Health and Economic Benefits of Tobacco Use Interventions

At a glance

  • Tobacco use is the leading preventable cause of disease, disability, and death in the United States.
  • In 2018, cigarette smoking cost the United States over $600 billion.
  • CDC works to prevent youth from starting to use tobacco products, eliminate secondhand smoke exposure, help people quit, and eliminate disparities in tobacco use.
no smoking sign at a playground

Tobacco use in the United States

Commercial* tobacco use is the leading cause of preventable disease and death in the United States.1 Cigarette smoking harms nearly every organ of the body and causes many diseases, including cancer, heart disease stroke, lung diseases, type 2 diabetes, and chronic obstructive pulmonary disease (COPD).

Secondhand smoke also causes stroke, lung cancer, and heart disease in adults. Children who are exposed to secondhand smoke are at increased risk for sudden infant death syndrome, slowed lung growth, acute respiratory infections, respiratory symptoms, middle ear disease, and more frequent and severe asthma.1

* "Commercial tobacco" means harmful products that are made and sold by tobacco companies. It does not include "traditional tobacco" used by Indigenous groups for religious or ceremonial purposes.

Quick facts

  • About 28 million U.S. adults smoke cigarettes,2 and 58 million nonsmoking Americans are exposed to secondhand smoke.3
  • Cigarette smoking causes more than 480,000 deaths every year in the U.S., including 41,000 deaths from secondhand smoke.1
  • For every American who dies because of smoking, at least 30 are living with a serious smoking-related illness. That's more than 16 million Americans.14
  • Disparities related to commercial tobacco use, secondhand smoke exposure, and quitting exist across population groups. For example, American Indian and Alaska Native people have the highest prevalence of cigarette smoking compared to other racial and ethnic groups in the U.S.2
  • In 2021, 21.5% of adult Medicaid enrollees currently smoked cigarettes, compared to 8.6% of adults with private health insurance.2

The high cost of tobacco use

Cigarette smoking cost the United States more than $600 billion in 2018,5 including:

  • More than $240 billionA in health care spending.6
  • Nearly $185 billionA in lost productivity from smoking-related illnesses and health conditions.6
  • Nearly $180 billionA in lost productivity from smoking-related premature death.6
  • $7 billionB in lost productivity from premature death from secondhand smoke exposure.7

Strategies that work

CDC is committed to advancing health equity by reducing diseases and deaths caused by commercial tobacco use in all communities. These efforts can also help reduce smoking-related costs.

CDC and its partners work to prevent youth from starting to use tobacco products, eliminate exposure to secondhand smoke, help people quit, and reduce health disparities for groups at higher risk of chronic diseases caused by smokinghealth inequities and disparities related to tobacco product use.

For example, CDC's National and State Tobacco Control Program is the only nationwide initiative for comprehensive tobacco prevention and control efforts that supports all 50 states, the District of Columbia, 8 U.S. territories, and 26 tribes and tribal organizations.

CDC efforts have protected Americans from the risks of tobacco use and secondhand smoke exposure. For example:

  • CDC's Tips From Former Smokers® (Tips®) campaign is the first federally funded tobacco education campaign focused on motivating U.S. adults who smoke to quit. Tips features real people from diverse backgrounds who are living with serious long-term health effects from smoking and secondhand smoke exposure.
  • CDC connects people who smoke with resources to help them quit, including a free quitline portal, 1-800-QUIT- NOW, which links callers to their state quitline, as well as web-based, text-based, and app-based quit support resources.
  • The percentage of the population covered by comprehensive state or local smoke-free laws has increased over the past 2 decades, with 62.7% of the U.S. population currently covered.
  • CDC, states, territories, tribal organizations, and other partners have helped reduce cigarette smoking among U.S. adults from 20.9% (about 1 in every 5 adults) in 2005 to 11.5% (nearly 1 in every 9 adults) in 2021.2

