sign up

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

Adult smoking from CDC 2020 BRFSS online data; 2020 BRFSS rate is not comparable to years prior to 2011; state youth tobacco use rates from 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 2019 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.

State proportion of cancer deaths attributable to smoking from Lortet-Tieulent, J, et al., “State-Level Cancer Mortality Attributable to Cigarette Smoking in the United States,” JAMA Internal Medicine, published online October 24, 2016.

National adult smoking rate from the 2019 National Health Interview Survey. National high school cigarette and cigar smoking rates from the 2020 National Youth Tobacco Survey (NYTS). National high school e-cigarette rate from the 2021 NYTS; 2021 NYTS rate is not comparable to prior years due to a methodology change. 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.

Smoking-caused health expenditures, productivity losses, tax burdens
CDC, Best Practices for Comprehensive Tobacco Control Programs, 2014. See also, CDC, Data Highlights 2006; CDC's Smoking Attributable Mortality, Morbidity and Economic Costs, SAMMEC, average annual smoking attributable productivity losses from 2000-2004 (updated to 2009 dollars). State Medicaid program expenditures are before any federal reimbursement. State and federal tax burden equals state residents’ federal & state tax payments necessary to cover all state government tobacco-caused costs plus the residents’ pro-rated share, based on state populations, of all federal tobacco-caused costs. See Xu, X et al., “U.S. healthcare spending attributable to cigarette smoking in 2014,” Preventive Medicine, 2021, with other state government tobacco costs taken to be 3% of all state smoking-caused health costs, as in CDC, “Medical Care Expenditures Attributable to Smoking—United States, 1993,” MMWR 43(26):1-4, July 8, 1994. State health cost data in 2009 dollars, national health cost data in 2014 dollars.

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), Cigarette Report for 2020, October 2021; see also, FTC, Smokeless Tobacco Report for 2020, October 2021; State total is a prorated estimate based on cigarette pack sales in the 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.

Last updated Nov. 11, 2021