Reports | 10.19.2023

2021 Wyoming Adult Tobacco Survey

Wyoming Adults’ Use of and Attitudes about Commercial Tobacco and Nicotine Products


Smoking is the leading preventable cause of death in the United States, annually causing more than 480,000 deaths. In Wyoming, smoking leads to approximately 800 deaths from smoking-related illnesses each year and nearly $258 million in annual healthcare costs (Centers for Disease Control and Prevention [CDC], 2014a). In addition, scientists have known since the 1950s that smoking can cause lung cancer. This link between smoking and cancer was widely published in the landmark 1964 Surgeon General’s report Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service (U.S. Department of Health, Education, and Welfare, 1964). Since then, further research has established that smoking cigarettes and breathing secondhand smoke causes multiple cancers and chronic diseases (U.S. Department of Health and Human Services [USDHHS], 2010, 2014).

The Surgeon General declared vaping (the use of e-cigarettes or electronic nicotine delivery systems [ENDS]; also known as e-cigarettes or vaping devices) an epidemic among youth and young adults in 2018 (USDHHS, 2018). Research indicates that vaping can lead to cigarette smoking (Berry et al., 2019; Hair et al., 2021). However, the CDC also states that vaping could be better than smoking for non-pregnant adult smokers if they completely switch from smoked tobacco products to ENDS (CDC, 2022a). More research is needed to learn about the long-term effects of vaping and breathing secondhand aerosol exhaled from someone who is using ENDS (CDC, 2022a).

Certain groups of people are more at risk of suffering the impacts of tobacco use than others. Research has repeatedly shown that tobacco companies have targeted promotional efforts toward certain neighborhoods, the LGBTQ+ community, people of color, people with lower incomes, Indigenous people, and people experiencing behavioral health conditions (D’Silva et al., 2018; Farber & Folan, 2017; Lee et al., 2015; Prochaska et al., 2017). As a result, people in these groups are more likely to smoke. That puts these populations at a disproportionate risk of smoking-related disease and death. These inequities have a greater impact on health outcomes than individual choices.

The Wyoming Substance Use and Tobacco Prevention Program (SUTPP) and the CDC share four goals:

  1. Preventing initiation of tobacco use (CDC, 2014b)
  2. Eliminating nonsmokers’ exposure to secondhand smoke (CDC, 2017)
  3. Promoting quitting among adults and young people (CDC, 2015)
  4. Identifying and eliminating tobacco-related disparities (CDC, 2014b, 2015, 2017, 2021b)

The SUTPP uses a variety of strategies as it focuses on reducing the impact of tobacco use in Wyoming by achieving these goals. The SUTPP monitors its progress on these goals by tracking the use and availability of tobacco products including cigarettes, ENDS, and other forms of tobacco.

The achievement of tobacco prevention outcomes is the collective result of the work of many organizations over time. The efforts of state government programs including the SUTPP, multiple federal agencies, county prevention specialists, and other groups have all played a part in tobacco prevention and control in Wyoming. Key federal agencies include the U.S. Food and Drug Administration (FDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the CDC. Non-governmental groups include the Robert Wood Johnson Foundation, the Campaign for Tobacco-Free Kids, the American Nonsmokers’ Rights Foundation, the American Cancer Society, and the American Lung Association. Changes also reflect influences of the tobacco industry, such as changes in marketing practices or the release of new products such as ENDS.

The Wyoming Adult Tobacco Survey (ATS) is a telephone survey administered by the Wyoming Survey & Analysis Center (WYSAC) at the University of Wyoming under contract to the Wyoming Department of Health (WDH), Public Health Division (PHD). Its purpose is to collect state- and county-level data about tobacco use, the four SUTPP/CDC goals, and the broader goal of reducing tobacco-related disease and death. In addition to analyzing the 2021 data, WYSAC used data from previous versions of the survey to analyze trends.