{"id":3965,"date":"2026-10-28T10:20:05","date_gmt":"2026-10-28T16:20:05","guid":{"rendered":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/?p=3965"},"modified":"2026-10-28T10:49:57","modified_gmt":"2026-10-28T16:49:57","slug":"2025-wyoming-adult-commercial-tobacco-and-nicotine-survey","status":"publish","type":"post","link":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/2026\/10\/28\/2025-wyoming-adult-commercial-tobacco-and-nicotine-survey\/","title":{"rendered":"2025 Wyoming Adult Commercial Tobacco and Nicotine Survey"},"content":{"rendered":"<h1>Executive Summary<\/h1>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-4007 size-medium\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_01_ES-284x300.png\" alt=\"Callout box: Stopping youth from starting to use com-mercial tobacco is a key strategy for tobacco prevention. Almost all adults (91%) who ever smoked started before age 21, with an average age of 16.\" width=\"284\" height=\"300\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_01_ES-284x300.png 284w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_01_ES.png 469w\" sizes=\"auto, (max-width: 284px) 100vw, 284px\" \/><\/p>\n<p>The 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey (formerly known as the Wyoming Adult Tobacco Survey) provides insights into how Wyoming adults use and perceive commercial tobacco and nicotine products. The survey, conducted by the Wyoming Survey &amp; Analysis Center (WYSAC), tracks progress toward commercial tobacco and nicotine prevention goals.<\/p>\n<p><strong>Cigarettes, ENDS (Electronic Nicotine Delivery Systems), and nicotine pouches are the most commonly used products in Wyoming.<\/strong><\/p>\n<h2>Key Findings<\/h2>\n<ul>\n<li><strong>ENDS:<\/strong>\n<ul>\n<li>Most adults (69%) have never tried ENDS, but current use has increased from 7% in 2015 to 10% in 2025, matching the 2025 cigarette smoking rate of 10%.<\/li>\n<li>Perceived harm of ENDS use has increased from 35% of adults saying it is very harmful in 2017 to 72% in 2025.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Cigarette Smoking:<\/strong>\n<ul>\n<li>Current smoking rate is 10% in 2025, down from a recent peak of 21% in 2006.<\/li>\n<li>Nearly all adults (98%) acknowledge that smoking cigarettes is harmful.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Secondhand Smoke:<\/strong>\n<ul>\n<li>Most adults (87%) support smokefree indoor air policies for restaurants, while 85% support similar policies in workplaces. Support for smokefree bars and casinos\/clubs is over 50%.<\/li>\n<li>Most employed adults (91%) report working in smokefree indoor workplaces.<\/li>\n<li>About one in three adults (33%) report exposure to secondhand smoke in public places.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Quitting Efforts:<\/strong>\n<ul>\n<li>About half of adults who smoke (53%) want to quit, and many (81%) have tried at some time in their life.<\/li>\n<li>About 55% of current adult ENDS users have tried to quit.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Emerging Commercial Tobacco and Nicotine Products:<\/strong>\n<ul>\n<li>The use of new and emerging products remains low among Wyoming adults with the exception of nicotine pouches. One in twenty adults (5%) reports using nicotine pouches, similar to the rate for smokeless tobacco (4%).<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>There has been a decline in cigarette smoking rates but a rise in ENDS use among Wyoming adults. Public awareness of the harms of smoking is high, and there is considerable support for smokefree policies. Preventing new commercial tobacco or nicotine use, especially among youth, requires targeted efforts and continuous monitoring of emerging products. <!--nextpage--><\/p>\n<h1>Background<\/h1>\n<p>In this report, we refer to the use of commercial tobacco, not ceremonial or traditional use of tobacco by Indigenous Peoples such as the Eastern Shoshone or Northern Arapaho. Smoking refers to the use of commercial cigarettes. Smokeless tobacco refers to commercial products such as chew, moist snuff, and snus. Legally, the U.S. Food and Drug Administration has deemed electronic nicotine delivery systems (ENDS, also known as e-cigarettes or vaping devices) to be commercial tobacco products and subject to their regulation. Wyoming Statute (Wyo. Stat. \u00a7 14-3-301, 2013\/2023) also includes ENDS in the legal definition of commercial tobacco products.<\/p>\n<p>Smoking is the leading preventable cause of death in the United States, annually causing more than 480,000 deaths (U.S. Department of Health and Human Services [USDHHS], 2014). In Wyoming, smoking leads to approximately 800 deaths from smoking-related illnesses each year (Centers for Disease Control and Prevention [CDC], 2014a). In addition, scientists have known since the 1950s that smoking can cause lung cancer. The Surgeon General widely publicized this link between smoking and cancer in the landmark 1964 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 cause multiple cancers and chronic diseases (USDHHS, 2010, 2014).<\/p>\n<p>The Surgeon General declared vaping (the use of ENDS) 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 commercial tobacco products to ENDS (CDC, 2024e). More research is needed to learn about the long-term effects of vaping and breathing secondhand aerosol exhaled by someone who is using ENDS.<\/p>\n<p>Certain groups of people are more at risk of suffering the impacts of commercial tobacco use than others. Research has repeatedly shown that commercial tobacco companies have targeted promotional efforts toward specific neighborhoods, people with lower incomes, people of color, Indigenous People, people experiencing behavioral health conditions, and other communities (D\u2019Silva et al., 2018; Farber &amp; 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 higher risk of smoking-related disease and death.<\/p>\n<p>JUUL&#8217;s rapid rise in the ENDS market raised significant concerns about its targeted marketing towards youth and young adults. JUUL uses approaches similar to traditional cigarette advertising, such as lower prices, price discounts, and attractive advertising. The Federal Trade Commission reported that e-cigarette companies, including JUUL, spent over $859 million on advertising and promotions in 2021, focusing on price discounts, promotional allowances, and point-of-sale advertising\u2014all strategies that appeal to youth by making e-cigarettes more accessible and affordable (Counter Tobacco, 2024). A large portion of JUUL\u2019s X (formerly Twitter) followers were underage, indicating exposure of minors to age-restricted content (Kim et al., 2019). JUUL&#8217;s marketing attracted high school and college students (Willis &amp; Mindicino, 2020). As a result, increased exposure to ENDS marketing is linked to high usage among youth, suggesting effective targeting of this demographic and contributing to youth experimentation, sustained use, and difficulties in quitting (Mantey et al., 2016). A significant portion of JUUL&#8217;s 2018 profits came from underage users, highlighting the need for stricter regulations to prevent youth e-cigarette use (Kaplan et al., 2021).<\/p>\n<p>The Wyoming Department of Health, Public Health Division, Substance Use and Tobacco Prevention Program (SUTPP) funds the Adult Commercial Tobacco and Nicotine Survey to inform public health programming across the state. By capturing information on current patterns of use, identifying emerging product trends, and monitoring progress towards health goals, survey findings directly guide decision-making and strategic prevention efforts. The SUTPP has four main goals:<\/p>\n<ul>\n<li>Preventing initiation of commercial tobacco use<\/li>\n<li>Eliminating exposure to secondhand smoke for people who do not smoke<\/li>\n<li>Promoting quitting among adults and young people<\/li>\n<li>Identifying and eliminating disparities related to commercial tobacco use<\/li>\n<\/ul>\n<p>The SUTPP uses various strategies to focus on reducing the impact of commercial tobacco and nicotine use in Wyoming by achieving these goals. The SUTPP monitors its progress on these goals by tracking the use and availability of commercial tobacco and nicotine products, including cigarettes, ENDS, and other forms of commercial tobacco.<\/p>\n<p>The achievement of commercial 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 Wyoming\u2019s commercial tobacco prevention and control. 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\u2019 Rights Foundation, the American Cancer Society, and the American Lung Association. Changes also reflect the influences of the commercial tobacco and nicotine industry, such as changes in marketing practices or the release of new products such as ENDS.<\/p>\n<p>The Wyoming Survey &amp; Analysis Center (WYSAC) at the University of Wyoming administers the Wyoming Adult Commercial Tobacco and Nicotine Survey under contract to the Wyoming Department of Health, Public Health Division (WDH-PHD). Its purpose is to collect state- and county-level data about commercial tobacco and nicotine use, the previously listed four specific goals, and the broader goal of reducing disease and death related to commercial tobacco and nicotine use. In addition to analyzing the 2025 data, WYSAC used data from previous survey versions to analyze trends. <!--nextpage--><\/p>\n<h1>2025 Survey Methods<\/h1>\n<p>This report summarizes results from the 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey and trend analyses using previous versions of the survey.<\/p>\n<p>In this section, WYSAC provides a general summary of the methods used to collect and analyze the data for the 2025 survey. For statistical analysis, WYSAC performed logistic regression and multinomial logistic regression to identify associations with time. Relationships and linear trends noted as significant in the body of the report are statistically significant, p &lt; .05.<\/p>\n<p>Appendix A provides tables reporting Wyoming\u2019s state-level unweighted counts, weighted percentages, and 95% confidence intervals (CIs) for weighted percentages for every survey item and WYSAC-calculated variable.<\/p>\n<p>Appendix B provides the technical details of the methods used to collect the data for the 2025 survey as reported by WYSAC.<\/p>\n<p>Appendix C provides details of statistical analyses summarized in the body of this report.<\/p>\n<p>WYSAC purchased a random sample of telephone numbers in Wyoming and, beginning in 2023, requested that the sample include the following:<\/p>\n<ul>\n<li>Email and postal mail addresses linked to those phone numbers when available.<\/li>\n<li>An additional, separate stratum of phone numbers intended to reach American Indian respondents to increase participation and improve representation of Wyoming\u2019s American Indian population.<\/li>\n<\/ul>\n<p>First, on April 1, 2025, WYSAC sent an email with an invitation to complete the survey online when emails were available for the numbers selected. On April 7, 2025, WYSAC sent an email reminder to those who had not responded to the first email invite.<\/p>\n<p>Second, on April 5, 2025, WYSAC mailed an invitation to complete the survey online to people with postal addresses on the list and who either did not have an email address or had undeliverable email addresses from the initial email invites. On April 15, 2025, WYSAC sent a second invitation letter to those who had not responded.<\/p>\n<p>Finally, WYSAC called people who had not completed a survey online regardless of whether they had email or postal addresses in the sample list. Trained WYSAC telephone interviewers conducted the telephone interviews. Calling began on April 3, 2025, and ended on June 12, 2025. WYSAC completed 2,484 surveys. Survey participants completed 1,868 surveys online. WYSAC callers completed 616 surveys (89% on cell phones; 11% on landlines).<\/p>\n<p>This three-tier approach maintained the basic sampling process as in previous versions of the survey and sped up data collection by providing adults with options on how to respond.<\/p>\n<p>In some figures and tables, percentages may not total 100% because respondents could choose more than one response. Occasionally, rounding of the actual percentages may result in reporting percentages that do not total 100.<\/p>\n<h2>Key Limitations<\/h2>\n<p>Most Adult Commercial Tobacco and Nicotine Survey items have been tested and validated by the CDC and reused over time. However, the survey relies on self\u2010reported data, respondents\u2019 memory of events, and their interpretation of the survey items. Therefore, the results presented here might include recall errors or respondent bias (such as not reporting behaviors that might be perceived as embarrassing or unpopular).<\/p>\n<p>Unlike survey iterations before 2023, which were conducted exclusively via phone, the 2025 survey used two response modes: online and phone. In 2025, 75% of respondents completed the survey online, while 25% responded via phone. WYSAC examined the demographic characteristics of respondents (unweighted frequencies) by mode:<\/p>\n<ul>\n<li>The online survey had a lower proportion of young adults (ages 18-29) than the phone survey.<\/li>\n<li>The online survey had a higher proportion of women than the phone survey.<\/li>\n<li>The online survey had a lower proportion of American Indian respondents than the phone survey.<\/li>\n<li>The online survey had a lower proportion of respondents with low income (annual household income less than $30,000) than the phone survey.<\/li>\n<\/ul>\n<p>Because of its complex skip pattern, the survey does not ask every question of every respondent. For example, people who have never smoked are not asked about quitting smoking. In some cases, fewer than 50 people were asked a question. Estimates generated from such small groups are extremely imprecise, so WYSAC does not report them in the body of the report. This practice follows the example set by the CDC in reporting Behavioral Risk Factor Surveillance System (BRFSS) statistics (<a href=\"https:\/\/www.cdc.gov\/brfss\/brfssprevalence\/\">https:\/\/www.cdc.gov\/brfss\/brfssprevalence\/<\/a>).<\/p>\n<p>Additionally, while the 2025 survey collected data on respondents\u2019 industry and occupation, it did not sample a sufficiently large number of adults from specific industries or occupations to produce reliable estimates. As a result, WYSAC did not report industry or occupational differences in prevalence of tobacco or nicotine use, secondhand exposure, or quitting behaviors. These data are available upon request. <!--nextpage--><\/p>\n<h1>Electronic Nicotine Delivery Systems (ENDS)<\/h1>\n<h2>2025 ENDS Use in Wyoming<\/h2>\n<p>In previous iterations of the Wyoming Adult Commercial Tobacco and Nicotine Survey, ENDS use has been more common among young adults than among other adults. A limitation of the survey is the difficulty of getting young adults to respond. With a small subset of the respondents being young adults, reporting on the total adult population is necessary. That may hide some key findings that would be clearer in a survey of only young adults.<\/p>\n<p>Most Wyoming adults (69%) have never tried ENDS, and few are current ENDS users (10%; Figure 1). For this report, current ENDS users are the respondents who said they use ENDS every day or some days.