The Toll of Tobacco


Smoking and smokeless rates, deaths, and other state tobacco-related information

Adult smoking from CDC 2013 BRFSS; 2013 BRFSS rate is not comparable to years prior to 2011; youth tobacco use from state YRBS, YTS, or other state-specific surveys.

New underage daily smoker estimate based on data from U.S. Dept of Health and Human Services (HHS), “Results from the 2013 National Survey on Drug Use and Health,” with the state share of national initiation number based on CDC data on future youth smokers in each state compared to national total.

National adult smoking rate from the 2012 National Health Interview Survey. National High school smoking and smokeless rates from the 2013 Youth Risk Behavior Survey.

State estimates of smoking-attributable deaths: CDC, Best Practices for Comprehensive Tobacco Control Programs—2014.

Youth projected to die prematurely: The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General, 2014.

Packs illegally sold to kids or smoked by them

DiFranza, J. & J. Librett, "State and Federal Revenues from Tobacco Consumed by Minors," American Journal of Public Health (AJPH) 89(7): 1106-1108, July 1999; Cummings, et al., "The Illegal Sale of Cigarettes to US Minors: Estimates by State," AJPH 84(2): 300-302, February 1994.

Smoking-caused health expenditures, productivity losses, tax burdens

CDC, Best Practices for Comprehensive Tobacco Control Programs, 2014. See also, CDC, Data Highlights 2006  [and underlying CDC data/estimates; CDC's STATE System average annual smoking attributable productivity losses from 1997-2001 (1999 estimates updated to 2004 dollars); See also, See also, Zhang, X., et al., "Cost of Smoking to the Medicare Program, 1993," Health Care Financing Review 20(4): 1-19, Summer 1999; Office of Management & Budget, The Budget for the United States Government - Fiscal Year 2000, Table S-8, January 1999; Leistikow, B., et al., "Estimates of Smoking-Attributable Deaths at Ages 15-54, Motherless or Fatherless Youths, and Resulting Social Security Costs in the United States in 1994," Preventive Medicine 30(5): 353-360, May 2000. CDC, "Medical Care Expenditures Attributable to Smoking -- United States, 1993," MMWR 43(26): 1-4, July 8, 1994.

Additional information on tobacco-related costs

U.S. Department of the Treasury, The Economic Costs of Smoking in the U.S. and the Benefits of Comprehensive Tobacco Legislation, 1998; F.J. Chaloupka & K.E. Warner, "The Economics of Smoking," in J. Newhouse $ A. Culyer (eds), The Handbook of Health Economics, 2000.

Tobacco industry marketing

U.S. Federal Trade Commission (FTC), Federal Trade Commission (FTC). Cigarette Report for 2011, 2013, See also, FTC, Smokeless Tobacco Report for 2011, 2013, State total a prorated estimate based on cigarette pack sales in the state. State total a prorated estimate based on cigarette pack sales in state. For tobacco marketing influence on youth, see Pollay, R., et al., "The Last Straw? Cigarette Advertising and Realized Market Shares Among Youths and Adults," Journal of Marketing 60(2):1-16, April 1996; Evans, N., et al., "Influence of Tobacco Marketing and Exposure to Smokers on Adolescent Susceptibility to Smoking," Journal of the National Cancer Institute 87(20): 1538-45, October 1995; Pierce, J.P., et al., "Tobacco Industry Promotion of Cigarettes and Adolescent Smoking," Journal of the American Medical Association (JAMA) 279(7): 511-505, February 1998 [with erratum in JAMA 280(5): 422, August 1998].

See, also Campaign factsheets, for more detailed information on these data.