The Smoking Comeback: Why an Old Habit is Trending Again

For decades, the lit cigarette on screen was a powerful symbol – it conveyed noirish danger, cool detachment, and sophisticated rebellion. Think Humphrey Bogart shrouded in smoke or the edgy aesthetic of a David Lynch film. Then came the public health reckoning. A tidal wave of lawsuits, visceral anti-smoking campaigns, widespread public smoking bans, and the rise of vaping seemed to signal a permanent shift. For a time, it appeared America had finally and decisively kicked its most notorious habit. But now, a strange and unsettling comeback is underway, and the smoke signals are impossible to ignore.

In popular culture, smoking is re-emerging from the shadows. Zendaya lights up in the hit series “Euphoria”; Jacob Elordi does the same in “Saltburn.” A new generation of celebrities, from Dua Lipa and Charli XCX to Timothée Chalamet and Anya Taylor-Joy, have been spotted puffing away, becoming unwitting modern-day “cigfluencers.” This cultural shift is mirrored by some concerning data. In 2020, cigarette sales in the U.S. rose for the first time in two decades. Even among teens, there are whispers of a shift from vaping back to traditional cigarettes. A recent report by the Truth Initiative found that depictions of tobacco in top-grossing films have increased for the first time since the organization began tracking them in 2002. So, what’s behind this resurgence, and what does it mean for our collective health?

From Public Health Victory to Cultural Relapse

It’s worth remembering how far we’ve come. In the early 20th century, cigarette smoking was glamorized by Hollywood, normalized by society, and even endorsed by some doctors. By the 1960s, nearly half of all U.S. adults smoked. Then came the inevitable and devastating fallout: soaring rates of emphysema, heart disease, stroke, and, most famously, lung cancer. The medical evidence finally caught up with the carefully crafted image.

A massive public health effort, fueled by landmark reports from the Surgeon General, powerful anti-smoking campaigns, advertising bans, and billions of dollars in legal settlements against tobacco companies, successfully turned the tide. This, combined with the steadily increasing price of cigarettes and comprehensive bans on smoking in public places, led to a remarkable achievement. The 2020 Surgeon General’s report marked a historic milestone: adult cigarette smoking in the U.S. had fallen to just 14% – the lowest rate ever recorded. It was hailed as one of the greatest public health victories of the modern era.

But smoking never truly vanished. It shape-shifted. It evolved into a brief resurgence of cigars and hookahs, and then, most significantly, into the sleek, tech-savvy form of e-cigarettes or vapes. Vaping was initially marketed as a safer alternative for adult smokers, a harm-reduction strategy to help them move away from the deadly effects of combustion. The reality, however, proved more complicated. While vaping is widely considered less harmful than smoking, it introduced a new generation to nicotine inhalation, often through appealing flavors. Juul didn’t kill the cigarette; for many, it simply trained a new cohort to inhale nicotine.

Now, we are witnessing a strange reversal: a cultural pivot from vape back to smoke, from a digital habit to a vintage, almost Instagrammable vice. And once again, public health seems to be playing catch-up to pop culture.

A Healthcare Advisor’s Perspective: Why This Matters Now

As a healthcare advisor who helps families and individuals navigate complex health decisions, I’ve learned a crucial lesson: the greatest threats are often not the novel ones making headlines, but the silent resurgences of risks we assumed were relegated to history. We’ve seen this with preventable diseases like measles. For over 20 years, we nearly eradicated it, but declining vaccination rates have allowed it to flare up again in communities we thought were protected.

The resurgence of smoking, while it may look like an edgy accessory for Gen Z, has real and immediate consequences, especially for anyone with a family history of heart disease, lung disease, or cancer. What makes this moment so dangerous is the insidious process of normalization. When something long-established as taboo gets rebranded as a “choice,” a form of rebellion, or even an aesthetic, it catches many people with their guard down. We start hearing the same old rationalizations from the 1980s: “I’m just a social smoker.” “At least it’s not vaping.” “I don’t really inhale.” We already know where this path leads.