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4019\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_01-300x261.png\" alt=\"Figure 1: Most Adults Have Never Tried ENDS.\n\nBar chart showing 2025 Wyoming adult ENDS use: 69% never tried ENDS, 21% tried ENDS but are not using them now, and 10% currently use ENDS.\" width=\"350\" height=\"304\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_01-300x261.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_01.png 576w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<p>However, current ENDS use has increased significantly from 7% in 2015 to 10% in 2025. ENDS use is now matching the cigarette smoking rate (10% in 2025; Figure 2).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4020\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_02-300x267.png\" alt=\"Figure 2: Adult ENDS Use Has Increased Since 2015.\n\nLine chart showing the percentage of adults who currently use ENDS in survey years: 7% in 2015, 6% in 2017, 6% in 2019, 8% in 2021, 10% in 2023, and 10% in 2025. ENDS use increased over this period.\n\n\" width=\"350\" height=\"312\" data-wp-editing=\"1\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_02-300x267.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_02.png 602w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Flavored ENDS Use<\/h3>\n<p>In 2025, the use of flavored ENDS was common for Wyoming adults:<\/p>\n<ul>\n<li>93% of adults who currently use ENDS had used products flavored to taste like mint, candy, fruit, chocolate, or other flavors besides tobacco in the past 30 days.<\/li>\n<li>33% of adults who currently use ENDS had used products flavored to taste like menthol in the past 30 days.<\/li>\n<li>47% of adults who had tried ENDS in their lifetime did so for the flavoring.<\/li>\n<\/ul>\n<p>Wyoming adults\u2019 use of flavored ENDS products has not significantly changed between 2017 and 2025, despite regulations implemented by the FDA in 2020 that partially banned ENDS flavors except menthol and tobacco. However, the ban has loopholes. It only applies to cartridge-style ENDS devices, like JUUL. These products have closed, pre-filled e-liquid cartridges that the user replaces when empty. The ban does not include ENDS with refillable e-liquid tanks or single-use or disposable products, like Juice Head. According to the FDA, these exceptions avoided restricting all flavor options for adults who may be using ENDS to stop smoking (FDA, 2020). However, research shows that youth and young adults are using menthol instead of mint and are switching to the types of ENDS that can still have flavors (Truth Initiative, 2020).<\/p>\n<h3>Reasons for Trying ENDS<\/h3>\n<p>For adults, the top three reasons for trying ENDS were for the flavoring (63%), to quit smoking cigarettes (59%), and to not disturb other people with smoke (56%; Figure 3). The pattern of these results has not changed significantly since these questions were first asked in 2015, except the \u201cfor the flavoring\u201d response, which was added in 2017.<img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-4021\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_03-188x300.png\" alt=\"Figure 3: Adults Who Use ENDS Often Do So for the Flavor and to Avoid Smoking Near Others.\n\nBar chart showing reasons for using ENDS among adults who currently use ENDS: 63% reported flavoring; 59%, to quit smoking cigarettes; 56%, to not disturb other people with smoke; 50%, to try something new or out of curiosity; 48%, because ENDS might be less harmful than cigarettes; 43%, to smoke less but not necessarily quit; 42%, to save money compared with cigarettes; 32%, to smoke where cigarette smoking is banned; 30%, for marijuana, THC, or Delta 8; 2%, for another substance; and 24%, other. Respondents could select more than one reason.\n\nNote: Percentages do not add up to 100% because respondents could choose more than one response option.\n\nIn the 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey, WYSAC added two new response options: (1) \u201cFor marijuana, THC, or Delta-8\u201d and (2) \u201cFor another substance,\u201d replacing the previous response option \u201cFor a drug other than nicotine (for example, marijuana).\u201d\n\n\n\" width=\"400\" height=\"639\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_03-188x300.png 188w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_03-641x1024.png 641w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_03.png 827w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<p>However, comparisons using data between 2015 and 2025 may indicate some emerging trends among adults who currently use ENDS. There was a significant decrease in trying ENDS because they think ENDS might be less harmful than cigarettes, from 64% in 2015 to 48% in 2025.<\/p>\n<p>Some research suggests that use of ENDS with nicotine is associated with quitting smoking. The CDC has said that adults who smoke may see benefits from completely switching from smoking to ENDS (CDC, 2024e). However, there is not enough evidence to be sure (CDC, 2020, 2024e). More research is needed to learn if ENDS are a broadly successful tobacco-related harm reduction tool. The FDA has not approved ENDS as a cessation aid (CDC, 2024e).<\/p>\n<h3>Do People Think ENDS Use Is Harmful?<\/h3>\n<p>The survey includes a question regarding how harmful people think ENDS use is to one\u2019s health. Perceived harmfulness of ENDS has significantly increased since 2017, with most adults saying it is very harmful (72%; Figure 4).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4022\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_04-281x300.png\" alt=\"Figure 4: Compared to 2017, More Adults See ENDS Use as Very Harmful.\n\nLine chart showing the percentage of adults who think using e-cigarettes or vape pens is harmful to one\u2019s health in 2017, 2019, 2021, 2023, and 2025: very harmful was 35%, 49%, 58%, 72%, and 72%; somewhat harmful was 39%, 36%, 32%, 19%, and 22%; not at all harmful was 7%, 3%, 4%, 2%, and 1%; and don\u2019t know was 19%, 12%, 6%, 6%, and 5%.\" width=\"400\" height=\"427\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_04-281x300.png 281w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_04.png 824w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<p>One reason for this change may be that the public health community, including the SUTPP and county partners, sponsored media messaging about the harms of ENDS use after 2017.<\/p>\n<p>This increased perception of harm may also be a factor in fewer adults trying ENDS because they think ENDS might be less harmful than cigarettes (see Reasons for Trying ENDS).<\/p>\n<h2>Starting ENDS Use<\/h2>\n<p>Findings about first using cigarettes or ENDS are somewhat limited because many people in the Wyoming Adult Commercial Tobacco and Nicotine Survey sample would have started using commercial tobacco or nicotine before ENDS became commonly used in the US (roughly 2012). Adults who had ever tried smoking (see Table 1 for a summary of the four smoking status categories) and had also tried ENDS were asked whether they used cigarettes or ENDS first. In 2025, 17% of adults who currently smoke and had also tried ENDS used ENDS first, with no significant change from 2017 to 2025. Similarly, 13% of adults who used to smoke and had also tried ENDS used ENDS first, also with no significant change. Among adults who experimented with smoking and had also tried ENDS, those who used ENDS first increased significantly from 18% in 2017 to 41% in 2019 and remained relatively stable from 2019 to 2025 (37%).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4012 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_01-1024x444.png\" alt=\"Table 1: Definitions of Smoking Status.\n\nTable showing four smoking status categories based on survey responses. Adults who currently smoke report smoking daily or some days and having smoked at least 100 cigarettes in their lifetime. Adults who used to smoke have smoked at least 100 cigarettes in their lifetime but do not currently smoke. Adults who experimented with smoking have tried smoking but have not smoked at least 100 cigarettes in their lifetime. Adults who never smoked have not tried smoking. Adults who currently smoke and adults who used to smoke together make up adults who smoke or have smoked regularly.\" width=\"640\" height=\"278\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_01-1024x444.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_01-300x130.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_01.png 1260w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h2>Eliminating Secondhand Exposure<\/h2>\n<h3>Exposure to Secondhand ENDS Aerosol in Public Places<\/h3>\n<p>About one in four (24%) adults were exposed to secondhand aerosol from ENDS use in public places, indoors or outdoors (Figure 5). Fewer (14%) adults reported breathing someone else\u2019s secondhand aerosol in indoor public places. One in five (20%) adults were exposed to secondhand aerosol in outdoor public places. These may be underestimates if the short-lived cloud or smell from secondhand aerosol is not noticed.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4023\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_05-292x300.png\" alt=\"Figure 5: About One in Four Adults Were Exposed to Secondhand ENDS Aerosol in Public Places.\n\nBar chart showing the percentage of adults who had been exposed to someone else\u2019s secondhand ENDS aerosol in indoor or outdoor public places in the past seven days: 14% in indoor public places, 20% in outdoor public places, and 24% overall.\" width=\"350\" height=\"360\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_05-292x300.png 292w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_05.png 594w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Opinions About the Harms of Secondhand ENDS Aerosol<\/h3>\n<p>In 2025, most (83%) adults thought that breathing someone else\u2019s secondhand aerosol was very or somewhat harmful (Figure 6). Consistent with a lack of firm research findings, a few (11%) said they were unsure about the harmfulness of secondhand aerosol.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3974\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_06-270x300.png\" alt=\"Figure 6: Most Adults Think that Secondhand ENDS Aerosol Is Harmful.\n\nBar chart showing the percentage of adults who think breathing vapor or aerosol from other people\u2019s e-cigarettes or vape pens is harmful to one's health: 39% said very harmful, 44% somewhat harmful, 6% not at all harmful, and 11% did not know.\" width=\"350\" height=\"388\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_06-270x300.png 270w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_06.png 601w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h2>Conclusion<\/h2>\n<p>These findings reflect the total adult population of Wyoming. Surveys focused on young adults or youth may find different patterns.<\/p>\n<p>Current ENDS use among adults has increased since 2015, now matching the cigarette smoking rate (10% in 2025).<\/p>\n<p>Many adults who currently use ENDS tried ENDS for the flavor, to not disturb other people with smoke, or to quit smoking cigarettes. Current research (CDC, 2020, 2024e) does not show a consistent benefit of using ENDS to quit smoking. The FDA has not approved ENDS as a cessation aid (CDC, 2024e).<\/p>\n<p>The perceived harm of ENDS has grown over time. Compared to 2017, more Wyoming adults said vaping is harmful. <!--nextpage--><\/p>\n<h1>Cigarette Smoking and Use of Other Commercial Tobacco and Nicotine Products<\/h1>\n<h2>Cigarette Smoking in 2025<\/h2>\n<p>Wyoming Adult Commercial Tobacco and Nicotine Survey responses were divided into four key categories of smoking status, described in Table 2.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4013 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_02-1024x443.png\" alt=\"Table 2: Definitions of Smoking Status.\n\nTable showing four smoking status categories based on survey responses. Adults who currently smoke report smoking daily or some days and having smoked at least 100 cigarettes in their lifetime. Adults who used to smoke have smoked at least 100 cigarettes in their lifetime but do not currently smoke. Adults who experimented with smoking have tried smoking but have not smoked at least 100 cigarettes in their lifetime. Adults who never smoked have not tried smoking. Adults who currently smoke and adults who used to smoke together make up adults who smoke or have smoked regularly.\" width=\"640\" height=\"277\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_02-1024x443.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_02-300x130.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_02.png 1261w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<p>Most (90%) adults do not currently smoke, and nearly two in three (62%) adults have never smoked regularly. That is, they have not smoked at least 100 cigarettes in their lifetime. About one in three (30%) adults had never tried smoking or (32%) had experimented with smoking and nearly one in three (28%) used to smoke (Figure 7). Although current cigarette smoking has decreased from 21% in 2006 to 10% in 2025, one in 10 Wyoming adults currently smoke.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3975\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_07.png\" alt=\"Figure 7: Most Adults Do Not Currently Smoke.\n\nBar chart showing 2025 Wyoming adult smoking status: 10% currently smoke, 28% used to smoke, 32% experimented with smoking, and 30% never smoked.\" width=\"400\" height=\"269\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_07.png 754w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_07-300x202.png 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h3>Do People Think Smoking Cigarettes Is Harmful?<\/h3>\n<p>About sixty years ago (January 11, 1964), the U.S. Surgeon General first released an official report documenting links between smoking and two diseases: cancer and chronic bronchitis (U.S. Department of Health, Education, and Welfare, 1964). Since then, the list of smoking-related diseases has grown dramatically (USDHHS, 2014). Additionally, SUTPP, CDC, county, and other public health efforts have worked to educate the public about the potential harms of commercial tobacco use. Key components of these education efforts include warning labels on packaging and advertising, sharing research findings, and sharing educational content in various forms from print to social media (CDC, 2024a; USDHHS, 2014). These efforts have succeeded in Wyoming; in 2025, only 2% of adults said smoking was \u201cnot at all harmful\u201d (Figure 8).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3976\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_08.png\" alt=\"Figure 8: Almost All Adults Know Smoking Cigarettes Is Harmful.\n\nBar chart showing the percentage of adults who think smoking cigarettes is harmful to one\u2019s health: 87% said very harmful, 11% somewhat harmful, and 2% not at all harmful.\" width=\"350\" height=\"316\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_08.png 592w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_08-300x271.png 300w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h2>Other Commercial Tobacco and Nicotine Products (Including ENDS)<\/h2>\n<p>In 2025, about one in four (24%) Wyoming adults use one or more types of commercial tobacco and nicotine products. These include cigarettes, smokeless tobacco, cigars, pipes, hookah, ENDS, and new and emerging products such as heated tobacco, nicotine pouches, dissolvable nicotine, nicotine gels, and any other types. This overall rate has remained relatively stable since questions about new and emerging products were first asked in 2021, when 28% of adults reported using these products.