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Smoking and smokeless rates, deaths, and other state tobacco-related information
Adult smoking from CDC 2022 BRFSS online data; 2022 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 2022 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 American Cancer Society Cancer Action Network, “Smoking-Related Cancer Deaths by State, 2020,” February 2024

National adult smoking rate from the 2022 National Health Interview Survey. National high school cigarette, e-cigarette, and cigar smoking rates from the 2023 National Youth Tobacco Survey (NYTS); 2021, 2022, and 2023 NYTS rates are not comparable to prior years due to methodology changes. 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 2022, October 2023; FTC, Smokeless Tobacco Report for 2022, October 2023; FTC, E-Cigarette Report for 2021, April 2024. 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 April 23, 2024