Pixelated lines zoomed out

 I need to be drawing at more than 100% to get smother lines. 

By @Astonished_artist0D45

Hello, did you check the smoothing options in the option bar? there is also a leash mode, many useful settings.

Also, what is the spacing setting of your brush?

"Is it photoshop? Is it my cintiq?"

Photoshop for good reason. We want immediate zoom result, all of us. In order to speed up zooming esspecially when large files in question, Photoshop is doing quick, not so accurate scaling to show us result of zoming in almost no time. Judge in 100% and draw freely in any percentage level. Just make it your habit and ignore pixelation which is actually fake. You will always get what you expect and what it shows you at 100% zoom.

You're trying to draw a small circle around about 9 pixels when you're zoomed in to 1%. You won't get a smooth circle zoomed in that far drawing a small circle like that.