<\/p>\n<p>Among the 24% of Wyoming adults who use some form of commercial tobacco or nicotine, cigarettes, ENDS, and nicotine pouches were the most commonly used commercial tobacco and nicotine products among Wyoming adults. Cigarettes was the most used product throughout the history of the Wyoming Adult Commercial Tobacco and Nicotine Survey until ENDS use matched smoking in 2025 (Figure 9).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3977\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_09-786x1024.png\" alt=\"Figure 9: Cigarettes, ENDS, and Smokeless Tobacco Were the Most Commonly Used Established Commercial Tobacco and Nicotine Products Among Adults.\n\nBar chart showing the percentage of adults reporting current cigarette, ENDS, smokeless tobacco, or other commercial tobacco and nicotine use: cigarettes, 10%; ENDS, 10%; nicotine pouches, 5%; smokeless tobacco, 4%; cigars, 2%; pipes, 1%; and hookah, 1%.\n\nNote: Cigars also include cigarillos and very small cigars that look like cigarettes. Prior to 2023 ATS, two separate item sets asked about lifetime and past 30-day use of smokeless tobacco: (1) chewing tobacco, moist snuff, or dip and (2) snus. Starting in 2023, WYSAC consolidated these items, combining chewing tobacco, moist snuff, or dip and snus under the term smokeless tobacco. In 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey, WYSAC replaced the word \u201csnuff\u201d with \u201cmoist snuff\u201d to increase clarity.\" width=\"400\" height=\"521\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_09-786x1024.png 786w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_09-230x300.png 230w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_09.png 836w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<p>From 2015 to 2025, current ENDS use increased from 7% to 10% and is now at the same level as cigarette use. The use of cigars and smokeless tobacco has significantly decreased since 2010, while the use of regular pipes and hookah have remained consistent.<\/p>\n<p>The use of new and emerging commercial tobacco and nicotine products remains lower among adults. The most common of these emerging products was nicotine pouches, such as ZYN or on!; 5% of adults used these products. The use of nicotine pouches among Wyoming adults has significantly increased from 3% in 2021 to 5% in 2025, making the use of nicotine pouches comparable to smokeless tobacco. Surveys specific to youth or young adults, who might be more likely to try new and emerging products, have shown similar increases with one survey showing an increase in reported nicotine pouch use of nearly 4 times between 2022 and 2023 among youth and young adults in the U.S. (CDC Foundation, 2025).<\/p>\n<p>Wyoming\u2019s commercial tobacco and nicotine landscape is changing (Figure 10). Cigarette smoking has fallen, vaping is now just as common as smoking, and nicotine pouches are emerging as a newer product being used at a similar rate as smokeless tobacco.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3978\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_10.png\" alt=\"Figure 10: Wyoming's Commercial Tobacco and Nicotine Landscape Is Changing.\n\nLine chart showing the percentage of adults reporting current cigarette, ENDS, smokeless tobacco, or nicotine pouch use in survey years: cigarette use was 16% in 2015, 16% in 2017, 13% in 2019, 16% in 2021, 12% in 2023, and 10% in 2025; ENDS use was 7%, 6%, 6%, 8%, 10%, and 10%; smokeless tobacco use was 8%, 10%, 10%, 7%, 6%, and 4%; and nicotine pouch use was 3% in 2021, 5% in 2023, and 5% in 2025.\n\nNote: Nationally, vaping became more common among youth by 2018 as ENDS devices such as JUUL (introduced in 2015) became widely used (Cullen et al., 2018; Fadus et al., 2019).\" width=\"400\" height=\"456\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_10.png 821w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_10-263x300.png 263w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h2>Conclusion<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-4008 size-medium\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_02_Tob-Use-300x272.png\" alt=\"Callout box: In 2025, cigarettes, ENDS, and nicotine pouches were the most commonly used commercial to-bacco and nicotine products for adults.\" width=\"300\" height=\"272\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_02_Tob-Use-300x272.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_02_Tob-Use.png 420w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>The public is very aware that smoking is harmful. Only 2% of adults said that smoking is not at all harmful.<\/p>\n<p>The adult smoking rate, as measured by the Wyoming Adult Commercial Tobacco and Nicotine Survey, has decreased significantly to 10% compared to 21% in 2006. Since 2010, the use of other commercial tobacco and nicotine products has remained fairly consistent or decreased, except for ENDS and nicotine pouches. ENDS use is now at the same level as cigarette use, and nicotine pouch use is about the same level as smokeless tobacco use.<\/p>\n<p>Cigarettes, ENDS, and nicotine pouches were the three most commonly used commercial tobacco and nicotine products among adults. ENDS and nicotine pouches are a subject of concern for youth and young adults because of national trends showing increased use (Gentzke et al., 2022; CDC Foundation, 2025) and the potential for them to lead to cigarette smoking (Berry et al., 2019; Hair et al., 2021). Their relative use rate is also increasing.<\/p>\n<p>There is developing evidence that newer commercial tobacco and nicotine products (such as nicotine pouches) may become more commonly used than more established types (such as smokeless tobacco, hookah, or cigars). <!--nextpage--><\/p>\n<h1>Commercial Tobacco and Nicotine Taxes<\/h1>\n<p>Preventing new cigarette smoking and decreasing the use of other commercial tobacco and nicotine products are key goals of the SUTPP.<\/p>\n<p>According to the CDC, increasing commercial tobacco product prices is an effective way to prevent youth from starting to smoke (CDC, 2014b). It also encourages adults to quit smoking (CDC, 2015a).<\/p>\n<p>Taxes are one way that federal and state governments can influence commercial tobacco prices. Nationally, every 10% increase in cigarette prices decreases cigarette use by 3\u20135%. Raising cigarette prices prevents youth and people with lower incomes from smoking and reduces the average number of cigarettes smoked (USDHHS, 2014).<\/p>\n<p>In one study of adults aged 50 years and older, a $1 increase in the price of cigarettes was associated with a 6% higher quit rate (Stevens et al., 2017). Increasing cigarette taxes could encourage quitting among adults and could decrease the risk of smoking-related diseases.<\/p>\n<h2>Commercial Tobacco and Nicotine Tax Rates<\/h2>\n<h3>Cigarettes<\/h3>\n<p>At the time of data collection, Wyoming\u2019s cigarette excise tax was $0.60 per pack, the second lowest among neighboring states (Figure 11). Wyoming ranks 45th out of the 50 states and the District of Columbia on cigarette taxes and 52nd out of the 58 states and territories (CDC, 2025). Wyoming\u2019s cigarette excise tax has not changed since 2003.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3979\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_11.png\" alt=\"Figure 11: Wyoming\u2019s Cigarette Tax Second Lowest Among Neighboring States.\n\nMap showing cigarette excise tax per pack in Wyoming and neighboring states: Idaho, 57 cents; Wyoming, 60 cents; Nebraska, 64 cents; South Dakota, 1 dollar and 53 cents; Montana, 1 dollar and 70 cents; Utah, 1 dollar and 70 cents; and Colorado, 2 dollars and 24 cents. Wyoming has the second-lowest cigarette tax among neighboring states.\" width=\"350\" height=\"437\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_11.png 596w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_11-240x300.png 240w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Smokeless Tobacco<\/h3>\n<p>At the time of data collection, Wyoming\u2019s smokeless tobacco (chewing tobacco, dip, or snus) tax had a minimum tax of $0.60 per ounce, with an additional $0.60 per ounce for packaging larger than one ounce.<\/p>\n<h3>Electronic Nicotine Delivery Systems (ENDS)<\/h3>\n<p>Since July 2020 and through the time of data collection, Wyoming has had a default ENDS tax at the rate of 15% of the wholesale purchase price. If the tax is not paid by the wholesaler, consumers pay 7.5% of the retail purchase price (Wyo. Stat. \u00a7 39-18-104(g)-(h), 2020).<\/p>\n<h2>Support for Evidence-Based Policy<\/h2>\n<p>About half of adults support tax increases for each major class of commercial tobacco: cigarettes (53%) and smokeless tobacco (chewing tobacco, moist snuff, dip, or snus; 54%). More than half of adults supported a tax increase for ENDS (59%; Table 3).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4014 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_03-1024x396.png\" alt=\"Table 3: About Half of Adults Supported Increasing the Taxes on Cigarettes or Smokeless Tobacco, and Over Half Supported a Tax Increase for ENDS Products.\n\nTable showing the percentage of adults who would support an increase in the tax on cigarettes, chewing tobacco, moist snuff, dip, or snus, and ENDS. For cigarettes, 53% supported an increase, 25% opposed it, and 21% did not know. For chewing tobacco, moist snuff, dip, or snus, 54% supported an increase, 27% opposed it, and 20% did not know. For electronic nicotine delivery systems (ENDS), 59% supported an increase, 23% opposed it, and 18% did not know.\n\nNote: Percentages do not add up to 100% because of rounding.\" width=\"640\" height=\"248\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_03-1024x396.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_03-300x116.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_03.png 1224w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h2>Costs of Smoking<\/h2>\n<p>Smoking is the leading preventable cause of illness and death in the United States. In 2018, the costs of smoking-related illness totaled more than $600 billion. These costs included more than $240 billion for direct medical care and more than $372 billion in lost productivity (CDC, 2024f).<\/p>\n<h2>Conclusion<\/h2>\n<p>Wyoming\u2019s cigarette excise tax has remained at $0.60 per pack since 2003. About half of Wyoming adults support increasing taxes on commercial tobacco or nicotine.<\/p>\n<p>Higher commercial tobacco taxes are an evidence-based way to keep youth from starting to smoke (CDC, 2014b). Increasing commercial tobacco product pricing through taxation, minimum price laws, or other means is an evidence-based strategy for encouraging people to quit using commercial tobacco products (CDC, 2015a). Wyoming could further reduce negative outcomes from smoking by raising its commercial tobacco or nicotine taxes. <!--nextpage--><\/p>\n<h1>Preventing New Commercial Tobacco Use<\/h1>\n<p>The SUTPP has the goal of reducing the health burdens of commercial tobacco use by preventing new commercial tobacco use. A success related to this goal was raising the legal age of purchase from 18 (or 19 in some areas) to 21 (see <a href=\"https:\/\/tobacco21.org\/\">https:\/\/tobacco21.org\/<\/a>). Federal law implemented this change in 2019 (FDA, 2025), and Wyoming law followed in 2020 (Wyo. Stat. \u00a7 14-3-305). Broad surveys, such as the Wyoming Adult Commercial Tobacco and Nicotine Survey, with few young adults in the sample. are not strong methods for showing short-term effects of Tobacco 21, though patterns in the data may change over time.<\/p>\n<p>A key limitation of this section\u2019s findings is that many survey questions ask about events (such as when someone first smoked a whole cigarette) that happened years before data collection. Responses to such questions are especially vulnerable to memory errors. However, precise recall is not critical to the conclusions in this report.<\/p>\n<h2>Age of Smoking a Whole Cigarette for the First Time<\/h2>\n<p>The age of first smoking a whole cigarette is related to long-term smoking habits. Those who start smoking at an early age are more likely to smoke as adults (CDC, 2014b).<\/p>\n<p>In 2025, among adults who had ever smoked an entire cigarette, almost all (91%) smoked their first one before the age of 21 (Figure 12). Moreover, the vast majority of them smoked their first cigarette before they were 18, with an average age of 16. This pattern has remained consistent since similar questions were first asked in 2010.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3980\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_12-261x300.png\" alt=\"Figure 12: Almost All Smoking Begins Before the Age of 21.\nBar chart showing age of smoking the first whole cigarette among adults who had smoked a whole cigarette: younger than 18, 67%; ages 18 to 20, 24%; ages 21 to 25, 5%; and age 26 or older, 3%. Percentages do not add up to 100% because of rounding.\" width=\"350\" height=\"403\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_12-261x300.png 261w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_12.png 598w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h2>Conclusion<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-4009 size-medium\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_03_Goal1-300x239.png\" alt=\"Callout box: The vast majority of adults who smoke started when they were younger than 21.\" width=\"300\" height=\"239\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_03_Goal1-300x239.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_03_Goal1.png 346w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>The vast majority of adults who have ever smoked an entire cigarette first smoked when they were under the legal minimum age of 21, with the largest group starting before the age of 18. Wyoming Adult Commercial Tobacco and Nicotine Survey data are consistent with other research findings that the earlier someone starts smoking, the more likely they are to continue smoking (Dierker et al., 2012; Sharapova et al., 2020). Wyoming may benefit from continued commercial tobacco prevention efforts focusing on youth, though the survey may not show results until years after success with youth happens. <!--nextpage--><\/p>\n<h1>Eliminating Exposure to Secondhand Smoke for People Who Do Not Smoke<\/h1>\n<h2>Support for Smokefree Indoor Air Policies at Restaurants, Workplaces, Casinos and Clubs, and Bars<\/h2>\n<p>The Wyoming Adult Commercial Tobacco and Nicotine Survey questions about smokefree indoor air policies asked adults if they think smoking should be allowed indoors at workplaces, restaurants, bars, and casinos and clubs. Casinos and clubs were combined in one item on the survey, so WYSAC treated them as a single venue type.<\/p>\n<p>In 2025, most adults (87%; Figure 13) supported smokefree indoor air policies for restaurants. Most (85%) adults supported smokefree indoor air policies for workplaces. More than half (65%) of adults supported smokefree indoor air policies for casinos and clubs. More than half (63%) of adults supported smokefree indoor air policies for bars.