Tobacco Use

CDC works to reduce the four main risk factors for preventable chronic diseases: tobacco use, poor nutrition, lack of physical activity, and excessive alcohol use.

man standing with folded arms.

Fast Facts

  • Tobacco use is the leading cause of preventable disease, disability, and death in the United States.
  • About 34 million US adults smoke cigarettes, and 58 million nonsmokers are exposed to secondhand smoke. Every day, about 2,000 young people under age 18 smoke their first cigarette, and more than 300 become daily cigarette smokers.
  • Cigarette smoking causes more than 480,000 deaths annually, including 41,000 deaths from secondhand smoke. For every American who dies because of smoking, at least 30 are living with a serious smoking-related illness.
  • Smoking-related illness cost the United States over $300 billion each year, including $170 billion in direct medical costs.
  • CDC is at the forefront of the nation’s efforts to reduce deaths and prevent chronic diseases that result from tobacco use and secondhand smoke exposure.

Tobacco use is the leading cause of preventable disease, disability, and death in the United States. As of 2017, about 34 million US adults smoke cigarettes. Every day, about 2,000 young people under 18 smoke their first cigarette, and more than 300 become daily cigarette smokers. Cigarette smoking causes more than 480,000 deaths annually, including 41,000 deaths from secondhand smoke. For every American who dies because of smoking, at least 30 are living with a serious smoking-related illness.

Smoking-related illness costs society over $300 billion each year, including $170 billion in direct medical costs. These costs could be reduced if we prevent young people from starting to smoke and help smokers quit. CDC and its partners work to reduce tobacco-related diseases and deaths by:

  • Preventing young people from starting to use tobacco.
  • Promoting quitting among adults and young people.
  • Reducing exposure to secondhand smoke.
  • Identifying and eliminating tobacco-related health disparities.

The Harmful Effects of Tobacco Use

Cigarette smoking leads to disease and disability and harms nearly every organ of the body. Smoking causes cancer, heart disease, stroke, lung diseases, type 2 diabetes, and other chronic health conditions. The impact also extends beyond the smoker. For example, smoking during pregnancy increases the risk of premature birth (being born too early) and sudden infant death syndrome (SIDS).

Secondhand smoke, which affects 58 million nonsmoking Americans, also causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk of SIDS, impaired lung function, acute respiratory infections, middle ear disease, and more frequent and severe asthma attacks.

Cancer

Cigarette smoking causes several forms of cancer, including about 90% of lung cancer deaths. Nonsmokers who are exposed to secondhand smoke at home or work have a 20% to 30% higher risk of getting lung cancer. Smoking also causes cancers of the voice box (larynx), mouth and throat, esophagus, bladder, kidney, liver, pancreas, cervix, colon, rectum, and stomach, as well as a type of blood cancer called acute myeloid leukemia. In addition, it can interfere with cancer treatment, increasing the risk of recurrence, more serious complications, and death.

In the United States:
gravestones engraved with RIP

480,000 PEOPLE

die each year because
of cigarette smoking.
family with children standing in a cloud of cigarette smoke

58 MILLION

nonsmokers are exposed to
secondhand smoke.
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$170 BILLION

is spent each year to treat
smoking-related diseases.
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Doctor and patient in an exam.

Woman self-administering a blood glucose test.

Heart Disease and Stroke

Cigarette smoking is a major cause of heart disease and stroke and causes 1 in every 4 deaths from heart disease and stroke. Nonsmokers who breathe secondhand smoke at home or work have a 25% to 30% higher risk of heart disease and a 20% to 30% higher risk of stroke. Smoking can damage the body by:

  • Raising triglycerides (a type of fat in the blood) and lowering high-density lipoprotein (HDL) or “good” cholesterol.
  • Making blood sticky and more likely to clot, which can block blood flow to the heart and brain.
  • Damaging cells that line blood vessels, increasing the buildup of plaque (fat, cholesterol, calcium, and other substances) in blood vessels, and causing blood vessels to thicken and narrow.

