In 2019, approximately 20.8% of U.S. adults (50.6 million) reported currently using any tobacco product, with cigarettes being the most commonly used (14.0%). E-cigarettes were the most commonly used noncigarette product (4.5%). The highest prevalence of e-cigarette use was among adults aged 18–24 years (9.3%), with over half (56.0%) of these young adults reporting they had never smoked cigarettes. Combustible tobacco products (cigarettes, cigars, or pipes) were used by 80.5% of current tobacco product users, and 18.6% used two or more products. Prevalence of any current tobacco product use was higher among males, adults aged ≤65 years, non-Hispanic American Indian/Alaska Native adults, those with a GED, those with annual household income < $35,000, LGB adults, uninsured adults, those with Medicaid, those with a disability, and those with generalized anxiety disorder. E-cigarette use was highest among adults aged 18–24 years, with a significant proportion of these users having never smoked cigarettes. The report emphasizes the need for comprehensive, evidence-based interventions to reduce tobacco-related disease and death, including tobacco price increases, smoke-free policies, and antitobacco media campaigns. Targeted interventions are also needed to address subpopulations with higher tobacco use rates. The findings are subject to limitations, including potential nonresponse bias and the reliance on self-reported data. The U.S. Surgeon General concluded that there is currently insufficient evidence to determine whether e-cigarettes increase smoking cessation. Continued efforts to reduce all forms of tobacco use are necessary.In 2019, approximately 20.8% of U.S. adults (50.6 million) reported currently using any tobacco product, with cigarettes being the most commonly used (14.0%). E-cigarettes were the most commonly used noncigarette product (4.5%). The highest prevalence of e-cigarette use was among adults aged 18–24 years (9.3%), with over half (56.0%) of these young adults reporting they had never smoked cigarettes. Combustible tobacco products (cigarettes, cigars, or pipes) were used by 80.5% of current tobacco product users, and 18.6% used two or more products. Prevalence of any current tobacco product use was higher among males, adults aged ≤65 years, non-Hispanic American Indian/Alaska Native adults, those with a GED, those with annual household income < $35,000, LGB adults, uninsured adults, those with Medicaid, those with a disability, and those with generalized anxiety disorder. E-cigarette use was highest among adults aged 18–24 years, with a significant proportion of these users having never smoked cigarettes. The report emphasizes the need for comprehensive, evidence-based interventions to reduce tobacco-related disease and death, including tobacco price increases, smoke-free policies, and antitobacco media campaigns. Targeted interventions are also needed to address subpopulations with higher tobacco use rates. The findings are subject to limitations, including potential nonresponse bias and the reliance on self-reported data. The U.S. Surgeon General concluded that there is currently insufficient evidence to determine whether e-cigarettes increase smoking cessation. Continued efforts to reduce all forms of tobacco use are necessary.