no smoking sign

Power of Prevention

Health and Economic Benefits of Tobacco Use Interventions

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.

Tobacco Use in the United States

  • About 31 million US 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
  • 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
* “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.
The High Cost of Tobacco Use

Over $600‡(b) BILLION

annual cost of smoking-related disease and death6

  • 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.5,7
  • Cigarette smoking cost the United States more than $600 billion‡(b) in 2018,13 including:
    • More than $240 billion‡(b) in health care spending.7,8
    • Nearly $185 billion‡(b) in lost productivity from smoking-related illnesses and health conditions.8
    • Nearly $180 billion‡(b) in lost productivity from smoking-related premature death.5,8
    • $7 billionb in lost productivity from premature death from secondhand smoke exposure.5,9
  • Globally, tobacco use leads to about $1.4 trillion‡(c) a year in health care costs and lost productivity.10
Costs were measured in (a)2011 US dollars, (b)2018 US dollars, and (c)2012 US dollars.

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 healthcare costs exceed intervention.13
  • A nationwide smokefree policy could save $700 to $1,297‡(a) for each person not currently covered by a smokefree policy by preventing illness and reducing deaths from secondhand smoke exposure.14
  • Interventions that increase the price of tobacco products by 20% can save an average of $72‡(a) per person per year in health care costs.15
  • Mass-reach health communication interventions target large audiences to change knowledge, beliefs, attitudes, and behaviors affecting tobacco use.16

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

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 US 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 US 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 US 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 US population.11
  • CDC, states, and other partners have helped reduce cigarette smoking among US adults from 20.9% (about 1 in every 5 adults) in 2005 to 12.5% (nearly 1 in every 8 adults) in 2020.1
  • During 2012–2018, CDC estimates that more than 16.4 million people who smoke have attempted to quit, and about 1 million have quit because of the Tips campaign.10
  1. Cornelius ME, Loretan CG, Wang TW, Jamal A, Homa DM. Tobacco product use among adults — United States, 2020. MMWR Morb Mortal Wkly Rep. 2022;71(11):397–405.
  2. Tsai J, Homa DM, Gentzke AS, et al. Exposure to secondhand smoke among nonsmokers—United States, 1988–2014. MMWR Morb Mortal Wkly Rep. 2018;67(48);1342–1346.
  3. Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Appendix A. Table A.3A. Center for Behavioral Health Statistics and Quality; 2019. [PDF – 1.59 MB]
  4. Campaign for Tobacco-Free Kids. Smoking and Kids. 2022.
  5. US Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2014.
  6. Centers for Disease Control and Prevention. Economic trends in tobacco. Updated July 26, 2022. Accessed September 26, 2022.
  7. Xu X, Shrestha S, Trivers KF, Neff L, Armour BS, King BA. US healthcare spending attributable to cigarette smoking in 2014. Prev Med. 2021(150):106529.
  8. Shrestha SS, Ghimire R, Wang X, Trivers KF, Homa DM, Armour BS. Cost of cigarette smoking attributable productivity losses, United States, 2018. Am J Prev Med. 2022;63(4):478-485.
  9. Max W, Sung HY, Shi Y. Deaths from secondhand smoke exposure in the United States: economic implications. Am J Public Health. 2012;102(11):2173–2180. doi: 10.2105/AJPH.2012.300805.
  10. Goodchild M, Nargis N, Tursan d’Espaignet E. Global economic cost of smoking-attributable diseases. Tob Control. 2018;27(1):58–64.
  11. American Nonsmokers’ Rights Foundation. Percent of Population Covered by 100% Smokefree Non-Hospitality Workplace, Restaurant, and Bar Laws in Effect as of July 1, 2022. 2022.
  12. Murphy-Hoefer R, Davis KC, King BA, Beistle D, Rodes R, Graffunder C. Association between the Tips From Former SmokersCampaign and smoking cessation among adults, United States, 2012–2018. Prev Chronic Dis. 2020;17:200052.
  13. Community Preventive Services Task Force. Reducing Tobacco Use and Secondhand Smoke Exposure: Smokefree Policies. The Community Guide; 2013. [PDF – 214 KB]
  14. Community Preventive Services Task Force. Tobacco use: comprehensive tobacco control programs. The Community Guide. Accessed December 18, 2019.
  15. Contreary KA, Chattopadhyay SK, Hopkins DP. Economic impact of tobacco price increases through taxation: a Community Guide systematic review. Am J Prev Med. 2015;49(5):800–808.
  16. Community Preventive Services Task Force. Tobacco use and secondhand smoke exposure: mass-reach health communication interventions. The Community Guide. Accessed December 18, 2019.