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Tobacco Use

The topic of Tobacco includes not only current use of tobacco products, but also initiation, cessation, secondhand smoke, and tobacco-related policy.


As the single most preventable cause of death and disease in the United States, tobacco use must be examined from all angles.
  1. Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, and economic costs-United States, 1995-1999. MMWR. 2002;51(14):300-3, downloaded on 8/6/2014 from

Why It's Important

Tobacco use accounts for one of every five deaths in the United States, approximately 480,000 people each year. Further, for each person who dies from tobacco use, another 33 will suffer a tobacco-related illness; tobacco use has been linked to diseases in nearly every organ. The national economic cost in medical expenses and lost productivity is over $289 billion annually.

What Is Known

After decades of study, much is known about tobacco use in the United States:

  • In 2019, 20.8% of adults were tobacco users, including 14.0% who used cigarettes.
  • In 2020, 6.7% of middle school students and 23.6% of high school students reported current tobacco use. E-cigarettes were the most commonly used tobacco product among high school (19.6%) and middle school (4.7%) students.
  • Initiation starts early; more than 80% of current adult smokers started before the age of 18 years.
  • Quitting tobacco use greatly decreases a person's risk for many negative health outcomes, some within a very short time after stopping.
  • There is no risk-free level of exposure to secondhand smoke; even brief exposure can be damaging to health.
  • Smoke-free laws are an effective approach to reducing exposure to secondhand smoke and to reducing the prevalence of tobacco use.

Who Is at Risk

Everyone is susceptible to the negative consequences of tobacco use. However, some disparities exist. Tobacco use is more prevalent among :
  • Men
  • Persons aged 25-44 years
  • Non-Hispanics
  • Persons with low household income
  • Lesbian, gay, bisexual, transgender (LGBT) persons

How To Reduce Risk

The most effective way to reduce the risk of tobacco-related illness and death is to avoid using tobacco products. However, secondhand smoke still increases the risk of disease. Policies that ban smoking indoors, in public locations, and in vehicles with children can help reduce the risk to everyone.

How It's Tracked

Tobacco use is tracked using a range of surveys. Some examples include:
  • National Survey on Drug Use and Health (NSDUH)
  • National Health Interview Survey (NHIS)
  • National Health and Nutrition Examination Survey (NHANES)
  • Youth Risk Behavior Surveillance System (YRBS)
  • Monitoring the Future (MTF)
  • State Tobacco Activities Tracking and Evaluation System (STATE)
For more information on tracking tobacco use health objectives, please visit the Healthy People 2020 Tobacco Use objectives page here.