Highlights: United States

Tobacco use remains the leading cause of preventable death and disease in the United States.  To address this enormous toll, the American Lung Association and its partners have committed to three bold goals:

  1. Reduce smoking rates, currently at about 18 percent, to less than 10 percent by 2024;
  2. Protect all Americans from secondhand smoke by 2019; and
  3. Ultimately eliminate the death and disease caused by tobacco use. 

The American Lung Association recognizes that these bold goals will only be met if federal policymakers take these three actions:

  1. The Food and Drug Administration (FDA) must finalize the regulation that would extends its authority over all tobacco products;
  2. FDA must issue product standards governing the design and content of tobacco products;
  3. Congress must increase and equalize tobacco taxes across all products.

January 2014 marked the 50th anniversary of the landmark 1964 Surgeon General's report on Smoking and Health. The American Lung Association and its partners recognized this anniversary by committing to ending tobacco use in the United States through these three bold goals.  Also in January, Acting U.S. Surgeon General Boris Lushniak released the 2014 new Surgeon General’s report The Health Consequences of Smoking—50 Years of Progress

In April, FDA released its long-overdue proposal to assert its authority over all tobacco products. The proposed regulation would give FDA basic oversight authority over unregulated products, such as cigars and electronic cigarettes, and require manufacturers to register with FDA and disclose their products’ ingredients to the agency. It would also prohibit tobacco companies from making health claims without FDA review. One very troubling provision in the proposed regulation would create an exemption for certain types of cigars. The American Lung Association filed extensive organizational comments as well as submitted comments with other public health and medical partners, urging FDA to ensure it has authority over all tobacco products.  The Lung Association also made clear that any exemption for cigars or any other tobacco products is unacceptable. 

In May, the Obama Administration issued guidance on quit smoking benefits available through the Affordable Care Act (ACA). This announcement clarified what treatments insurance plans should cover for quitting smoking as part of their preventive services benefit.  The guidance will help health insurance commissioners, employers and insurance plans make sure that smokers get the assistance they need to quit. 

The Centers for Disease Control and Prevention continued its very successful "Tips from Former Smokers" media campaign to help encourage adult smokers to quit and in 2014, FDA launched "The Real Cost Campaign" which targets youth ages 12 to 17 at greatest risk for smoking. The evidence that such mass media campaigns are an important part of reducing tobacco use were highlighted in the 2014 Surgeon General's report as well as in the 2014 Best Practices for Comprehensive Tobacco Control Programs–2014.

United States Facts

Economic Costs Due to Smoking: $289,500,000,000
Adult Smoking Rates: 18.0%
High School Smoking Rates: 12.7%
Middle School Smoking Rates: 2.9%
Smoking Attributable Deaths Rates: 480,320
Smoking Attributable Lung Cancer Death Rates: 163,700
Smoking Attributable Respiratory Disease Death: 113,100

Adult smoking rate is taken from the 2013 National Health Interview Survey. High school and middle school smoking rates are taken from the 2013 National Youth Tobacco Survey.

Health impact information is taken from The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. 2014. Smoking attributable deaths reflect average annual estimates for the period 2005-2009 and are calculated for persons aged 35 years and older. Respiratory diseases include pneumonia, influenza, bronchitis, emphysema and chronic airway obstruction. The estimated economic impact of smoking is based on smoking-attributable health care expenditures in 2009, the average annual productivity losses for the period 2005-2009, and the value of lost productivity due to secondhand smoke exposure in 2006.

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