Costs and Expenditures

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Smoking costs the United States billions of dollars each year.1

  • Cigarette smoking cost the United States more than $600 billion in 2018, including:
    • More than $240 billion in healthcare spending,2,3
    • Nearly $185 billion in lost productivity from smoking-related illnesses and health conditions,3
    • Nearly $180 billion in lost productivity from smoking-related premature death,3,4
    • $7 billion in lost productivity from premature death from secondhand smoke exposure.4,5*

The tobacco industry spends billions of dollars each year on cigarette and smokeless tobacco advertising and promotions.6,7

  • $8.2 billion was spent on advertising and promotion of cigarettes and smokeless tobacco combined—about $22.5 million every day, and nearly $1 million every hour. Smokeless tobacco products include dry snuff, moist snuff, plug/twist, loose-leaf chewing tobacco, snus, and dissolvable products.
  • Price discounts to retailers account for 74.7% of all cigarette marketing (about $5.7 billion). These are discounts paid in order to reduce the price of cigarettes to consumers.

State spending on tobacco prevention and control does not meet CDC-recommended levels.1,8,9

  • States have billions of dollars from the taxes they put on tobacco products and money from lawsuits against cigarette companies that they can use to prevent smoking and help smokers quit. Right now, though, the states only use a very small amount of that money to prevent and control tobacco use.
  • In fiscal year 2020, states will collect $27.2 billion from tobacco taxes and settlements in court, but will only spend $740 million in the same year. That’s only 2.7% of it spent on programs that can stop young people from becoming smokers and help current smokers quit.8
  • Right now, not a single state out of 50 funds these programs at CDC’s “recommended” level. Only three states (Alaska, California, and Maine) give even 70% of the full recommended amount. Twenty-eight states and the District of Columbia spend less than 20 percent of what the CDC recommends. One state, Connecticut, gives no state funds for prevention and quit-smoking programs.8
  • Spending 12% (about $3.3 billion) of the $27.2 billion would fund every state’s tobacco control program at CDC-recommended levels.8
  1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2018 Feb 22].
  1. Xu X, Shrestha SS, Trivers KF, Neff L, Armour BS, King BA. U.S. Healthcare Spending Attributable to Cigarette Smoking in 2014. Preventive Medicine 2021 (150): 106529. https://doi.org/10.1016/j.ypmed.2021.106529.
  2. Shrestha SS, Ghimire R, Wang X, Trivers KF, Homa DM, Armour BS. Cost of Cigarette Smoking Attributable Productivity Losses, United States, 2018. Forthcoming at Am J Prev Med 2022.
  3. U.S. Department of Health and Human Services, 2014. The Health Consequences of Smoking—50 Years of Progress: a Report of the Surgeon General. U.S. Department of Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/tobacco/sgr/50th-anniversary/index.htm.
  4. Max W, Sung HY, Shi Y. Deaths from secondhand smoke exposure in the United States: economic implications. American Journal of Public Health 2012;102(11): 2173–80. doi: 2105/AJPH.2012.300805.
    *The $7 billlion number is based on original Max, et al estimate 4, updated to 2018 dollars.
  5. U.S. Federal Trade Commission (FTC). Federal Trade Smokeless Tobacco Report for 2019 [PDF – 1 MB]. Washington: Federal Trade Commission, 2021 [accessed 2021 Apr 27].
  6. U.S. Federal Trade Commission (FTC). Federal Trade Smokeless Tobacco Report for 2019 [PDF – 1MB]. Washington: Federal Trade Commission, 2021 [accessed 2021 Apr 27].
  7. Campaign for Tobacco-Free Kids. Broken Promises to Our Children: The 1998 State Tobacco Settlement 20 Years Later. Washington: Campaign for Tobacco Free Kids, 2018 [accessed 2019 Jan 7].
  8. Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs–2014. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2018 Feb 22].
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