Office on Smoking and Health At A Glance

group of people

CDC’s Office on Smoking and Health (OSH) is the lead federal agency for comprehensive tobacco prevention and control. OSH prioritizes health equity, creating resources and opportunities for all people to be as healthy as possible. With this foundation, OSH saves lives and money by preventing and reducing commercial* tobacco use—the leading cause of preventable disease, disability, and death in the United States.

* When CDC references tobacco on this web page, we are referring to the use of commercial tobacco and not the sacred and traditional use of tobacco by some American Indian communities.

What We Do

No smoking sign on a pole

With an FY 2021 budget of $237.5 million, OSH works to prevent people from using tobacco products, help people quit using tobacco products, reduce secondhand smoke exposure, and advance health equity by identifying and eliminating tobacco-related disparities.

To meet these goals, OSH:

  • Measures how tobacco use affects population groups.
  • Promotes what works best to prevent tobacco use and help people quit tobacco use.
  • Funds and guides states, territories, tribes, and nonprofit organizations to use proven strategies and study promising practices.
  • Informs the public about the dangers of tobacco use and breathing secondhand smoke.

Why We Do It

In the United States:

icon US map and 34 million

30.8 MILLION

adults smoke cigarettes.
Kid's backpack with smoking paraphernalia

2.55 MILLION

middle and high school students use tobacco products.
icon family surrounded by smoke

1 IN 4 PEOPLE

who don’t smoke are exposed to secondhand smoke.
icon money and clipboard with medical aid

$225 BILLION

is spent each year to treat smoking-related diseases.

Some groups of people have a higher percentage of tobacco use, secondhand smoke exposure, and related health problems, as well as less access to treatment to help them quit. These disparities can be based on where people live, the kind of job they have, whether they have health insurance, and factors like race, ethnicity, age, or sexual orientation.

Every day in the United States, about 1,600 young people under age 18 try their first cigarette, and nearly 200 end up smoking cigarettes daily. Over 16 million people live with at least one disease caused by smoking, and smoking-related illness costs society over $300 billion each year, including more than $225 billion in direct medical costs.

How We Do It

Measure Tobacco Use and Translate Data Into Effective Action
Teen at School

CDC collects, studies, and shares information to assess tobacco use and its effects on health, promote evidence-based approaches, and measure progress toward goals. CDC uses this information to:

  • Monitor changes and trends in the use of tobacco products among young people and adults.
  • Understand tobacco-related knowledge, attitudes, and behaviors among young people and adults.
  • Promote comprehensive tobacco control programs and policies.
  • Answer important questions about tobacco use and tobacco control.
  • Measure how tobacco use affects population groups to reduce health disparities and advance health equity.

Information is shared in high-quality reports, easy-to-understand web resources, infographics, and interactive data applications. The Tobacco Use Data Portal provides access to the latest tobacco prevention and control data, graphs, and maps, which users can download for more analysis. The STATE System provides data on state tobacco use prevention and control policies.

Examples of Our Impact

  • The National Youth Tobacco Survey collects information on use, beliefs, and knowledge about tobacco products among middle and high school students.
  • Surgeon General’s Reports form the basis of the public’s understanding of the health effects of tobacco use, secondhand smoke exposure, and evidence-based tobacco control strategies.
  • Best Practices for Comprehensive Tobacco Control Programs outlines how to develop, implement, and budget for evidence-based tobacco prevention and control programs.
  • Global Tobacco Surveillance System Data are available from four tobacco surveys conducted around the world. CDC’s global tobacco work is supported by the CDC Foundation through donations from the Bloomberg Initiative to Reduce Tobacco Use and the Bill and Melinda Gates Foundation.
Support Comprehensive Tobacco Control Programs

In FY 2021, CDC provided over $96 million to 50 states and the District of Columbia, 8 US territories and freely associated states, 26 tribes/tribal organizations, 8 national networks, and several other partners to support their work in reducing tobacco-related disease and death. Recipients focus on using evidence-based strategies to achieve the following OSH goals:

  • Prevent young people from using tobacco products.
  • Help people quit using tobacco products.
  • Eliminate exposure to secondhand smoke.
  • Advance health equity by identifying and eliminating tobacco-related disparities.

States that have made larger investments in comprehensive tobacco control programs have seen larger and faster declines in cigarette smoking among adults and young people. For every $1 spent on comprehensive tobacco control programs, states get a $55 return on investment, mostly in averted health care costs to treat smoking-related illness.