Lung Disease

Cigarette smoking can cause lung disease by damaging the airways and the small air sacs (alveoli) found in the lungs. It can cause chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking accounts for as many as 8 in 10 COPD-related deaths. If you have asthma, tobacco smoke can trigger an asthma attack or make an attack worse.

Diabetes

The risk of developing type 2 diabetes is 30% to 40% higher for current smokers than nonsmokers. The more cigarettes a person smokes, the higher their risk of type 2 diabetes. People with diabetes who smoke are more likely than nonsmokers to have trouble controlling their blood sugar and to have serious complications, including:

  • Heart disease and kidney disease.
  • Poor blood flow in the legs and feet that can lead to infections, ulcers, and amputation (surgery to remove a body part, such as toes or feet).
  • Retinopathy (an eye disease that can cause blindness).
  • Peripheral neuropathy (nerve damage in the arms and legs that causes numbness, pain, weakness, and poor coordination).

Tobacco Use During Pregnancy

Cigarette smoking during pregnancy increases the risk of pregnancy complications, including premature birth, low birth weight, certain birth defects, and SIDS. Smoking can also make it harder for a woman to get pregnant. Exposure to secondhand smoke is also dangerous for infants and increases the risk of SIDS, slowed lung growth, and middle ear disease.

 

CDC’s Response to Tobacco Use

Measure Tobacco Use and Translate Data Into Effective Action

CDC’s Office on Smoking and Health collects, studies, and shares information to assess tobacco use and its effect on health, promote evidence-based approaches, and measure progress towards 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.
  • Study the impact of comprehensive tobacco control programs and policies.
  • Publish studies to answer important questions about tobacco use and tobacco control.

Information is shared in many ways, including through high-quality reports, easy-to-understand web pages, report, articles, and infographics and easy-to-use, interactive data applications, such as OSHData and the STATE System.

Support for Comprehensive Tobacco Control Programs

CDC’s National Tobacco Control Program is the only nationwide initiative that supports all 50 states, the District of Columbia, 8 US territories, and 12 tribal organizations for comprehensive tobacco control efforts and quitlines. In FY 2018, CDC provided $72 million to support strong tobacco control programs that reduce tobacco-related diseases and deaths.

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

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no smoking sign
secondhand smoke triggers asthma attacks poster.

man talking on a cell phone.

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Help People Understand the Dangers of Smoking

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 motivate people to quit. CDC’s Tips From Former Smokers® (Tips®) campaign, the first federally funded tobacco education campaign, focuses 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.

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.

Support People Who Want to Quit Smoking

CDC supports programs to help people stop using tobacco, such as 1-800-QUIT-NOW. This toll-free telephone line routes callers to their state quitlines, which provide free counseling and, in many states, limited supplies of free smoking cessation medications for certain populations. CDC also promotes the national Spanish Language Quitline portal, which routes Spanish-speaking callers to free Spanish-language services, and the national Asian Language Quitline, which provides free services in Chinese, Korean, and Vietnamese.

CDC also works with health insurance companies, health care providers and practices, and employers to improve support for tobacco users who want to quit.

Provide Information About the Risks of Tobacco Products for Young People

Despite the good news that cigarette smoking is decreasing among young people, 2.1 million middle and high school students used electronic cigarettes (e-cigarettes) in 2017. This is a concern because any tobacco use among young people—whether smoked, smokeless, or electronic—is unsafe. Nicotine, which is found in almost all e-cigarettes, is addictive and can harm the developing brain.

In addition to monitoring tobacco use among young people, CDC also helps parents, educators, health care providers, and other youth influencers understand and talk to young people about the dangers of tobacco products. CDC activities include developing easy-to-understand materials using the best available science and leveraging social media platforms to create and deliver information where young people and youth influencers seek information.

Note: Tobacco in this document refers specifically to the use of manufactured, commercial tobacco products and not the sacred and traditional use of tobacco by American Indians and other groups.

Page last reviewed: March 18, 2019