<\/p>\n<p>Support for smokefree indoor workplaces has remained stable since 2015. Support for smokefree indoor air policies for restaurants, casinos and clubs, and bars significantly increased between 2015 and 2025. For casinos and clubs, the increase in support from 2023 to 2025 was also significant.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3981\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_13-300x300.png\" alt=\"Figure 13: Adult Support for Smokefree Indoor Air Policies Remained Strong.\nLine chart showing the percentage of adults who said smoking should never be allowed in restaurants, bars, indoor workplaces, or casinos and clubs. For restaurants, support was 76% in 2015, 79% in 2017, 82% in 2019, 75% in 2021, 88% in 2023, and 87% in 2025. For indoor workplaces, support was 82%, 83%, 84%, 82%, 83%, and 85%. For casinos and clubs, support was 50%, 49%, 54%, 47%, 58%, and 65%. For bars, support was 46%, 48%, 51%, 45%, 57%, and 63%. Support increased significantly from 2015 to 2025 for restaurants, casinos and clubs, and bars, while support for indoor workplaces remained stable.\" width=\"400\" height=\"400\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_13-300x300.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_13-150x150.png 150w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_13.png 826w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h2>Support for Other Smokefree Air Policies<\/h2>\n<h3>Commercial Tobacco-Free School Policies<\/h3>\n<p>In 2025, most adults (84%; Figure 14) thought that commercial tobacco should be completely banned at schools. This high level of support has been consistent since 2010.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3982\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_14-300x218.png\" alt=\"Figure 14: Most Adults Support Commercial Tobacco-Free Schools.\nBar chart showing 84% of adults said commercial tobacco use should be completely banned on school grounds and at all school events, including for teachers and other adults.\" width=\"350\" height=\"254\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_14-300x218.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_14.png 603w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Smokefree Park Policies<\/h3>\n<p>In 2025, the majority of Wyoming adults (86%) thought smoking should be restricted at outdoor parks, at least in some manner. This is a significant increase from 82% in 2015. About two in five (43%; Figure 15) adults thought that smoking should never be allowed, significantly higher than in 2023. Meanwhile, another two in five (43%) thought that smoking should be allowed only at some times or in some places, which was significantly lower than in 2023.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3983\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_15-300x219.png\" alt=\"Figure 15: Most Adults Think Smoking Should Be Restricted in Parks in Some Manner.\nBar chart showing 86% of adults said smoking at parks should never be allowed or be allowed only at some times or in some places.\" width=\"350\" height=\"256\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_15-300x219.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_15.png 610w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Smokefree Outdoor Workplace Policies<\/h3>\n<p>Support for policies making outdoor workplaces smokefree was substantially lower than support for policies making indoor workplaces smokefree. In 2025, only 23% (Figure 16) of adults supported a smokefree air policy for outdoor workplaces, compared to 85% for indoor workplaces. However, support for such a policy has increased significantly since its recent low of 9% in 2021.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3984\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_16-300x267.png\" alt=\"Figure 16: Support for Smokefree Outdoor Workplaces Increased Since Its Recent Low in 2021.\nLine chart showing the percentage of adults who said smoking outdoors at workplaces should be never allowed, allowed only at some times or in some places, or always allowed in 2015, 2017, 2019, 2021, 2023, and 2025: never allowed was 16%, 14%, 13%, 9%, 19%, and 23%; allowed only at some times or in some places was 56%, 55%, 60%, 60%, 62%, and 58%; and always allowed was 29%, 31%, 26%, 30%, 20%, and 18%. \nPercentages do not add up to 100% in some years because of rounding.\" width=\"400\" height=\"356\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_16-300x267.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_16.png 809w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h2>Exposure to Secondhand Smoke<\/h2>\n<h3>Smoking Policies at Work<\/h3>\n<p>In 2025, most employed adults (91%; Figure 17) reported that smoking was never allowed in indoor areas (including inside a vehicle) at their place of work. This is a significant increase from 87% in 2019.<\/p>\n<p>About one in three (30%; Figure 17) adults reported that smoking was not allowed in outdoor areas. This has significantly increased since 2012 (25%). Workers are better protected by smoking regulations indoors than outdoors.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3985\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_17-300x273.png\" alt=\"Figure 17: Most Adults Are Protected by Smokefree Indoor Air Regulations at Their Workplace.\nBar chart showing the percentage of employed adults who responded that smoking was never allowed at their workplaces: 91% in indoor areas and 30% in outdoor areas.\" width=\"350\" height=\"318\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_17-300x273.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_17.png 614w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Exposure to Secondhand Smoke at Work and in Public Places<\/h3>\n<p>In 2025, most employed adults (81%) were not exposed to secondhand smoke at their workplace. Still, 19% of employed adults reported experiencing secondhand smoke indoors or outdoors at their workplace. There has been no significant change between 2015 and 2025.<\/p>\n<p>In 2025, about one in three adults (33%; Figure 18) reported breathing someone else\u2019s secondhand smoke in public places, indoors or outdoors. Most adults (67%) were not exposed to secondhand smoke. Almost one in three adults (31%) reported exposure to secondhand smoke in outdoor public places. Fewer adults (8%) reported exposure to secondhand smoke in indoor public places. Although still a cause for concern, exposure to secondhand smoke has significantly decreased in public places, indoors or outdoors, between 2015 and 2025.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-3986 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_18-1024x545.png\" alt=\"Figure 18: Most Secondhand Smoke Exposure Occurs in Outdoor Public Places.\nLine chart showing the percentage of adults who had been exposed to someone else\u2019s smoke in indoor or outdoor public places in the past seven days in 2015, 2017, 2019, 2021, 2023, and 2025: indoor public-place exposure was 13%, 12%, 10%, 8%, 11%, and 8%; outdoor public-place exposure was 38%, 32%, 29%, 30%, 30%, and 31%; and overall exposure, combining exposure in indoor and outdoor public places, was 43%, 37%, 34%, 34%, 34%, and 33%.\nNote: Prior to 2023, the questions asked for the number of days exposed to secondhand smoke in the past seven days. Starting from 2023, the questions simply asked whether respondents were exposed to secondhand smoke in the past seven days.\" width=\"640\" height=\"341\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_18-1024x545.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_18-300x160.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_18.png 1237w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<p>In 2025, the chances of being exposed to secondhand smoke while in a public place were not significantly different between adults who currently smoke and those who do not smoke:<\/p>\n<ul>\n<li>36% of adults who currently smoke reported exposure to secondhand smoke<\/li>\n<li>32% of adults who do not smoke reported exposure to secondhand smoke<\/li>\n<\/ul>\n<h3>Opinions About the Harms of Secondhand Smoke<\/h3>\n<p>Over the years, nearly all adults have thought that exposure to secondhand smoke is harmful to one\u2019s health. In 2025, 97% (Figure 19) believed secondhand smoke was very or somewhat harmful to one\u2019s health. Only 3% believed that it was not harmful. These perceptions of harm have not changed significantly between 2015 and 2025.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3987\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_19-300x279.png\" alt=\"Figure 19: Most Adults Think Secondhand Smoke Is Harmful.\nLine chart showing the percentage of adults who think breathing smoke from other people\u2019s cigarettes or other tobacco products is harmful to one\u2019s health in 2015, 2017, 2019, 2021, 2023, and 2025: very harmful was 63%, 62%, 63%, 51%, 52%, and 55%; somewhat harmful was 34%, 35%, 34%, 44%, 46%, and 41%; and not at all harmful was 3%, 4%, 2%, 4%, 2%, and 3%. Percentages do not add up to 100% in some years because of rounding.\" width=\"400\" height=\"372\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_19-300x279.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_19.png 825w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<p>However, opinions about the harmfulness of secondhand smoke have shifted in recent years. Adults who think breathing secondhand smoke is very harmful significantly decreased between 2019 and 2025.<\/p>\n<h2>Conclusion<\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-4010 size-medium\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_04_SHS-146x300.png\" alt=\"Callout box: Support for smokefree outdoor workplace policies has increased since its re-cent low in 2021.\" width=\"146\" height=\"300\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_04_SHS-146x300.png 146w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_04_SHS.png 237w\" sizes=\"auto, (max-width: 146px) 100vw, 146px\" \/>Over the years, exposure to secondhand smoke has significantly decreased in public places, indoors or outdoors. Two in three adults reported not being exposed to secondhand smoke in public places, indoors or outdoors.<\/p>\n<p>Adults have consistently and strongly supported smokefree indoor air policies for workplaces and restaurants. In addition, support for smokefree indoor air policies for casinos and clubs and bars has increased. Wyoming adults continue to support a complete ban on commercial tobacco use at schools. Most adults thought that smoking should be restricted at parks, at least in some manner. Most employed adults are not exposed to secondhand smoke at work, indoors or outdoors.<\/p>\n<p>Wyoming still has room for improvement. Smoking policies in outdoor areas, including at work and in public places, are less protective of adults. Adult support for outdoor policies at work and indoor air policies at adult-oriented establishments has increased. Wyoming may benefit from focusing on prevention efforts in these areas. Recent decreases in reports of seeing secondhand smoke as \u201cvery harmful\u201d may indicate a need for revisiting education about the harms of secondhand smoke. <!--nextpage--><\/p>\n<h1>Promoting Quitting<\/h1>\n<p>Quitting commercial tobacco and nicotine products is difficult because they rapidly deliver addictive nicotine to the brain (CDC, 2024d, 2024g). Regular use leads to dependence, and quitting often leads to withdrawal. Use of these products can also become part of a person\u2019s daily routine, making it even harder to stop.<\/p>\n<p>The SUTPP has the goal of reducing the health burdens of commercial tobacco and nicotine use by promoting and supporting quitting among adults and youth.<\/p>\n<p>In this section, WYSAC explores the desire to quit among adults who currently use commercial tobacco and their quit attempts. WYSAC looks at awareness of quitlines, use of quit aids, and barriers to quitting. This section also covers visits to healthcare providers and conclusions and recommendations based on the data and best practices in helping people quit.<\/p>\n<h2>Efforts to Quit Smoking<\/h2>\n<h3>Desire to Quit Among Adults Who Smoke<\/h3>\n<p>About half (53%) of adults who currently smoke want to quit smoking cigarettes. This was a significant decrease from 68% in 2015. The 13 percentage-point difference between 2023 and 2025 was not significant. About one in four adults who currently smoke were unsure about whether they want to quit smoking cigarettes. This was a significant increase from 6% in 2015 (Figure 20).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3988\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_20-300x300.png\" alt=\"Figure 20: About Half of Adults Who Smoke Want to Quit.\nLine chart showing the percentage of adults who smoke who want to quit smoking cigarettes for good in survey years 2015, 2017, 2019, 2021, 2023, and 2025. Want to quit was 68%, 69%, 68%, 57%, 66%, and 53%; don\u2019t want to quit was 26%, 26%, 28%, 34%, 21%, and 23%; and unsure was 6%, 6%, 4%, 8%, 13%, and 24%. Want to quit and unsure changed significantly over time.\nPercentages do not add up to 100% in some years because of rounding.\n\" width=\"400\" height=\"399\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_20-300x300.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_20-150x150.png 150w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_20.png 827w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h3>Quit Attempts Among Adults Who Smoke<\/h3>\n<p>At some point in their lives, the majority (81%) of adults who currently smoke had stopped smoking for at least one day because they were trying to quit for good.<\/p>\n<p>About one in three (35%) adults who currently smoke have tried to quit smoking at least once in the past year because they were trying to quit for good (Figure 21).<\/p>\n<p>Smokers\u2019 quit attempts have not changed significantly between 2010 and 2025.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3989\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_21-300x281.png\" alt=\"Figure 21: Most Adults Who Smoke Have Tried to Quit.\nBar chart showing the percentage of adults who smoke who tried to quit in the past year, tried in their lifetime but not in the past year, or never tried to quit: 35% tried in the past year, 46% tried in their lifetime but not in the past year, and 19% never tried to quit.\" width=\"350\" height=\"328\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_21-300x281.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_21.png 612w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h2>Aids to Quit Smoking<\/h2>\n<h3>Awareness of Quitlines<\/h3>\n<p>Most (69%) adults who use commercial tobacco or nicotine (including ENDS) were aware of telephone quitline services (Figure 22). About two in five (43%) adults who do not use commercial tobacco or nicotine were aware of telephone quitline services.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4054\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_22-1-300x270.png\" alt=\"Figure 22: Most Adults Who Use Commercial Tobacco or Nicotine Were Aware of the Quitline.