Effectiveness of the Tips campaign‎

During 2012–2018, CDC estimates that more than 16.4 million people who smoke have attempted to quit, and about 1 million have quit because of the Tips campaign. Tips prevented an estimated 129,000 early deaths and helped save an estimated $7.3 billion in smoking-related health care costs.8

Benefits of using proven strategies

The Community Preventive Services Task Force (CPSTF) reviews health interventions to determine which are evidence-based and cost-effective.* For example:

  • Comprehensive tobacco control programs are cost-effective, and savings from averted health care costs exceed intervention costs.9
  • A nationwide smokefree policy could save $700 to $1,297C for each person not currently covered by a smokefree policy by preventing illness and reducing deaths from secondhand smoke exposure.10
  • Interventions that increase the price of tobacco products by 20% can save an average of $72C per person per year in health care costs.11
  • Mass-reach health communication interventions to change knowledge, beliefs, attitudes, and behaviors affecting tobacco use.12

* The CPSTF considers interventions cost-effective if they cost less than $50,000 per quality-adjusted life year gained.

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National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
  1. Costs were measured in 2018 US dollars.
  2. Costs were measured in 2012 US dollars. Older cost estimates are likely to be underestimates.
  3. Costs were measured in 2011 US dollars. Older cost estimates are likely to be underestimates.
  1. US Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention; 2014. https://www.cdc.gov/tobacco/sgr/50th-anniversary/index.htm
  2. Cornelius ME, Loretan CG, Wang TW, Jamal A, Homa DM. Tobacco product use among adults — United States, 2020. MMWR Morb Mortal Wkly Rep. 2022;71(11):397–405.
  3. Tsai J, Homa DM, Gentzke AS, et al. Exposure to secondhand smoke among nonsmokers—United States, 1988–2014. MMWR Morb Mortal Wkly Rep. 2018;67(48);1342–1346.
  4. Xu X, Shrestha S, Trivers KF, Neff L, Armour BS, King BA. US healthcare spending attributable to cigarette smoking in 2014. Prev Med. 2021(150):106529.
  5. Economic trends in tobacco. Centers for Disease Control and Prevention. Updated July 26, 2022. Accessed September 26, 2022. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm#economic-costs
  6. Shrestha SS, Ghimire R, Wang X, Trivers KF, Homa DM, Armour BS. Cost of cigarette smoking attributable productivity losses, United States, 2018. Am J Prev Med. 2022;63(4):478–485.
  7. Max W, Sung HY, Shi Y. Deaths from secondhand smoke exposure in the United States: economic implications. Am J Public Health. 2012;102(11):2173–2180. doi: 10.2105/AJPH.2012.300805. [Original estimate updated to 2018 dollars.]
  8. Shrestha SS, Davis K, Mann N, et al. Cost effectiveness of the Tips From Former Smokers® campaign—U.S., 2012-2018. Am J Prev Med. 2021;60(3):406–410. doi:10.1016/j.amepre.2020.10.009
  9. Community Preventive Services Task Force. Reducing tobacco use and secondhand smoke exposure: smokefree policies. The Community Guide; 2013. https://www.thecommunityguide.org/media/pdf/Tobacco-Smokefree-Policies.pdf
  10. Community Preventive Services Task Force. Tobacco use: comprehensive tobacco control programs. The Community Guide. Accessed December 18, 2019. https://www.thecommunityguide.org/findings/tobacco-use-comprehensive-tobacco-control-programs.html
  11. Contreary KA, Chattopadhyay SK, Hopkins DP. Economic impact of tobacco price increases through taxation: a Community Guide systematic review. Am J Prev Med. 2015;49(5):800–808.
  12. Community Preventive Services Task Force. Tobacco use and secondhand smoke exposure: mass-reach health communication interventions. The Community Guide. Accessed December 18, 2019. https://www.thecommunityguide.org/findings/tobacco-use-mass-reach-health-communication-interventions.html