Examples of Our Impact

  • Among adults, current cigarette smoking declined from 20.9% (about 1 in 5) in 2005 to 12.5%  (1 in 8) in 2020. The proportion of “ever smokers” who have quit has also increased.
  • Twenty-eight states, the District of Columbia, American Samoa, Marshall Islands, Puerto Rico, and the US Virgin Islands have comprehensive smokefree laws that prohibit smoking in all indoor areas of worksites, restaurants, and bars. Currently, excluding populations in American Samoa and Marshall Islands, more than 60% of the US population is protected by a comprehensive state or local smokefree law.
Help People Understand the Dangers of Smoking
A woman and man having breakfast

For every American who dies because of smoking, at least 30 are living with a serious smoking-related illness. Hard-hitting media campaigns are a proven way to raise awareness about the dangers of smoking and to motivate people to quit.

CDC’s Tips From Former Smokers® (Tips®) campaign, the first federally funded national tobacco education campaign, focuses on motivating US adults who smoke to try to quit. Tips features real people who are living with serious health conditions caused by smoking and breathing secondhand smoke.

Tips connects people who smoke with resources to help them quit, including 1-800-QUIT-NOW, which directs people to free services from their state quitlines. With CDC support, state quitlines are able to handle the increases in calls they receive during the Tips campaign.

Examples of Our Impact

  • During 2012–2018, an estimated 16.4 million people who smoke have tried to quit and about 1 million have successfully quit because of the Tips campaign.
  • The more exposure people who smoke have to Tips ads, the more likely they are to report making a quit attempt in the next 30 days.
  • During 2012–2018, Tips helped prevent an estimated 129,000 early deaths and save an estimated $7.3 billion in smoking-related health care costs.
Help All People Quit Using Tobacco

CDC helps people quit using tobacco by promoting free support services such as:

  • CDC.gov/quit, which has information about how to quit smoking and resources that provide quitting support.
  • 1-800-QUIT-NOW, a toll-free telephone portal that routes callers to their state quitlines. Callers have access to a variety of quitting services available in multiple languages.
  • The national texting portal (text QUITNOW to 333888), which connects people to text messaging services and other state resources in English and Spanish.

State tobacco control programs can access cessation-related materials, including information about best practices, clinical guidelines, and health insurance coverage.

CDC also works with health insurers, health care providers, and employers to improve support for people who want to quit using tobacco. CDC’s activities include:

  • Promoting coverage of proven tobacco cessation treatments and the removal of barriers to these treatments.
  • Promoting health system changes that ensure that providers ask patients if they use tobacco, advise them to quit, and help them quit by providing cessation counseling and medicines.
  • Encouraging employers to cover proven tobacco cessation treatments for workers and their families and to have tobacco-free workplace policies.
  • Educating people who smoke on the benefits of using proven tobacco cessation treatments when trying to quit.

Examples of Our Impact

  • In 2021, CDC released a suite of new resources that healthcare providers can use to encourage smoking cessation among youth and adults who use tobacco, as well as additional resources to help people quit smoking.
  • During the 2021 Tips® campaign, 1-800-QUIT-NOW received more than 362,000 calls. Almost 90,000 of these calls were generated by the campaign, which represents a 33% increase compared to the number of calls three weeks before the 2021 campaign launch.
Help All People Understand the Risks of Youth Tobacco Use

Despite the good news that cigarette smoking is decreasing among young people, over 2 million middle and high school students used electronic cigarettes (e-cigarettes) in 2021. This is a concern because any tobacco use among young people—whether smoked, smokeless, or electronic—is unsafe. Nicotine is addictive and can harm the developing brain.

In addition to monitoring tobacco use among young people, CDC helps parents, educators, health care providers, and other youth influencers understand and talk to young people about the dangers of tobacco products. CDC’s activities include:

  • Developing easy-to-understand materials using the best available science.
  • Using digital and social media platforms to create and deliver information where young people and youth influencers seek information.
  • Working with all 50 states and the District of Columbia to support state and community activities to prevent use of emerging tobacco products, including e-cigarettes, among youth and young adults.
Nicotine in e-cigarettes can prime the adolescent brain for addiction to other drugs

Examples of Our Impact

  • In 2021, CDC OSH’s “Protect Young People from E-cigarettes” communication initiative reached educators and other youth influencers about the risks of youth e-cigarette use. Digital and social media messages achieved more than 92.4 million impressions, 9.3 million video views, and more than 411,000 views of the e-cigarettes web pages.
  • CDC partnered with the American Academy of Pediatrics to develop and publish Youth Tobacco Cessation: Considerations for Cliniciansexternal icon. This resource guides pediatric health clinicians in screening patients for tobacco use and providing support to help them quit.
Health Equity Highlight: Tobacco-Free Campuses at Mental Health and Substance Use Treatment Facilities

The Challenge:

In 2019, 27.2% of adults with a mental health condition reported past-month cigarette smoking, compared to 15.8% of adults with no mental health condition.

CDC’s Approach:

With CDC support, 47 states are using interventions to reduce smoking among people with behavioral health conditions by increasing tobacco use screening, tobacco cessation treatment access, and tobacco-free policies at facilities. See People With Mental Health Conditions for more information.

Page last reviewed: May 9, 2022