\n\nBar chart showing the percentage of adults who were aware of telephone quitline services by commercial tobacco or nicotine use: 69% of adults who use commercial tobacco or nicotine were aware of quitline services. 43% of adults who do not use tobacco or nicotine were aware of quitline services.\n\n\" width=\"350\" height=\"315\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_22-1-300x270.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_22-1.png 607w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<p>This may demonstrate the success of media campaigns by SUTPP and their partners, including county-level efforts.<\/p>\n<h3>Obstacles to Quitting Cigarettes Among Adults Who Smoke<\/h3>\n<p>Cravings for a cigarette were the most common obstacle for adults who smoke and tried to quit in their lifetime or wanted to quit (90%; Figure 23). The second most common obstacle to quitting cigarettes was the loss of a way to handle stress (76%). The Wyoming Quit Tobacco (WQT) program specifically targets the most common obstacles to quitting smoking (<a href=\"https:\/\/www.quitwyo.org\">https:\/\/www.quitwyo.org<\/a>). In particular, the medications provided are designed to reduce cravings. Coaching can include strategies to deal with other obstacles, such as losing a way to handle stress.<\/p>\n<p>In addition, 56% reported that other people smoking around them is an obstacle to quitting smoking. These adults could benefit from increased smokefree air policies in their environments.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-3991 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_23-1024x1024.png\" alt=\"Figure 23: Most Obstacles to Quitting Smoking Are Addressed by the WQT.\nBar chart showing the percentage of adults who smoke and had tried to quit in their lifetime or wanted to quit who faced obstacles to quitting smoking: cravings for a cigarette, 90%; loss of a way to handle stress, 76%; withdrawal, 61%; other people smoking around you, 56%; worsening anxiety, 52%; cost of medicines or products to help with quitting, 38%; fear of gaining weight, 30%; worsening depression, 28%; cost of classes to help with quitting, 15%; and other, 26%.\nPercentages do not add up to 100% because respondents could choose more than one option.\" width=\"640\" height=\"640\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_23-1024x1024.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_23-300x300.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_23-150x150.png 150w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_23.png 1051w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h2>Quitting ENDS Use<\/h2>\n<p>In 2025, about half (55%) of adults who currently used ENDS had tried to quit in the past year or in their lifetime (Figure 24).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3992\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_24-298x300.png\" alt=\"Figure 24: About Half of Adults Who Currently Used ENDS Tried to Quit in the Past Year or in Their Lifetime.\nBar chart showing the percentage of adults who currently use ENDS who tried to quit using ENDS in the past year, tried in their lifetime but not in the past year, or never tried to quit: 43% tried in the past year, 12% tried in their lifetime but not in the past year, and 45% never tried to quit.\" width=\"350\" height=\"353\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_24-298x300.png 298w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_24-150x150.png 150w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_24.png 612w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h2>Health Professionals\u2019 Involvement in Quitting Commercial Tobacco or Nicotine Use<\/h2>\n<h3>Visits with Health Professionals<\/h3>\n<p>The 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey asked respondents if they had seen a health professional (a doctor, dentist, nurse, or another health professional) in the past year and, if so, if the health professional asked if they smoked cigarettes or used any other commercial tobacco or nicotine products, including ENDS.<\/p>\n<p>In 2025, 25% of adults used commercial tobacco or nicotine (including those who smoked in the past year). Most of these adults had seen a health professional in the past year (87%; Figure 25). Those who did not see a health professional (13%) missed an opportunity to discuss tobacco and nicotine use and quitting with their provider, a key intervention point. Commercial tobacco or nicotine use was not related to the likelihood of seeing a health professional.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3993\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_25-293x300.png\" alt=\"Figure 25: Most Adults Who Use Commercial Tobacco or Nicotine See a Health Professional.\nBar chart showing the percentage of adults who had seen a health professional by commercial tobacco or nicotine use status: 87% among adults who use tobacco or nicotine, 91% among adults who do not use tobacco or nicotine, and 90% overall.\" width=\"350\" height=\"358\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_25-293x300.png 293w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_25.png 601w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Patient Experiences with Health Professionals\u2019 Support for Quitting Commercial Tobacco and Nicotine Use<\/h3>\n<p>Adults are often asked about their commercial tobacco or nicotine use when visiting a health professional. In 2025, 78% of all adults were asked if they smoked cigarettes or used any other commercial tobacco or nicotine products. Adults who used commercial tobacco or nicotine (90%) were more likely to be asked if they smoked cigarettes or used any other commercial tobacco or nicotine products than adults who did not use commercial tobacco or nicotine (73%).<\/p>\n<p>WYSAC does not know to what extent health professionals use medical records to screen for commercial tobacco or nicotine use during a visit. This may have been a limitation when health professionals did not ask about commercial tobacco or nicotine use because they already had records of it.<\/p>\n<p>About a quarter (23%) of commercial tobacco or nicotine users were offered assistance with quitting, even when focusing on those who say a professional asked them about their commercial tobacco or nicotine use (Figure 26).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-3994 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_26-1024x536.png\" alt=\"Figure 26: About One Fourth of Adults Who Use Commercial Tobacco or Nicotine Received Assistance from Health Professionals.\nBar chart showing experiences of adults who use commercial tobacco or nicotine and had seen a health professional in the past year. The full group, represented by 100%, consists of tobacco or nicotine users who had seen a health professional. Among this group, 90% were asked about tobacco or nicotine use, 46% were advised to quit, 26% were asked about their desire to quit, and 23% were offered assistance with quitting.\" width=\"640\" height=\"335\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_26-1024x536.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_26-300x157.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_26.png 1231w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<p>When adults who use commercial tobacco or nicotine were offered assistance, health professionals provided WQT information (67%; Figure 27), recommended nicotine replacement therapies (NRTs) (60%), and prescribed medication (13%). The percentage of adults who received WQT information significantly decreased from 87% in 2021 to 67% in 2025. The percentage of adults who were prescribed medication also significantly decreased from 39% in 2021 to 13% in 2025. Healthcare providers offering support such as NRT, prescription medication, and referral to quitline services such as WQT align with best practices for support of quitting. Opportunities exist to increase the number of adults who are offered assistance by their healthcare provider to quit.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3995\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_27-300x267.png\" alt=\"Figure 27: Medication is the Least Frequently Offered Quit Aid.\nBar chart showing the percentage of adults who use commercial tobacco or nicotine who were advised to quit and were offered assistance by a health professional to help them quit: 67% received Wyoming Quit Tobacco information, 60% were recommended nicotine replacement therapies, and 13% were prescribed medication. \nRespondents could report more than one type of assistance. \nMedication may include Wellbutrin, Zyban, bupropion, Chantix, or varenicline.\" width=\"400\" height=\"355\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_27-300x267.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_27.png 816w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h2>Conclusion<\/h2>\n<p>Most smokers want to quit smoking cigarettes or have tried to quit at some point in their lives. When they try to quit or want to quit, adults who use commercial tobacco or nicotine face obstacles such as cravings for a cigarette, loss of a way to handle stress, and others smoking around them. The WQT program is designed to assist with all of these obstacles.<\/p>\n<p>Most adults who use commercial tobacco or nicotine are aware of quitline services.<\/p>\n<p>Education and media emphasizing how the WQT program addresses common barriers to quitting smoking may increase enrollment in the WQT program. Additionally, the use of WQT program offerings (such as NRT and medications) can then increase the chances of adults quitting.<\/p>\n<p>Many adults who currently use ENDS want to quit. Among adults who currently use ENDS, about half had tried to quit ENDS in the past year or in their lifetime.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-4011 size-medium\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_05_Cessation-300x295.png\" alt=\"Callout box: Opportunities exist to increase the number of adults who are offered assistance by their healthcare provider to quit.\" width=\"300\" height=\"295\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_05_Cessation-300x295.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Sidebar_05_Cessation.png 389w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>Visits to health professionals are opportunities for connecting current commercial tobacco or nicotine users to available resources and addressing barriers to quitting. Most adults were asked by a health professional if they used commercial tobacco or nicotine products. Adults who use commercial tobacco or nicotine were less likely to report that health professionals followed up or offered help with quitting than they were to report being asked about their use. Greater collaboration with health professionals could result in more commercial tobacco or nicotine users becoming aware of, and receiving, services that could increase their chances of quitting (CDC, 2015a). <!--nextpage--><\/p>\n<h1>Identifying and Eliminating Commercial Tobacco and Nicotine-Related Disparities Among Populations of Focus<\/h1>\n<p>Addressing populations disproportionately impacted by commercial tobacco or nicotine use is the fourth goal of the SUTPP.<\/p>\n<p>Starting in 2019, the SUTPP identified four populations of focus in Wyoming that were disproportionally impacted by commercial tobacco or nicotine use: people with low incomes, people who self-identify as American Indian, people reporting behavioral health conditions, and young adults (aged 18-29). The sampling methods described in the 2025 Survey Methods section included extra effort to recruit people identified as American Indian in the sampling frame WYSAC purchased.<\/p>\n<p>For ENDS within each population, WYSAC analyzed three key indicators: the prevalence of use, ENDS quit attempts, and exposure to secondhand ENDS aerosol in public places.<\/p>\n<p>For commercial tobacco within each population, WYSAC analyzed three key indicators: the prevalence of smoking cigarettes, smoking quit attempts, and exposure to secondhand smoke at work.<\/p>\n<p>Because the Wyoming Adult Commercial Tobacco and Nicotine Survey is primarily designed to obtain state-level data for the full adult population, WYSAC does not recruit people from these populations of focus in a way that allows for all analyses in the main body of the report or for intersectionality (such as estimates for young adults with low incomes). Specifically, because of the small number of survey respondents who currently use commercial tobacco or nicotine products within each population of focus, there is a high degree of uncertainty around the estimates for most of these groups. Therefore, WYSAC took a cautious approach and chose not to provide interpretations for statistical tests in which WYSAC had a low degree of confidence, including when fewer than 50 adults responded to a question. Because of this issue, WYSAC does not report ENDS quit attempts among all populations of focus (including adults with low annual household income, American Indian adults, adults who reported behavioral health conditions, and young adults) or cigarette quit attempts among these populations, except for adults with behavioral conditions.<\/p>\n<p>Proportion plots in the following sections are adapted from a template distributed by Stephanie Evergreen: <a href=\"https:\/\/stephanieevergreen.com\/proportion-plots\/\">https:\/\/stephanieevergreen.com\/proportion-plots\/<\/a><\/p>\n<h2>Population of Focus: Adults with Low Annual Household Income<\/h2>\n<p>A common measure for identifying people with low incomes would be the poverty level. However, this varies by the size of household and other factors not included in the Wyoming Adult Commercial Tobacco and Nicotine Survey. Based on practical considerations such as survey sample size and other standard indicators, WYSAC and the SUTPP used a threshold of $30,000 in annual household income to identify adults with a low annual household income.<\/p>\n<p>For context, in 2024, the median household income in Wyoming was $75,532 (U.S. Census Bureau, 2024). By definition, half of the adults in the state have an annual income less than the median.<\/p>\n<h3>ENDS and Adults with Low Annual Household Income<\/h3>\n<p>Evidence on ENDS marketing targeting people with low income is limited and inconclusive, as research has yielded mixed results (Addo Ntim et al., 2022). More research is needed to understand if the ENDS industry is using focused marketing toward people with low incomes.<\/p>\n<h4>ENDS Use<\/h4>\n<p>In 2025, adults with annual household incomes less than $30,000 were significantly more likely to use ENDS every day or some days (24%) than those with higher incomes (9%).<\/p>\n<p>Adults living in households making less than $30,000 per year were overrepresented among adults who use ENDS. While only 13% of survey respondents were living in households with an income of less than $30,000, they made up 28% among adults who currently use ENDS (Figure 28).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3996\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_28-237x300.png\" alt=\"Figure 28: Adults Living in Households Making Less than $30,000 per Year Were Overrepresented Among Adults Who Use ENDS.\nProportion plot showing the distribution of annual household income among all adults and adults who use ENDS: among all respondents, 13% had household income less than 30,000 dollars per year, and 87% had household income of 30,000 dollars or more; among adults who use ENDS, 28% had household income less than 30,000 dollars, and 72% had household income of 30,000 dollars or more.