Although smoking has diminished in the United States since the 1990s, new study shows there was a international record of 1.1 billion people who smoked in 2019.

The number of smokers was directly connected to population increase, according to the peer-reviewed study published Thursday in the medical journal The Lancet.

The analysis stated that in the previous 30 years, smoking tobacco accounted for more than 200 million deaths. The annual financial costs exceeded $1 trillion.

“I am not surprised at all. Tobacco use smoking remains the No. 1 preventable cause of death globally,” Dr. Albert Rizzo, the chief medical officer told for the American Medical Association.

Ten countries made up two-thirds of the global tobacco smoking population: China, India, Indonesia, the U.S., Russia, Bangladesh, Japan, Turkey, Vietnam and the Philippines.

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The U.S. Centers for Disease and Control Prevention reported smoking diminished in the U.S. by 20.9percent in 2005 to 14% in 2019. The U.S. also saw the lowest number of cigarette smokers ages 18 to 25.

Regardless of the reported reduction in smoking,” Rizzo said, additional data stays high because smoking is among the most addictive substances. He said the early adoption of smoking in teens makes quitting difficult later in life.