Sources: State Toll of Tobacco | Campaign for Tobacco-Free Kids
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Smoking and smokeless rates, deaths, and other state tobacco-related information
Adult smoking from CDC 2021 BRFSS online data; Florida adult smoking rate from CDC 2020 BRFSS online data; 2021 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 2021 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 Islami F, et al., “Person‐years of life lost and lost earnings from cigarette smoking‐attributable cancer deaths, United States,” International Journal of Cancer, 2019.  

National adult smoking rate from the 2020 National Health Interview Survey. National high school prevalence rates are from the 2022 National Youth Tobacco Survey (NYTS); 2021 NYTS rates are not comparable to other years due to methodological differences. 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
To make all of the cost data more comparable, some figures have been adjusted to 2018 dollars. 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); Shrestha, SS, et al., “Cost of Cigarette Smoking‒Attributable Productivity Losses, U.S., 2018,” AJPM, July 27, 2022. 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.

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; FTC, Smokeless Tobacco Report for 2020, October 2021; FTC, E-Cigarette Report for 2019-2020, August 2022. State total is a prorated estimate based on cigarette pack sales in the state. For tobacco marketing influence on youth, see HHS, Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, 2012; National Cancer Institute (NCI), The Role of the Media in Promoting and Reducing Tobacco Use, Smoking and Tobacco Control Monograph No. 19, 2008.

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

Last updated Jan. 20, 2023