\nNote: The commercial tobacco industry has targeted lower-income households (Lee et al., 2015).\" width=\"400\" height=\"507\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_28-237x300.png 237w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_28-807x1024.png 807w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_28.png 828w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h4>Exposure to Secondhand Aerosol in Public Places<\/h4>\n<p>Partly because the survey did not sample a large number of adults with an annual income of less than $30,000, the differences in secondhand aerosol exposure in public places (indoors or outdoors) by household income in the last seven days were not significant (Figure 29).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-3997 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_29-1024x735.png\" alt=\"Figure 29: Exposure to Secondhand ENDS Aerosol in Public Places Was About the Same for Adults Living in Households Making Less than $30,000 per Year and Those Making $30,000 or More.\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in indoor public places in the past seven days by annual household income: 10% among adults with household income less than 30,000 dollars and 16% among adults with household income of 30,000 dollars or more.\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in outdoor public places in the past seven days by annual household income: 15% among adults with household income less than 30,000 dollars and 22% among adults with household income of 30,000 dollars or more.\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in public places overall in the past seven days by annual household income: 17% among adults with household income less than 30,000 dollars and 26% among adults with household income of 30,000 dollars or more.\n\" width=\"640\" height=\"459\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_29-1024x735.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_29-300x215.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_29.png 1260w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h3>Cigarettes and Adults with Low Annual Household Income<\/h3>\n<p>Commercial tobacco industry marketing has a documented history of targeting lower-income neighborhoods (Lee et al., 2015). This targeted marketing has included giving free cigarettes to children in low-income neighborhoods. Along with the increased marketing, low-income neighborhoods typically have a higher commercial tobacco outlet density than higher-income neighborhoods (CDC, 2024c; Truth Initiative, 2018). With the commercial tobacco industry\u2019s pointed strategies toward people with lower incomes, adults with lower incomes have a disproportionately high rate of commercial tobacco or nicotine use.<\/p>\n<h4>Cigarette Use<\/h4>\n<p>In 2025, adults with annual household incomes less than $30,000 were significantly more likely to smoke cigarettes every day or some days (29%) than those with higher incomes (9%; see Table 4 for a summary of the four smoking status categories).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4015 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_04-1024x446.png\" alt=\"Table 4: Definitions of Smoking Status.\nTable showing four smoking status categories based on survey responses. Adults who currently smoke report smoking daily or some days and having smoked at least 100 cigarettes in their lifetime. Adults who used to smoke have smoked at least 100 cigarettes in their lifetime but do not currently smoke. Adults who experimented with smoking have tried smoking but have not smoked at least 100 cigarettes in their lifetime. Adults who never smoked have not tried smoking. Adults who currently smoke and adults who used to smoke together make up adults who smoke or have smoked regularly.\" width=\"640\" height=\"279\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_04-1024x446.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_04-300x131.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_04.png 1264w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<p>Adults living in households making less than $30,000 per year were overrepresented among adults who smoke. While only 13% of survey respondents were living in households with an income of less than $30,000, they made up 33% of adults who currently smoke in the survey (Figure 30).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-3998\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_30-239x300.png\" alt=\"Figure 30: Adults Living in Households Making Less than $30,000 per Year Were Overrepresented Among Adults Who Smoke.\nProportion plot showing the distribution of annual household income among all adults and adults who smoke: among all respondents, 13% had household income less than 30,000 dollars per year, and 87% had household income of 30,000 dollars or more; among adults who smoke, 33% had household income less than 30,000 dollars, and 67% had household income of 30,000 dollars or more.\nNote: The commercial tobacco industry has targeted lower-income households (Lee et al., 2015).\" width=\"400\" height=\"501\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_30-239x300.png 239w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_30-817x1024.png 817w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_30.png 834w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h4>Exposure to Secondhand Smoke at Work<\/h4>\n<p>In 2025, 37% of adults with an annual household income of less than $30,000 were exposed to someone else\u2019s secondhand smoke at work. Among adults with an annual household income of $30,000 or more, 19% reported being exposed to secondhand smoke at work. Partly because the survey did not sample a large number of adults with an annual income of less than $30,000, the difference in exposure by household income was not significant.<\/p>\n<h3>Conclusion<\/h3>\n<p>The 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey data highlights the impact of the commercial tobacco industry\u2019s targeted efforts to engage already vulnerable populations in commercial tobacco use (Lee et al., 2015). People with an annual income of less than $30,000 are disproportionately affected by smoking.<\/p>\n<p>Adults with an annual income of less than $30,000 are significantly more likely to use ENDS every day or some days than those with an annual income greater than $30,000. Commercial tobacco is marketed at a higher rate in low-income neighborhoods (Lee et al., 2015).<\/p>\n<p>Partly due to the low sample size of adults with an annual income of less than $30,000, differences in exposure to secondhand ENDS aerosol in public places were not significant. Adults with an annual income of less than $30,000 are significantly more likely to smoke every day or some days than those with an annual income greater than $30,000. Commercial tobacco is marketed at a higher rate in low-income neighborhoods (Lee et al., 2015).<\/p>\n<p>Partly due to the low sample size of adults with an annual income of less than $30,000, the difference in exposure to secondhand smoke at work was not significant.<\/p>\n<h2>Population of Focus: American Indians<\/h2>\n<p>WYSAC acknowledges that different terms, such as Native American, refer to the Indigenous Populations of the U.S. when not referring to specific tribes. In this report, the use of the term American Indian mirrors the survey question (which does not ask about tribal affiliation) used for the Wyoming Adult Commercial Tobacco and Nicotine Survey.<\/p>\n<p>WYSAC considered respondents as American Indian when they self-identified as American Indian or multiracial, including American Indian, regardless of whether they reported Hispanic ethnicity. This approach allowed for a larger sample from which to draw conclusions.<\/p>\n<h3>ENDS and American Indians<\/h3>\n<h4>ENDS Use<\/h4>\n<p>In 2025, 10% of American Indian adults used ENDS every day or some days. Among non-American Indian adults, 10% reported using ENDS every day or some days. The difference in ENDS use between American Indian adults and non-American Indian adults was not significant.<\/p>\n<h4>Exposure to ENDS Aerosol in Public Places<\/h4>\n<p>Partly because the survey did not sample a large number of American Indian adults, the differences in secondhand aerosol exposure in public places (indoors or outdoors) between American Indian and non-American Indian adults in the last seven days were not statistically significant, though the estimates may look quite different (Figure 31).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-3999 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_31-1024x701.png\" alt=\"Figure 31: Exposure to Secondhand ENDS Aerosol in Public Places Was About the Same Between American Indian Adults and Non-American Indian Adults.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in indoor public places in the past seven days by American Indian self-identification: 27% among American Indian adults and 14% among non-American Indian adults.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in outdoor public places in the past seven days by American Indian self-identification: 32% among American Indian adults and 20% among non-American Indian adults.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in public places overall in the past seven days by American Indian self-identification: 36% among American Indian adults and 24% among non-American Indian adults.\" width=\"640\" height=\"438\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_31-1024x701.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_31-300x206.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_31.png 1254w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h3>Cigarettes and American Indians<\/h3>\n<p>Commercial tobacco companies have long used the ceremonial significance of tobacco to encourage American Indians to use their commercial tobacco products (D\u2019Silva et al., 2018). Commercial tobacco companies have a history of targeting this community, beginning with using American Indian imagery and symbols in marketing, often depicting negative stereotypes. The commercial tobacco industry misled these communities by providing financial support for their cultural events and providing highly discounted prices on commercial tobacco or nicotine products (Lempert &amp; Glantz, 2019). The commercial tobacco industry\u2019s focused efforts have contributed to disproportionately high smoking rates for American Indians (D\u2019Silva et al., 2018).<\/p>\n<h4>Cigarette Use<\/h4>\n<p>In 2025, 14% of American Indian adults smoked cigarettes every day or some days. Among non-American Indian adults, 10% reported smoking every day or some days (see Table 5 for a summary of the four smoking status categories). Partly because the survey did not sample a large number of American Indian adults, the difference in cigarette use between American Indian adults and non-American Indian adults was not significant.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4016 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_05-1024x446.png\" alt=\"Table 5: Definitions of Smoking Status.\n\nTable showing four smoking status categories based on survey responses. Adults who currently smoke report smoking daily or some days and having smoked at least 100 cigarettes in their lifetime. Adults who used to smoke have smoked at least 100 cigarettes in their lifetime but do not currently smoke. Adults who experimented with smoking have tried smoking but have not smoked at least 100 cigarettes in their lifetime. Adults who never smoked have not tried smoking. Adults who currently smoke and adults who used to smoke together make up adults who smoke or have smoked regularly.\" width=\"640\" height=\"279\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_05-1024x446.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_05-300x131.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_05.png 1257w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h3>Conclusion<\/h3>\n<p>The 2025 sample did not show disproportionate rates of ENDS use and cigarette smoking among American Indians, but findings were limited by small sample size.<\/p>\n<p>Continuing to partner with representatives from the two main tribes in Wyoming (Northern Arapaho and Eastern Shoshone) will support sensitive approaches to reducing the burdens of commercial nicotine use and secondhand exposure for this population.<\/p>\n<h2>Population of Focus: Behavioral Health<\/h2>\n<p>For this report, we use the term \u201cbehavioral health\u201d and recognize that subject matter experts may use, and distinguish between, terms such as behavioral or mental health, and these may have changed over time. The survey question used to identify this population from the Adult Commercial Tobacco and Nicotine Survey is as follows: \u201cDo you have any mental health conditions, such as an anxiety disorder, depression disorder, bipolar disorder, schizophrenia, attention-deficit\/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), or substance use disorder?\u201d About 26% of adults reported having at least one behavioral health condition.<\/p>\n<p>People experiencing behavioral health conditions have been harmed by unjust practices related to the sale of commercial tobacco and nicotine. These practices include promoting the false idea that tobacco and nicotine can be used to treat behavioral or mental health conditions and promoting unhealthy policies in behavioral healthcare facilities (CDC, 2024d). These misperceptions may affect healthcare providers\u2019 willingness to offer cessation treatments to adults with behavioral health conditions and increase smoking among people with behavioral health conditions (CDC, 2024b).<\/p>\n<p>As with any self-report data, it is possible that people under-reported health conditions on the Wyoming Adult Commercial Tobacco and Nicotine Survey, especially those conditions that may have a stigma attached such as behavioral health conditions.<\/p>\n<h3>ENDS and Behavioral Health<\/h3>\n<p>Historically, the commercial tobacco industry has targeted people experiencing behavioral health conditions (such as depressive disorder, bipolar disorder, substance use disorder, and psychotic disorder; Campbell et al., 2016; Prochaska et al., 2017). The ENDS industry might also be targeting those experiencing behavioral health conditions by claiming health benefits of using ENDS (Spears et al., 2019). Medical research, however, has shown that vaping is associated with higher incidence of reported depression among adults (Obisesan et al., 2019) and youth (Lechner et al., 2017). More research is needed to understand if the ENDS industry is also using focused marketing toward people experiencing behavioral health conditions.<\/p>\n<h4>ENDS Use<\/h4>\n<p>In 2025, adults who said they had at least one behavioral health condition were significantly more likely to use ENDS every day or some days than adults who did not have at least one behavioral health condition: 24% of adults who reported having behavioral health conditions used ENDS every day or some days, compared to 5% of adults who did not report having behavioral health conditions.