Health and Economic Benefits of Tobacco Use Interventions

Tobacco use in the United States

Commercial* tobacco use is the leading preventable cause of disease, disability, and death in the United States. Cigarette smoking harms nearly every organ of the body and causes cancer, heart disease, stroke, lung diseases, and type 2 diabetes.

Secondhand smoke also causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk of sudden infant death syndrome, impaired lung function, acute respiratory infections, middle ear disease, and more frequent and severe asthma attacks.

* ^{"Commercial tobacco" means harmful products that are made and sold by tobacco companies. It does not include "traditional tobacco" used by Indigenous groups for religious or ceremonial purposes.}

Quick facts

• About 31 million U.S. adults smoke cigarettes,1 and 58 million nonsmoking Americans are exposed to secondhand smoke.2
• Every day in the United States, about 1,6003 people under age 18 try their first cigarette, and nearly 200 young people start smoking daily.4
• Cigarette smoking causes more than 480,000 deaths every year, including 41,000 deaths from secondhand smoke.5
• For every American who dies because of smoking, at least 30 are living with a serious smoking-related illness. That's more than 16 million Americans.56
• Disparities related to commercial tobacco use, secondhand smoke exposure, and quitting exist across population groups. For example, American Indian and Alaska Native people have the highest prevalence of cigarette smoking compared to all other racial or ethnic groups in the United States.1
• In 2020, 22.7% of adult Medicaid enrollees currently smoked cigarettes, compared to 9.2% of adults with private health insurance.1

The high cost of tobacco use

Cigarette smoking cost the United States more than $600 billion in 2018,7 including:

• More than $240 billionA in health care spending.8
• Nearly $185 billionA in lost productivity from smoking-related illnesses and health conditions.8
• Nearly $180 billionA in lost productivity from smoking-related premature death.8
• $7 billionB in lost productivity from premature death from secondhand smoke exposure.9

Strategies that work

CDC is committed to improving health equity by reducing diseases and deaths caused by commercial tobacco use in all communities. These efforts can help reduce the costs of smoking.

The agency and its partners promote efforts to prevent young people from starting to smoke, create smokefree worksites and public spaces, connect everyone who wants to quit smoking to effective treatment, and reduce health disparities for groups at higher risk of chronic diseases caused by smoking.

For example, CDC's National and State Tobacco Control Program is the only nationwide initiative that supports all 50 states, the District of Columbia, 8 U.S. territories and freely associated states, and 27 tribes and tribal organizations to implement proven interventions to prevent and control commercial tobacco use.

These efforts have protected Americans from the risks of tobacco use and secondhand smoke exposure. For example:

• CDC's Tips From Former Smokers^® (Tips^®) campaign is the first federally funded tobacco education campaign focused on motivating U.S. adults who smoke to try to quit. Tips features real people—not actors—who are living with serious health conditions caused by smoking and secondhand smoke exposure.
• CDC also helps people stop using tobacco through 1-800-QUIT-NOW, a toll-free telephone line that routes callers to their state quitlines, which are available in every U.S. state, the District of Columbia, Puerto Rico, and Guam. Callers have access to free counseling and, in many states, free smoking cessation medications when eligible and available.
• A comprehensive state or local smokefree law [PDF – 282 KB] now protects 62.5% of the U.S. population.10
• CDC, states, and other partners have helped reduce cigarette smoking among U.S. adults from 20.9% (about 1 in every 5 adults) in 2005 to 12.5% (nearly 1 in every 8 adults) in 2020.¹

Benefits of using proven strategies

The Community Preventive Services Task Force (CPSTF) reviews health interventions to determine which ones work and offer good value.* Its review of tobacco interventions found that:

• Comprehensive tobacco control programs are cost-effective, and savings from averted health care costs exceed intervention.11
• A nationwide smokefree policy could save $700 to $1,297C for each person not currently covered by a smokefree policy by preventing illness and reducing deaths from secondhand smoke exposure.12
• Interventions that increase the price of tobacco products by 20% can save an average of $72C per person per year in health care costs.13
• Mass-reach health communication interventions target large audiences to change knowledge, beliefs, attitudes, and behaviors affecting tobacco use.14

^{* The CPSTF considers interventions cost-effective if they cost less than $50,000 per quality-adjusted life year gained.}