Tobacco use is still the leading preventable cause of death in the U.S., killing over 440,000 Americans each year. While smoking rates have declined, progress has stalled in recent years. Comprehensive tobacco control programs that increase tobacco taxes, implement smoke-free laws, fund anti-smoking media campaigns, and increase access to cessation services have been shown to effectively reduce smoking rates and the health burdens and economic costs of tobacco use. However, more remains to be done as the tobacco industry continues to outspend tobacco control efforts. Sustained funding and expansion of comprehensive tobacco control programs nationwide are needed to continue making progress toward creating a tobacco-free generation.

1. Tobacco Control:
A Winnable Battle
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention

2. Tobacco use damages virtually
every part of the body
Smoking Secondhand Smoke

3. Tobacco use is still the leading preventable cause
of death in the U.S.
 46.6 million U.S. adults smoke
 Tobacco causes nearly 1 in 5 deaths in U.S.
• >440,000 deaths/year, >1,200/day
 For each death, it is estimated that 20 more
suffer tobacco-related illnesses
 Annual costs: $96 billion in medical expenses
plus $97 billion in lost productivity
 Many Americans left unprotected, especially
service industry workers
• 26 states still lack comprehensive smoke-free laws

4. Tobacco kills about 443,000 in the U.S. every year
Average annual number of deaths, 2000-2004.
Source: Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses – United States, 2000-2004. MMWR
2008;57(45):1226-1228.

5. The decline in adult cigarette smoking
has stalled
Civilian, non-institutionalized adults, aged 18 years of age and over, who currently smoked cigarettes.
Source: National Health Interview Surveys, 1965-2009.

6. Smoking rates vary widely by race/ethnicity
Note: Question wording changed in 1992 in order to identify smokers who smoked less than daily. This graph includes all smokers,
regardless of frequency.
Source: National Health Interview Survey, 1978-2009; data aggregated for selected years.

7. Smoking rates vary widely by state/region
Note: Persons who have smoked at least 100 cigarettes in lifetime and currently smoke everyday or some days.
Source: Behavioral Risk Factor Surveillance Survey, NCCDPHP, CDC, 2009.

8. Heart disease deaths are closely aligned with smoking
Heart Disease Death Rates, 2000-2004
Adults ages 35 Years and Older by County
Source: Vital Records; National Center for Health Statistics, CDC, 2000-2004.
Division for Heart Disease and Stroke Prevention: Data Trends & Maps Web site. U.S. Department of Health and Human Services, Centers
for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, 2010.
Available at http://www.cdc.gov/dhdsp/.

9. Short-term impact of a comprehensive approach:
Youth and adult smoking rates in NYC
Source: BRFSS 1993-2001; NYC Community Health Survey 2002-2009; NYC YRBS 2001-2009.

10. Long-term impact of a comprehensive approach:
Lung and bronchus cancer incidence rates in CA
California: A 15 year investment of
$1.8 billion in tobacco control reduced
health care costs by $86 billion
Rates are per 100,000 and age-adjusted to the 2000 U.S. standard (19 age groups).
* The annual percent change is significantly different from zero (p<0.05).
Source: Cancer Surveillance Section. Prepared by: California Department of Public Health, California Tobacco Control Program, 1988-
2005. 2010.

12. We know what works
 Sustained funding of
comprehensive programs
 Excise tax increases
 100% smoke-free policies
 Aggressive media
campaigns
 Cessation access
 Comprehensive
advertising restrictions

13. The tobacco industry is outspending
tobacco prevention efforts 20:1
Sources: Campaign for Tobacco Free Kids; Federal Trade Commission; CDC Office on Smoking and Health.

14. When tobacco control funding increases,
high school smoking decreases
Source: Project ImpacTEEN; University of Illinois at Chicago; State University of New York at Buffalo; Youth Risk Behavior Survey,
1993-2009.
* Adjusted to 2009 CPI.
† High school students (grades 9-12) who smoked on 1 or more of the 30 days preceding the survey.

15. When cigarette prices increase,
cigarette sales decrease
Source: ImpacTeen Chartbook: Cigarette Smoking Prevalence and Policies in the 50 States.

16. Increased tobacco excise taxes
increase price
 10% increase in cigarette prices  4% drop
in adult cigarette consumption
 Youth much less likely to start smoking when
prices are high
 Adjust taxes to offset inflation and tobacco
industry attempts to control retail prices
• E.g., promotional discounts for retailers who reduce
cigarette prices
 Tobacco taxes are the single most effective
component of a comprehensive tobacco
control program

17. Smoke-free policies save lives
 Prevent heart attacks
• Up to 17% average reduction in heart attack
hospitalizations in places that enact smoke-free laws
 Help motivate smokers to quit
 Worker safety issue – not “personal nuisance”
• All workers deserve equal protection
• Only way to protect non-smokers from secondhand
smoke
 Smoke-free workplace laws don’t hurt
business
 No trade-off between health and economics

18. 25 states and D.C. have comprehensive
smoke-free indoor air laws
Laws in effect as of November 10, 2010
Source: CDC, Office on Smoking and Health. State Tobacco Activities Tracking and Evaluation (STATE) System.

19. Almost 50% of U.S. population is covered by
comprehensive state or local smoke-free laws
Population figures are as of December 31 of each given year; July for 2010. All population figures are from the United States Census.
Source: American Nonsmokers’ Rights Foundation, 2000-2010.

20. Aggressive media campaigns work
Media campaigns work to:
 Reduce youth initiation
 Encourage cessation
 Increase negative attitudes
toward tobacco use
 Increase support for policy
change

21. The impact of cessation services
 Currently: 46.6 million U.S. smokers
• 70% of smokers want to quit
• 40% try to quit each year
• Only 2% call state or national quitlines
• Medicaid coverage for cessation varies widely
among states
 Tobacco cessation can be achieved through:
• Significant tax and price increases
• Comprehensive smoke-free policies
• Aggressive counter-advertising

22. State and federal policy activities
(2009-2010)
 Excise Tax Increases
• 21 state increased cigarette taxes
 Smoke-Free Policies
• 10 additional states achieved comprehensive status
 Federal Legislation
• Federal excise tax increase
• Family Smoking Prevention and Tobacco Control Act
• Prevent All Cigarette Trafficking (PACT) Act
• Affordable Care Act

23. Closing Statement
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official
position of the Centers for Disease Control and Prevention.
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention