Amid mounting concerns over e-cigarette use, the adult smoking rate reached an all-time low of 13.7% in 2018, a new report from the Centers for Disease Control and Prevention shows.

More than 40% of American adults smoked in 1965, when the federal government began tracking tobacco use after the U.S. surgeon general released a landmark report on the health effects of smoking. Since then, smoking rates have been falling, yet smoking remains the leading cause of preventable death in the U.S., according to the new report.

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