023
	NHPI*	Total Population	Ratio (NHPI* / Total)
Male	19.9	29.1	0.68
Female	45.5	38.9	1.17
Both Sexes	35.3	33.8	1.04

Source: U.S. Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance System. (2024). 1991-2023 High School Youth Risk Behavior Survey Data: High school students who have ever used smokeless tobacco. U.S. Department of Health and Human Services.

Complications

Adults

Adults ages 18 and over with COPD, emphysema, or chronic bronchitis, percentage, 2022-2024
NHPI*	Total Population	Ratio (NHPI* / Total)
1.7	4.4	0.39

Source: U.S. Centers for Disease Control and Prevention, National Center for Health Statistics. (2025). Interactive summary health statistics for adults: Percentage of COPD, emphysema, or chronic bronchitis for adults aged 18 and over, United States, 2022-2024. U.S. Department of Health and Human Services.

*Population is non-Hispanic in the data source.

Date Last Reviewed: March 2026