<\/p>\n<p>Adults with behavioral health conditions were overrepresented among adults who use ENDS. While only 26% of survey respondents said they had a behavioral health condition, they made up 61% of adults who currently use ENDS in the survey (Figure 32).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4000\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_32-254x300.png\" alt=\"Figure 32: Adults with Behavioral Health Conditions Were Overrepresented Among Adults Who Use ENDS.\n\nProportion plot showing the distribution of behavioral health conditions among all adults and adults who use ENDS: among all respondents, 26% reported any behavioral health conditions, and 74% reported no behavioral health conditions; among adults who use ENDS, 61% reported any behavioral health conditions, and 39% reported no behavioral health conditions.\" width=\"400\" height=\"472\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_32-254x300.png 254w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_32.png 831w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h4>Exposure to Secondhand Aerosol in Public Places<\/h4>\n<p>In 2025, 40% of adults who reported having behavioral health conditions reported being exposed to someone else\u2019s ENDS aerosol in public places, indoors or outdoors, in the past seven days. Overall, exposure to secondhand aerosol in public places was significantly more likely for adults who reported behavioral health conditions than those who did not report behavioral health conditions (Figure 33). In indoor public places, adults who reported behavioral health conditions were significantly more likely to report exposure to secondhand aerosol (22%) than adults who did not report behavioral health conditions (11%). In outdoor public places, adults who reported behavioral health conditions were significantly more likely to report exposure to secondhand aerosol (34%) than adults who did not report behavioral health conditions (14%).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4001 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_33-1024x740.png\" alt=\"Figure 33: Exposure to ENDS Aerosol in Public Places Was Significantly Higher for Adults Who Reported a Behavioral Health Condition.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in indoor public places in the past seven days by behavioral health condition: 22% among adults with any behavioral health conditions and 11% among adults with no behavioral health conditions. The difference was statistically significant.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in outdoor public places in the past seven days by behavioral health condition: 34% among adults with any behavioral health conditions and 14% among adults with no behavioral health conditions. The difference was statistically significant.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in public places overall in the past seven days by behavioral health condition: 40% among adults with any behavioral health conditions and 18% among adults with no behavioral health conditions. The difference was statistically significant.\" width=\"640\" height=\"463\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_33-1024x740.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_33-300x217.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_33.png 1242w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h3>Cigarettes and Behavioral Health<\/h3>\n<p>Historically, the commercial tobacco industry has targeted people experiencing behavioral health conditions (such as depressive disorder, bipolar disorder, substance use disorder, and psychotic disorder; Campbell et al., 2016; Prochaska et al., 2017).<\/p>\n<p>For this reason, studies (such as the Substance Abuse and Mental Health Services Administration [SAMHSA], 2020, and Talati et al., 2016) have demonstrated an association between cigarette smoking and behavioral health conditions. People who report behavioral health conditions are more likely to smoke, and adults with these conditions who smoke tend to smoke more cigarettes than adults who do not report behavioral health conditions (National Institute on Drug Abuse [NIDA], 2023).<\/p>\n<h4>Cigarette Use<\/h4>\n<p>In 2025, adults with behavioral health conditions were significantly more likely to smoke cigarettes (18%) than adults with no behavioral health conditions (8%).<\/p>\n<p>Adults with behavioral health conditions were overrepresented among adults who smoke. While only 26% of adults who responded to the survey reported having behavioral health conditions, they made up 43% of adults in the survey who smoke. (Figure 34; see Table 6 for a summary of the four smoking status categories).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4002\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_34-233x300.png\" alt=\"Figure 34: Adults with Behavioral Health Conditions Were Overrepresented Among Adults Who Smoke.\n\nProportion plot showing the distribution of behavioral health conditions among all adults and adults who smoke: among all respondents, 26% reported any behavioral health conditions and 74% reported no behavioral health conditions; among adults who smoke, 43% reported any behavioral health conditions and 57% reported no behavioral health conditions.\n\nNote: Adults with behavioral health conditions have been targeted by commercial tobacco companies (Prochaska et al., 2017).\" width=\"400\" height=\"515\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_34-233x300.png 233w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_34-796x1024.png 796w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_34.png 827w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4017 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_06-1024x447.png\" alt=\"Table 6: Definitions of Smoking Status.\n\nTable showing four smoking status categories based on survey responses. Adults who currently smoke report smoking daily or some days and having smoked at least 100 cigarettes in their lifetime. Adults who used to smoke have smoked at least 100 cigarettes in their lifetime but do not currently smoke. Adults who experimented with smoking have tried smoking but have not smoked at least 100 cigarettes in their lifetime. Adults who never smoked have not tried smoking. Adults who currently smoke and adults who used to smoke together make up adults who smoke or have smoked regularly.\" width=\"640\" height=\"279\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_06-1024x447.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_06-300x131.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_06.png 1259w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h4>Quit Attempts: Lifetime and Past Year<\/h4>\n<p>Partly because the survey did not sample a large number of adults with behavioral health conditions, the difference in quit attempts (including lifetime and past year) between adults who smoke and who reported behavioral health conditions and those who did not report such conditions was not statistically significant, though the estimates may look quite different.<\/p>\n<p>Lifetime quit attempts:<\/p>\n<ul>\n<li>76% of adults who reported behavioral health conditions had stopped smoking for at least one day because they were trying to quit for good, and<\/li>\n<li>85% of adults who did not report behavioral health conditions had stopped smoking for at least one day because they were trying to quit for good.<\/li>\n<\/ul>\n<p>Past year quit attempts:<\/p>\n<ul>\n<li>18% of adults who reported behavioral health conditions had tried to quit smoking at least once in the past year, and<\/li>\n<li>47% of adults who did not report behavioral health conditions had tried to quit smoking at least once in the past year.<\/li>\n<\/ul>\n<h4>Exposure to Secondhand Smoke at Work<\/h4>\n<p>Adults who reported behavioral health conditions were more likely to be exposed to secondhand smoke at work (33%) than those who did not report such conditions (12%; Figure 35).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4003\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_35-287x300.png\" alt=\"Figure 35: Exposure to Secondhand Smoke at Work Is Significantly Higher for Adults Who Reported a Behavioral Health Condition.\n\nBar chart showing the percentage of adults who had been exposed to secondhand smoke at work by behavioral health condition: 33% among adults with any behavioral health conditions and 12% among adults with no behavioral health conditions. The difference was statistically significant.\" width=\"350\" height=\"366\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_35-287x300.png 287w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_35.png 610w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<h3>Conclusion<\/h3>\n<p>People experiencing behavioral health conditions are disproportionately affected by smoking and ENDS use. Particularly for cigarette smoking, this is likely related at least in part to the commercial tobacco industry\u2019s targeted marketing (Campbell et al., 2016; Prochaska et al., 2017). More research is needed to understand if the ENDS industry is also using focused marketing toward people experiencing behavioral health conditions.<\/p>\n<p>Adults who reported behavioral health conditions were more likely to use ENDS than those who did not report a behavioral health condition. They are also more likely to report being exposed to someone else\u2019s ENDS aerosol in public places, particularly indoors.<\/p>\n<p>Adults who report behavioral health conditions are more likely to smoke cigarettes than those who do not report such conditions. They are also more likely to be exposed to secondhand smoke at work than those who did not report such a condition. Because the survey included too few employed respondents from specific industries or occupations to produce reliable estimates and comparisons, we cannot explore whether workplace factors explain this relationship.<\/p>\n<p>In 2025, the survey sampled too few adults who smoke and reported behavioral health conditions to detect a disparity in smoking quit attempts.<\/p>\n<h2>Population of Focus: Young Adults<\/h2>\n<p>WYSAC considered respondents as young adults when they were between the ages of 18 and 29.<\/p>\n<h3>ENDS and Young Adults<\/h3>\n<p>Young adults (aged 18-29) are a population of focus because young adulthood is an impressionable stage when people may begin a lifelong smoking or vaping habit (Biener &amp; Albers, 2004; Lee et al., 2020). Additionally, nicotine use as the brain develops through the age of 25 (roughly) can change the brain to make it more vulnerable to additional addictions, cause difficulties in attention and thinking, and increase risk for behavioral health issues (USDHHS, 2016). Much like the commercial tobacco industry has targeted youth (Farber &amp; Folan, 2017), the ENDS industry has targeted young adults with advertising and marketing that are attractive to them and has used social media as a pathway to reach young adults (Lee et al., 2020; Willis &amp; Mindicino, 2020). The ENDS industry\u2019s focused efforts have contributed to disproportionately higher ENDS use rates for young adults (Do et al., 2022).<\/p>\n<h4>ENDS Use<\/h4>\n<p>Young adults (24%) were significantly more likely to use ENDS than other adults (7%). ENDS use may lead to later initiation of smoking, but more research is needed to investigate this potential pathway to smoking and, potentially, other commercial tobacco or nicotine products.<\/p>\n<p>Young adults were overrepresented among adults who used ENDS every day or some days. While only 20% of adults who responded to the survey reported being ages 18-29, they made up 45% of adults who currently used ENDS in the survey (Figure 36).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4004\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_36-253x300.png\" alt=\"Figure 36: Young Adults (Ages 18\u201329) Were Overrepresented Among Adults Who Currently Use ENDS.\n\nProportion plot showing the distribution of age among all adults and adults who use ENDS: among all respondents, 20% were ages 18 to 29, and 80% were age 30 or older; among adults who use ENDS, 45% were ages 18 to 29, and 55% were age 30 or older.\n\nNote: The ENDS industry has targeted young adults (Lee et al., 2020).\" width=\"400\" height=\"475\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_36-253x300.png 253w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_36.png 829w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><\/p>\n<h4>Exposure to ENDS Aerosol in Public Places<\/h4>\n<p>In 2025, young adults (35%) were more likely to report being exposed to someone else\u2019s ENDS aerosol in public places, indoors or outdoors, in the past seven days, compared to other adults (22%; Figure 37). In indoor public places, young adults (23%) were significantly more likely to report exposure to secondhand aerosol. Partly because the survey did not sample a large number of young adults, the difference in exposure in outdoor public places in the last seven days between young adults and other adults was not statistically significant, though the estimates may look quite different.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4005 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_37-1024x742.png\" alt=\"Figure 37: Exposure to ENDS Aerosol in Public Places Was Significantly Higher for Young Adults.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in indoor public places in the past seven days by age: 23% among adults ages 18 to 29 and 12% among adults age 30 or older. The difference was statistically significant.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in outdoor public places in the past seven days by age: 27% among adults ages 18 to 29 and 19% among adults age 30 or older.\n\nBar chart showing the percentage of adults exposed to someone else\u2019s ENDS aerosol in public places overall in the past seven days by age: 35% among adults ages 18 to 29 and 22% among adults age 30 or older. The difference was statistically significant.\" width=\"640\" height=\"464\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_37-1024x742.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_37-300x217.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_37.png 1240w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h3>Cigarettes and Young Adults<\/h3>\n<p>Wyoming Adult Commercial Tobacco and Nicotine Survey data (see Preventing New Commercial Tobacco Use) show that most adults who smoke start smoking as youths or young adults. Young adulthood is an impressionable stage when people may begin a lifelong smoking habit, or a habit that had begun during adolescence could become set (Biener &amp; Albers, 2004; Lee et al., 2020), making them a population of focus. The commercial tobacco industry has targeted young adults with advertising and marketing that promises to help them create the attractive, successful, and popular personas they seek (Farber &amp; Folan, 2017). Industry campaigns promote messages, values, and product features designed specifically for young adults (Lee et al., 2020). Commercial tobacco companies place these campaigns in places young adults frequent most, such as colleges, fraternities, and bars (Ling &amp; Glantz, 2002). With such targeted industry efforts, young adults are a population of focus and require equally targeted efforts for control strategies aimed at commercial tobacco and nicotine prevention.<\/p>\n<h4>Cigarette Use<\/h4>\n<p>The smoking rate of young adults (3%) was significantly lower than the smoking rate of other adults (12%; Figure 38).