Why Is Gen Z Smoking? Unpacking the Forces at Play

There’s no single answer to why a new generation might be drawn to an old habit, but several cultural and psychological forces are likely at play:

A Faded Sense of Danger (Nostalgia): Gen Z did not grow up with the same visceral, prime-time anti-smoking campaigns that shaped the views of Millennials and Gen X. For them, the immediate, visceral fear of smoking is more distant. Cigarettes can appear “retro” or “vintage,” like a Polaroid camera or a vinyl record – an artifact from a different era, detached from its historical health consequences.
Anxiety and Stress: The post-pandemic era has seen a well-documented increase in anxiety, stress, and mental health challenges among young people. For some, smoking offers a quick, albeit deceptive and highly addictive, form of self-soothing or a ritual to manage stress.
The Influence of Pop Culture and Social Media: With influencers and celebrities blurring the lines between their personal lives, their art, and what they endorse (implicitly or explicitly), cigarettes have re-entered the lifestyle conversation. An image of a celebrity smoking can be shared and romanticized across platforms like Instagram and TikTok, often without the necessary context or consequence. Social media algorithms reward aesthetics, not public health warnings.
A “Muddying of the Waters” by Vaping: The intense public health focus on the “youth vaping epidemic” over the past few years may have had an unintended consequence. By positioning vaping as the primary public health concern for youth, it may have inadvertently made traditional cigarettes seem less immediately threatening or even, paradoxically, a more “authentic” or “natural” choice in comparison to electronic devices.
A Lack of New, Impactful Messaging: The anti-smoking playbook of the 1990s, with its shocking commercials and public testimonies from people with tracheostomies, was incredibly effective for its time. Today, that shock factor may be gone, and public health messaging has struggled to find a new, culturally resonant voice to compete with the noise of social media.

The Unchanging Reality: What’s Actually in a Cigarette?

For all the romanticization, a cigarette remains one of the deadliest consumer products ever marketed. It’s a highly engineered nicotine delivery device designed for addiction. According to the American Lung Association, a single lit cigarette releases a toxic cocktail of more than 7,000 chemicals, at least 69 of which are known to cause cancer. Smoking contributes to one in every five deaths in the U.S. each year. It doesn’t just affect the lungs; it’s a systemic poison. The one question you are guaranteed to be asked at your next annual checkup is: “Do you smoke?” This is because smoking dramatically increases your risk of:

Heart attacks and stroke
Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis
Numerous cancers, including bladder, kidney, pancreatic, cervical, and throat cancers, in addition to lung cancer
Erectile dysfunction
Pregnancy complications, including premature birth and low birth weight
Weakened immune system
Accelerated aging and damage to skin elasticity

None of these outcomes aligns with the image of glamour or coolness that smoking’s cultural resurgence attempts to recapture.

Legislating Against the Comeback: A New Approach

Even as smoking regains some cultural cachet, some governments are pushing back with unprecedented measures. For example, Nevada has considered a proposal (AB 279) that could make it the first U.S. state to outlaw cigarette sales to entire generations by permanently banning sales to anyone born after 2004. This “rising age” restriction is designed to phase out cigarettes entirely over time, a model inspired by a similar (though since repealed) law in New Zealand.

What Can You Do? A Modern Playbook for Parents, Providers, and Individuals

If you’re a parent, a healthcare provider, or simply trying to stay on a healthier path, here’s what I advise:

Don’t Normalize It, But Don’t Moralize It: Shame is not an effective public health strategy. However, silence is a form of acceptance. It’s crucial to talk about smoking for what it is: a powerful addiction with severe health risks and a high financial cost. Frame the conversation around health, well-being, and freedom from addiction, rather than moral judgment.
Focus on Harm Reduction with Nuance: The concept of harm reduction is vital but requires context. For a person who smokes a pack of cigarettes a day and has been unable to quit, switching completely to a regulated vape product is almost certainly a step that reduces harm. But for a young person who has never smoked, starting to vape is a step *towards* nicotine dependence and potential harm. The context of the individual matters immensely.
Personalize the Cessation Plan: Quitting nicotine is not one-size-fits-all. Some people respond well to nicotine replacement therapies like patches or gum. Others may need prescription medications like varenicline (Chantix) or bupropion (Zyban). Many benefit most from behavioral support, such as coaching, therapy, or structured accountability programs. A combination of approaches is often most effective.
Understand the “Why” Behind the Habit: Smoking often serves as a coping mechanism for something deeper: stress, social anxiety, trauma, or even boredom. To successfully quit, it’s often necessary to address these root causes and develop healthier coping strategies. Treating the root issue is more effective than just trying to suppress the ritual.
Reinforce the Long Game and Immediate Benefits: The positive effects of quitting smoking begin almost immediately. Within just 20 minutes, your heart rate drops. Within 24 hours, your risk of a heart attack begins to decline. Within a year, your risk of coronary heart disease is cut in half. It is never too late to quit, and the benefits are both immediate and long-term.

In the world of public health, it’s easy to get caught up fighting the newest fire, but we must also stay attuned to the cultural cues – the smoke signals – that precede behavioral shifts. When the “smoking comeback” starts trending, it’s not just an aesthetic choice; it’s a public health flare. If we don’t intervene with empathy, context, and truth, we risk fighting an old war with a new generation of casualties. This time, we know better.