Tobacco Use

Tobacco use is the leading cause of preventable death in the United States. It affects not only those who choose to use tobacco, but also people who live and work around tobacco. The term “tobacco” on our website refers to commercial tobacco, not ceremonial or traditional tobacco.

Why Is Tobacco Use Important to Health?

Each year, smoking kills 480,000 Americans, including about 41,000 from exposure to secondhand smoke. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease which includes emphysema and chronic bronchitis. On average, smokers die 10 years earlier than nonsmokers [1].

Tobacco is not only smoked. Smokeless tobacco, while less lethal than smoked tobacco, can lead to various cancers, gum and teeth problems, and nicotine addiction. Almost 6% of young adults use smokeless tobacco and half of new users are younger than 18 [2].

Tobacco use has real economic impacts for individuals and communities. It costs the nation about $170 billion annually to treat tobacco-related illnesses, and another $156 billion in productivity losses. In 2006, over $5 billion of that lost productivity was due to secondhand smoke [1]. 

Researchers estimate that tobacco control policies have saved at least 8 million Americans [3]. Yet about 18% of adults still smoke. Each day, nearly 3,200 youth smoke their first cigarette, and 2,100 transition from occasional to daily smokers [1].

Continuing to adopt and implement tobacco control policies can motivate users to quit, help youth choose not to start, and improve the quality of the air we all breathe.


[1] Centers for Disease Control and Prevention. Smoking & tobacco use. February 6, 2019. Accessed March 12, 2019.
[2] American Cancer Society. Smokeless tobacco. November 13, 2015. Accessed February 28, 2018. 
[3] Robert Wood Johnson Foundation. Fifty years after first surgeon general’s report on smoking and health, tobacco advocacy groups pledge to “end the tobacco epidemic for good.” NewPublicHealth blog. January 8, 2014. Accessed March 3, 2014. 

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When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Minimum legal tobacco age (MLTA) laws specify the legal age to purchase or publicly consume tobacco products, including cigarettes, cigars, and e-cigarettes
Coordinate state and community-level cessation and prevention interventions and provide information on the dangers of tobacco using a combination of educational, regulatory, clinical, social, and economic strategies
Deliver phone-based counseling to tobacco users who want to quit, usually with follow-up calls proactively scheduled after initial contact

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