State of Tobacco Control 2014

Renewing the Nation’s Commitment: The 50th Anniversary of the 1964 Surgeon General’s Report

The twelfth annual American Lung Association "State of Tobacco Control" report tracks progress on key tobacco control policies at the state and federal levels, and assigns grades based on tobacco control laws and regulations in effect as of January 2, 2014. The federal government, all 50 state governments and the District of Columbia are graded to determine if tobacco control laws are adequately protecting citizens from the enormous toll tobacco use takes on lives and the economy. 

Cigarette smoking is lethal. From 1930 to 1950, the number of deaths each year from lung cancer shot up from fewer than 3,000 to 18,000.  Then, in just seven years as the industry began to heavily market its products - from 1955 to 1962 – lung cancer deaths increased even further from 27,000 to 41,000.1 Today, lung cancer kills more than 158,000 Americans each year and is the nation’s leading cancer killer.2 Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, is the nation’s third leading cause of death, and kills more than 134,000 Americans each year.3 Both of these leading lung diseases are primarily caused by smoking – a conclusion first reached in the landmark 1964 Surgeon General’s report on smoking and health, which celebrates its 50th anniversary this year.




# of Americans Smoking

52.8 million

43.2 million




Source: Centers for Disease Control and Prevention, National Health Interview Survey; 1965 number of Americans smoking calculated using U.S. Census Bureau data.




Number of Cigarettes Sold

505 billion

273.6 billion

Source: Federal Trade Commission Cigarette Report for 2011, historical chart.

Fifty years later, tobacco is our nation’s leading cause of preventable death and disease. According to the 2014 Surgeon General’s report “The Health Consequences of Smoking – 50 Years of Progress,” smoking is responsible for the deaths of close to 480,000 Americans and up to $333 billion in annual costs attributed to smoking, including more than $130 billion in healthcare costs and $150 billion in lost productivity each year. In addition, 5.6 million of today’s children under age 18 will die prematurely4 unless action is taken to reduce the burden of tobacco-caused death and disease.

In advance of the 50th anniversary of the 1964 Surgeon General’s report, the American Lung Association and its partners called for action by all levels of government to achieve three bold goals:

  • Reduce smoking rates, currently at about 18 percent, to less than 10 percent within 10 years;
  • Protect all Americans from secondhand smoke within five years; and
  • Ultimately eliminate the death and disease caused by tobacco use.

“State of Tobacco Control 2014” provides the blueprint for the proven tobacco control policies that will help us achieve these goals and issues an urgent call to action to policymakers across the country to pass them. However, in most cases our nation’s leaders are not listening, and have failed repeatedly to muster the political will to implement these measures. Unfortunately 2013 proved to be no exception. Trends include:

  • The Obama Administration maintained its poor record in combatting the tobacco industry’s ever changing and expanding ways to addict children to tobacco products, particularly other tobacco products such as cigars, little cigars and e-cigarettes. 
  • Continued inaction from almost all state governments in implementing effective policies proven to reduce tobacco use.
  • The tobacco industry continues its ruthless pursuit of addicting new users and keeping current users from quitting.

Fifty years after the Surgeon General first sounded the alarm on tobacco, the American Lung Association’s “State of Tobacco Control 2014” calls on our nation to renew its commitment to eliminating tobacco use and eradicate tobacco-caused diseases. America cannot afford to allow tobacco use to claim another 50 years of senseless death and disease.

  1. 1964 SGR Report, page 25, http://profiles.nlm.nih.gov/ps/access/NNBBMS.pdf
  2. Centers for Disease Control and Prevention. National Center for Health Statistics. National Vital Statistics Report. Deaths: Final Data for 2010. May 8, 2013; 61(04).
  3. Ibid.  
  4. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

Death of Tobacco Control Champion Dr. C. Everett Koop

As we commemorate the golden anniversary of the 1964 Surgeon General’s report, the American Lung Association remembers “America’s doctor,” U.S. Surgeon General C. Everett Koop who passed away in 2013.  Dr. Koop will be remembered for his passionate commitment to eliminating tobacco use in the U.S.

Did You Know

Read More Facts

Spread the Word

The American Lung Association’s annual "State of Tobacco Control" report was released nationwide on Wednesday, January 22, 2014.

Learn More

Surgeon General’s Report

Despite the great progress of the past, in the last few years, tobacco control efforts have slowed and in some areas, even stalled.

Learn More