Despite enormous progress in reducing smoking, tobacco use is still the leading cause of preventable death in the United States and imposes a terrible toll on families, businesses and government. Tobacco kills more than 480,000 people annually – more than AIDS, alcohol, car accidents, illegal drugs, murders and suicides combined. Tobacco costs the U.S. approximately $170 billion in health care expenditures and more than $150 billion in lost productivity each year.
The Toll of Tobacco in the U.S.
| High school students who are current (past month) smokers (2019) | 5.8% or 800,000+ [Boys: 7.3%, Girls 4.1%] |
| High school males who are current cigar smokers (2019) | 9.0% |
| High school students who are current e-cigarette users (2019) | 27.5% |
| Kids (under 18) who try smoking for the first time each day | 1,900 |
| Kids (under 18) who become new regular, daily smokers each day | 250+ |
| Kids (3-11) exposed to secondhand smoke | 37.9% [Black: 66.1%, White: 37.8%] |
| Adults in the U.S. who smoke (2018) | 13.7% [Men: 15.6% Women: 12.0%] |
Deaths and Disease in the U.S. from Tobacco Use
| People who die each year from their own cigarette smoking or exposure to secondhand smoke. | more than 480,000 |
| Kids under 18 alive today who will ultimately die from smoking (unless smoking rates decline) | 5.6 million |
| People in the U.S. who currently suffer from smoking-caused illness | 16 million |
Smoking kills more people than alcohol, AIDS, car accidents, illegal drugs, murders, and suicides combined, with thousands more dying from spit tobacco use. Of the more than 200,000 kids who become new regular, daily smokers each year, almost a third will ultimately die from it. In addition, smokers lose a decade of life because of their smoking.
Tobacco-Related Monetary Costs in the U.S.
Total annual public and private health care expenditures caused by smoking: Approximately $170 Billion
- Annual Federal and state government smoking-caused Medicaid payments: $39.6 billion
[Federal share: $22.6 billion per year. States’ share: $17.0 billion] - Federal government smoking-caused Medicare expenditures each year: $45.0 billion
- Other federal government tobacco-caused health care costs (e.g. through VA health care): $23.8 billion
Annual health care expenditures solely from secondhand smoke exposure: $6.03 billion
Additional smoking-caused health costs caused by tobacco use include annual expenditures for health and developmental problems of infants and children caused by mothers smoking or being exposed to second-hand smoke during pregnancy or by kids being exposed to parents smoking after birth. Also not included above are costs from smokeless or spit tobacco use, adult secondhand smoke exposure, or pipe/cigar smoking.
Productivity losses caused by smoking each year: $151 billion
[Only includes costs from productive work lives shortened by smoking-caused death. Not included: costs from smoking caused disability during work lives, smoking-caused sick days, or smoking-caused productivity declines when on the job.]
Other non-healthcare costs from tobacco use include residential and commercial property losses from smoking-caused fires, tobacco-related cleaning & maintenance, and expenditures through Social Security Survivors Insurance for kids who have lost at least one parent from a smoking-caused death.
- Taxpayers yearly fed/state tax burden from smoking-caused gov't spending: $925 per household
- Smoking-caused health costs and productivity losses per pack sold in U.S. (low estimate): $20.91 per pack
- Average retail price per pack in the U.S. (including sales tax): $6.36
Tobacco Industry Advertising & Political Influence
- Annual tobacco industry spending on marketing its products nationwide: $9.1 billion ($25 million each day)
Research studies have found that kids are three times as sensitive to tobacco advertising than adults and are more likely to be influenced to smoke by cigarette marketing than by peer pressure; and that a third of underage experimentation with smoking is attributable to tobacco company advertising and promotion.
- Tobacco company PAC contributions to federal candidates, 2018 election cycle: More than $1 million.
- Annual tobacco industry expenditures lobbying Congress in 2018: $23.4 million
Sources: Toll of Tobacco in the United States.
Last updated Jan. 15, 2020