<\/p>\n<p>Young adults were more likely to have never tried a cigarette: 55% of young adults have never tried a cigarette, compared to 23% of other adults. Because so few adults begin smoking after the age of 21 (see the Preventing New Commercial Tobacco Use section), this difference between age cohorts may indicate that experimentation with cigarettes is becoming less common over time.<\/p>\n<p>Young adults were significantly less likely to have smoked regularly and then quit (13%), compared to other adults (32%).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-4006\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_38-222x300.png\" alt=\"Figure 38: Young Adults Are More Likely to Have Never Tried a Cigarette.\n\nStacked column chart showing smoking status by age. Among adults ages 18 to 29, 3% currently smoke, 13% used to smoke, 29% experimented with smoking, and 55% never smoked. Among adults age 30 or older, 12% currently smoke, 32% used to smoke, 33% experimented with smoking, and 23% never smoked. Differences in the percentages who currently smoke, used to smoke, and never smoked were statistically significant; the difference in the percentage who experimented with smoking was not statistically significant.\" width=\"350\" height=\"473\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_38-222x300.png 222w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Figure_38.png 594w\" sizes=\"auto, (max-width: 350px) 100vw, 350px\" \/><\/p>\n<p>As shown in the ENDS Use section above, young adults are more likely to use ENDS (24%), which may lead to later initiation of smoking cigarettes. More research is needed to investigate this potential pathway to smoking or the use of new and emerging commercial nicotine products (such as nicotine pouches). Research about potentially complex relationships between the use of various commercial tobacco and nicotine products is currently lacking.<\/p>\n<p>Table 7 details the four categories of smoking status used in Figure 38.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-4018 size-large\" src=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_07-1024x444.png\" alt=\"Table 7: Definitions of Smoking Status.\n\nTable 1: Definitions of Smoking Status. Table showing four smoking status categories based on survey responses. Adults who currently smoke report smoking daily or some days and having smoked at least 100 cigarettes in their lifetime. Adults who used to smoke have smoked at least 100 cigarettes in their lifetime but do not currently smoke. Adults who experimented with smoking have tried smoking but have not smoked at least 100 cigarettes in their lifetime. Adults who never smoked have not tried smoking. Adults who currently smoke and adults who used to smoke together make up adults who smoke or have smoked regularly.\" width=\"640\" height=\"278\" srcset=\"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_07-1024x444.png 1024w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_07-300x130.png 300w, https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-content\/uploads\/2026\/10\/ACTNS_2025_Table_07.png 1257w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/p>\n<h4>Exposure to Secondhand Smoke at Work<\/h4>\n<p>In 2025, 23% of young adults were exposed to someone else\u2019s secondhand smoke at work. Partly because the survey did not sample a large number of young adults, the difference in exposure between young adults and other adults was not significant.<\/p>\n<h3>Conclusion<\/h3>\n<p>The 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey data highlight the impact of the commercial tobacco industry\u2019s targeted efforts to engage already vulnerable populations in commercial tobacco or nicotine use.<\/p>\n<p>Young adults were significantly more likely to use ENDS than other adults (age 30 and older).<\/p>\n<p>Young adults were significantly more likely than other adults to have been exposed to secondhand ENDS aerosols in public places in the last week. Without details about where survey respondents work, we cannot explore the reasons for this relationship.<\/p>\n<p>Young adults were more likely to have never tried a cigarette compared to other adults. <!--nextpage--><\/p>\n<h1>References<\/h1>\n<p>Addo Ntim, S., Martin, B., &amp; Termeh-Zonoozi, Y. (2022). 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Why and how the tobacco industry sells cigarettes to young adults: Evidence from industry documents. <em>American Journal of Public Health (1971), 92<\/em>(6), 908\u2013916. <a href=\"https:\/\/doi.org\/10.2105\/AJPH.92.6.908\">https:\/\/doi.org\/10.2105\/AJPH.92.6.908<\/a><\/p>\n<p>Mantey, D. S., Cooper, M. R., Clendennen, S. L., Pasch, K. E., &amp; Perry, C. L. (2016). E-cigarette marketing exposure is associated with e-cigarette use among US youth. <em>Journal of Adolescent Health<\/em>, 58(6), 686\u2013690. <a href=\"https:\/\/doi.org\/10.1016\/j.jadohealth.2016.03.003\">https:\/\/doi.org\/10.1016\/j.jadohealth.2016.03.003<\/a><\/p>\n<p>National Institute on Drug Abuse. (2023, February 24). <em>Do people with mental illness and substance use disorders use tobacco more often?<\/em> U.S. Department of Health and Human Services, National Institutes of Health. Retrieved January 6, 2026, from <a href=\"https:\/\/nida.nih.gov\/publications\/research-reports\/tobacco-nicotine-e-cigarettes\/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often\">https:\/\/nida.nih.gov\/publications\/research-reports\/tobacco-nicotine-e-cigarettes\/do-people-mental-illness-substance-use-disorders-use-tobacco-more-often<\/a><\/p>\n<p>Obisesan, O. H., Mirbolouk, M., Osei, A. D., Orimoloye, O. A., Uddin, S. M. I., Dzaye, O., El Shahawy, O., Al Rifai, M., Bhatnagar, A., Stokes, A., Benjamin, E. J., DeFilippis, A. P., &amp; Blaha, M. J. (2019). Association Between E-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017. <em>JAMA network open<\/em>, <em>2<\/em>(12), e1916800. <a href=\"https:\/\/doi.org\/10.1001\/jamanetworkopen.2019.16800\">https:\/\/doi.org\/10.1001\/jamanetworkopen.2019.16800<\/a><\/p>\n<p>Prochaska, J. J., Das, S., &amp; Young-Wolff, K. C. (2017). Smoking, mental illness, and public health. <em>Annual Review of Public Health, 38<\/em>(1), 165\u2013185. <a href=\"https:\/\/doi.org\/10.1146\/annurev-publhealth-031816-044618\">https:\/\/doi.org\/10.1146\/annurev-publhealth-031816-044618<\/a><\/p>\n<p>Sharapova, S., Reyes-Guzman, C., Singh, T., Phillips, E., Marynak, K. L., &amp; Agaku, I. (2020). Age of tobacco use initiation and association with current use and nicotine dependence among US middle and high school students, 2014\u20132016. Tobacco Control, 29(1), 49\u201354. <a href=\"https:\/\/doi.org\/10.1136\/TOBACCOCONTROL-2018-054593\">https:\/\/doi.org\/10.1136\/TOBACCOCONTROL-2018-054593<\/a><\/p>\n<p>Spears, C. A., Jones, D. M., Weaver, S. R., Yang, B., Pechacek, T. F., &amp; Eriksen, M. P. (2019). Electronic nicotine delivery system (ENDS) use in relation to mental health conditions, past-month serious psychological distress and cigarette smoking status, 2017. <em>Addiction, 114<\/em>(2), 315\u2013325. <a href=\"https:\/\/doi.org\/10.1111\/add.14464\">https:\/\/doi.org\/10.1111\/add.14464<\/a><\/p>\n<p>Stevens, V. L., Diver, W. R., Stoklosa, M., Flanders, W. D., Westmaas, J. L., Jemal, A., Drope, J. M., Gapstur, S. M., &amp; Jacobs, E. J. (2017). A prospective cohort study of cigarette prices and smoking cessation in older smokers. <em>Cancer Epidemiology, Biomarkers &amp; Prevention<\/em>, 26(7), 1071\u20131077. <a href=\"https:\/\/doi.org\/10.1158\/1055-9965.epi-16-0690\">https:\/\/doi.org\/10.1158\/1055-9965.epi-16-0690<\/a><\/p>\n<p>Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Retrieved January 6, 2026, from <a href=\"https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt29393\/2019NSDUHFFRPDFWHTML\/2019NSDUHFFR090120.htm\">https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt29393\/2019NSDUHFFRPDFWHTML\/2019NSDUHFFR090120.htm<\/a><\/p>\n<p>Talati, A., Keyes, K. M., &amp; Hasin, D. S. (2016). Changing relationships between smoking and psychiatric disorders across twentieth century birth cohorts: Clinical and research implications. Molecular Psychiatry, <em>21<\/em>, 464\u2013471. <a href=\"https:\/\/doi.org\/10.1038\/mp.2015.224\">https:\/\/doi.org\/10.1038\/mp.2015.224<\/a><\/p>\n<p>Truth Initiative. (2018, January 24). <em>Why are 72% of smokers from lower-income communities?<\/em> Retrieved December 9, 2025, from <a href=\"https:\/\/truthinitiative.org\/research-resources\/targeted-communities\/why-are-72-smokers-lower-income-communities\">https:\/\/truthinitiative.org\/research-resources\/targeted-communities\/why-are-72-smokers-lower-income-communities<\/a><\/p>\n<p>Truth Initiative. (2020). <em>Dangerous Loopholes: Young e-cigarette users report swapping products as vaping policies change<\/em>. Truth Initiative<em>. <\/em>Retrieved December 9, 2025, from <a href=\"https:\/\/truthinitiative.org\/research-resources\/emerging-tobacco-products\/dangerous-loopholes-young-e-cigarette-users-report\">https:\/\/truthinitiative.org\/research-resources\/emerging-tobacco-products\/dangerous-loopholes-young-e-cigarette-users-report<\/a><\/p>\n<p>U.S. Census Bureau. (2024). Income in the Past 12 Months (in 2024 Inflation-Adjusted Dollars). 2024 American Community Survey, ACS 1-Year Estimates Subject Tables, Table S1901. Retrieved April 15, 2026, from <a href=\"https:\/\/data.census.gov\/table\/ACSST1Y2024.S1901?g=040XX00US56\">https:\/\/data.census.gov\/table\/ACSST1Y2024.S1901?g=040XX00US56<\/a><\/p>\n<p>U.S. Department of Health and Human Services. (2010). How tobacco smoke causes disease: The biology and behavioral basis for smoking-attributable disease: A report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Retrieved December 9, 2025, from <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK53017\/\">http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK53017\/<\/a><\/p>\n<p>U.S. Department of Health and Human Services. (2014). <em>The health consequences of smoking \u2013 50 years of progress: A report of the Surgeon General<\/em>. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Retrieved December 9, 2025, from <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK179276\/pdf\/Bookshelf_NBK179276.pdf\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK179276\/pdf\/Bookshelf_NBK179276.pdf<\/a><\/p>\n<p>U.S. Department of Health and Human Services. (2016). <em>E-Cigarette use among youth and young adults: A report of the Surgeon General.<\/em> Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Retrieved December 9, 2025, from <a href=\"https:\/\/stacks.cdc.gov\/view\/cdc\/44007\">https:\/\/stacks.cdc.gov\/view\/cdc\/44007<\/a><\/p>\n<p>U.S. Department of Health and Human Services. (2018). <em>Surgeon General\u2019s advisory on e-cigarette use among youth.<\/em> Retrieved January 6, 2026, from <a href=\"https:\/\/stacks.cdc.gov\/view\/cdc\/153187\">https:\/\/stacks.cdc.gov\/view\/cdc\/153187<\/a><\/p>\n<p>U.S. Department of Health, Education, and Welfare. (1964). <em>Smoking and health: Report of the advisory committee to the Surgeon General of the Public Health Service<\/em>. Washington, DC: Department of Health, Education, and Welfare Public Health Service Publication No. 1103. Retrieved December 9, 2025, from <a href=\"https:\/\/www.govinfo.gov\/app\/details\/GPO-SMOKINGANDHEALTH\/summary\">https:\/\/www.govinfo.gov\/app\/details\/GPO-SMOKINGANDHEALTH\/summary<\/a><\/p>\n<p>U.S. Food &amp; Drug Administration. (2020, April). Enforcement priorities for electronic nicotine delivery systems (ENDS) and other deemed products on the market without premarket authorization (revised): Guidance for industry. Retrieved December 9, 2025, from <a href=\"https:\/\/www.fda.gov\/media\/133880\/download\">https:\/\/www.fda.gov\/media\/133880\/download<\/a><\/p>\n<p>U.S. Food &amp; Drug Administration. (2025, August 7). Tobacco 21. Retrieved December 9, 2025, from <a href=\"https:\/\/www.fda.gov\/tobacco-products\/retail-sales-tobacco-products\/tobacco-21\">https:\/\/www.fda.gov\/tobacco-products\/retail-sales-tobacco-products\/tobacco-21<\/a><\/p>\n<p>Willis, N., &amp; Mindicino, M. (2020). The role of advertisements in JUUL consumption: Analyzing the connections between different stimuli on advertisements and teenage vaping. Journal of Student Research, 9(2). <a href=\"https:\/\/doi.org\/10.47611\/jsrhs.v9i2.1069\">https:\/\/doi.org\/10.47611\/jsrhs.v9i2.1069<\/a><\/p>\n<p>Wyoming Statute \u00a7 14-3-301 (2013, Rev 2020, &amp; Rev 2023). <a href=\"https:\/\/wyoleg.gov\/NXT\/gateway.dll?f=templates&amp;fn=default.htm\">https:\/\/wyoleg.gov\/NXT\/gateway.dll?f=templates&amp;fn=default.htm<\/a><\/p>\n<p>Wyoming Statute \u00a7 14-3-305 (2013 &amp; Rev 2020). <a href=\"https:\/\/wyoleg.gov\/NXT\/gateway.dll?f=templates&amp;fn=default.htm\">https:\/\/wyoleg.gov\/NXT\/gateway.dll?f=templates&amp;fn=default.htm<\/a><\/p>\n<p>Wyoming Statute \u00a7 39-18-104(g)-(h) (2020). <a href=\"https:\/\/wyoleg.gov\/NXT\/gateway.dll?f=templates&amp;fn=default.htm\">https:\/\/wyoleg.gov\/NXT\/gateway.dll?f=templates&amp;fn=default.htm<\/a><\/p>\n<h1>Appendices<\/h1>\n<p>For frequency tables for every survey item and key variable, see <a href=\"https:\/\/wysac.uwyo.edu\/wysac\/reports\/View\/7747\">Appendix A: Frequency Tables<\/a>. For the other appendices, please download the <a href=\"https:\/\/wysac.uwyo.edu\/wysac\/reports\/View\/7748\">full report<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Executive Summary The 2025 Wyoming Adult Commercial Tobacco and Nicotine Survey (formerly known as the Wyoming Adult Tobacco Survey) provides insights into how Wyoming adults use and perceive commercial tobacco and nicotine products. The survey, conducted by the Wyoming Survey &amp; Analysis Center (WYSAC), tracks progress toward commercial tobacco and nicotine prevention goals. Cigarettes, ENDS [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":1395,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"footnotes":""},"categories":[77,3],"tags":[41,7,88,10,62,137,75,134,135,136,91,9,138,74,140,139,45],"coauthors":[21,142,146,22],"class_list":["post-3965","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publications","category-reports","tag-attitudes-adults","tag-use-adults","tag-adults","tag-cessation","tag-cigarettes","tag-commercial-tobacco","tag-disparities","tag-e-cigarettes","tag-ends","tag-ends-aerosol","tag-health","tag-health-econ","tag-nicotine-products","tag-secondhand-smoke","tag-smokefree-policies","tag-taxes","tag-wyoming"],"_links":{"self":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts\/3965","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/comments?post=3965"}],"version-history":[{"count":32,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts\/3965\/revisions"}],"predecessor-version":[{"id":4058,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/posts\/3965\/revisions\/4058"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/media\/1395"}],"wp:attachment":[{"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/media?parent=3965"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/categories?post=3965"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/tags?post=3965"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/wysac.uwyo.edu\/wyomingtobacco\/wp-json\/wp\/v2\/coauthors?post=3965"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}