Toll of Tobacco in the United States

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Last Updated: June 17, 2014

Tobacco use is the leading cause of preventable death in the United States, imposing a terrible toll in health, lives and dollars 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. more than $132.5 billion in health care expenditures and $151 billion in lost productivity each year.

While the United States has made major progress against tobacco use, nearly one in five Americans still smokes, and more than 3,000 kids try their first cigarette each day.

The Toll of Tobacco in the United States

High school students who are current (past month) smokers 15.7% or 2.7 million [Boys: 16.4% Girls: 15.0%]
High school males who currently use smokeless tobacco 14.7% [Girls: 2.9%]
Kids (under 18) who try smoking for the first time each day 3,000+
Kids (under 18) who become new regular, daily smokers each day 700
Kids (4-17) exposed to secondhand smoke 39.6%
Packs of cigarettes consumed by kids each year 800 million (roughly $2.0 billion per year in sales revenue)
Adults in the USA who smoke 18.1% or 42.1 million [Men: 20.5% Women: 15.8%]

Deaths and Disease in the USA from Tobacco Use

People who die each year from their own cigarette smoking or exposure to secondhand smoke. approx. 480,000
Kids under 18 alive today who will ultimately die from smoking (unless smoking rates decline) 5.6 million
People in the USA 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 roughly 260,000 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 USA

Total annual public and private health care expenditures caused by smoking: At least $132.5 Billion

  • Annual Federal and state government smoking-caused Medicaid payments: $37.5 billion
    [Federal share: $21.1 billion per year. States’ share: $16.4 billion]
  • Federal government smoking-caused Medicare expenditures each year: $32.8 billion
  • Other federal government tobacco-caused health care costs (e.g. through VA health care): $11.5 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 (at least $1.4 to $4.0 billion). 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: $156.6 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.]

Annual expenditures through Social Security Survivors Insurance for the more than 300,000 kids who have lost at least one parent from a smoking-caused death: $3.1 billion

Other non-healthcare costs from tobacco use include residential and commercial property losses from smoking-caused fires (about half a billion dollars per year) and tobacco-related cleaning & maintenance ($3 billion).

  • Taxpayers yearly fed/state tax burden from smoking-caused gov't spending: $86.4 billion ($743 per household)
  • Smoking-caused health costs and productivity losses per pack sold in USA (low estimate): $18.20 per pack
  • Average retail price per pack in the USA (including sales tax): $5.98

Tobacco Industry Advertising & Political Influence

  • Annual tobacco industry spending on marketing its products nationwide: $8.8 billion ($24+ 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.

  • Annual tobacco industry contributions to federal candidates: $1.5 million
  • Annual tobacco industry expenditures lobbying Congress in 2010: $16.6 million

Tobacco companies also spend enormous amounts to influence state and local politics; and, when threatened by the federal McCain tobacco control bill in 1998, spent more than $125 million in direct and grassroots lobbying to defeat it. Since 1998, Altria (Philip Morris) has spent more on lobbying Congress than almost any other business.

References and sources for "Toll of Tobacco in the United States of America" can be found in the complete fact sheet.