Tobacco Use

Goal

Reduce illness, disability, and death related to tobacco use and secondhand smoke exposure.

Overview

Scientific knowledge about the health effects of tobacco use has increased greatly since the first Surgeon General’s report on tobacco was released in 1964.1, 2, 3

Tobacco use causes:

• Cancer
• Heart disease
• Lung diseases (including emphysema, bronchitis, and chronic airway obstruction)3
• Premature birth, low birth weight, stillbirth, and infant death

There is no risk-free level of exposure to secondhand smoke. Secondhand smoke causes heart disease and lung cancer in adults and a number of health problems in infants and children, including:

• Severe asthma attacks
• Respiratory infections
• Ear infections
• Sudden infant death syndrome (SIDS)4

Smokeless tobacco causes a number of serious oral health problems, including cancer of the mouth and gums, periodontitis, and tooth loss. Cigar use causes cancer of the larynx, mouth, esophagus, and lung.1, 3

Why Is Preventing Tobacco Use Important?

Tobacco use is the single most preventable cause of death and disease in the United States.5 Each year, approximately 443,000 Americans die from tobacco-related illnesses. For every person who dies from tobacco use, 20 more people suffer with at least 1 serious tobacco-related illness.5, 6 In addition, tobacco use costs the U.S. $193 billion annually in direct medical expenses and lost productivity.

Healthy People 2020: A Framework for Ending the Tobacco Use Epidemic

Healthy People 2020 provides a framework for action to reduce tobacco use to the point that it is no longer a public health problem for the Nation. Research has identified a number of effective strategies that will contribute to ending the tobacco use epidemic.7, 8, 9, 10, 11, 12 Based on more than 45 years of evidence, it is clear that the toll tobacco use takes on families and communities can be significantly reduced by:

• Fully funding tobacco control programs.
• Increasing the price of tobacco products.
• Enacting comprehensive smoke-free policies.
• Controlling access to tobacco products.
• Reducing tobacco advertising and promotion.
• Implementing anti-tobacco media campaigns.
• Encouraging and assisting tobacco users to quit.

The Healthy People 2020 Tobacco Use objectives are organized into 3 key areas:

1. Tobacco Use Prevalence: Implementing policies to reduce tobacco use and initiation among youth and adults.
2. Health System Changes: Adopting policies and strategies to increase access, affordability, and use of smoking cessation services and treatments.
3. Social and Environmental Changes: Establishing policies to reduce exposure to secondhand smoke, increase the cost of tobacco, restrict tobacco advertising, and reduce illegal sales to minors.

Helping Smokers Quit

Preventing tobacco use and helping tobacco users quit can improve the health and quality of life for Americans of all ages. People who stop smoking greatly reduce their risk of disease and premature death.13, 14 Benefits are greater for people who stop at earlier ages, but quitting tobacco use is beneficial at any age.13

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Understanding Tobacco Use

Many factors influence tobacco use, disease, and mortality. Risk factors include race/ethnicity, age, education, and socioeconomic status. Significant disparities in tobacco use exist geographically; such disparities typically result from differences among states in smoke-free protections, tobacco prices, and program funding for tobacco prevention.

Emerging Issues in Tobacco Use

From 2009-2010, major advances were made in the campaign to end the tobacco use epidemic, including:

1. The U.S. Food and Drug Administration (FDA) was granted the authority to regulate the sales, advertising, and ingredient content of all tobacco products marketed in the United States.15
2. The Federal Government increased the Federal tobacco excise tax by $0.61 to $1.01 per pack.
3. 25 states and the District of Columbia (DC) had comprehensive smoke-free laws eliminating smoking in workplaces, restaurants, and bars, and 14 States and DC had cigarette excise tax rates of at least $2 per pack.

Over the coming decade, more States are poised to strengthen smoke-free laws and increase the price of tobacco, further reducing tobacco use and initiation throughout the Nation.

References

1Centers for Disease Control and Prevention (CDC), Office on Smoking and Health. Reducing the health consequences of smoking: 25 years of progress: A report of the Surgeon General. Atlanta: CDC; 1989.

2Centers for Disease Control and Prevention (CDC), Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The health benefits of smoking cessation: A report of the Surgeon General. Atlanta: CDC; 1990.

3US Department of Health and Human Services (HHS), Public Health Service, Office of the Surgeon General. The health consequences of smoking: A report of the Surgeon General. Rockville, MD: HHS; 2004. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm

4Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The health consequences of involuntary exposure to tobacco smoke: A report of the Surgeon General. Atlanta: CDC; 2006. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/2006/index.htm

5Centers 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 [cited 2009 Aug 18].

6Centers for Disease Control and Prevention. Cigarette smoking among adults and trends in smoking cessation—United States, 2008. MMWR. 2009;58(44):1227-32 [cited 2009 Nov 16].

7Institute of Medicine. Ending the tobacco problem: A blueprint for the nation. Washington: National Academies Press; 2007.

8World Health Organization (WHO). WHO report on the global tobacco epidemic, 2008: The MPOWER package. Geneva, Switzerland: WHO; 2008. Available from: http://www.who.int/tobacco/mpower/mpower_report_full_2008.pdf

9Centers for Disease Control and Prevention (CDC), Office on Smoking and Health. Best practices for comprehensive tobacco control programs—2007. Atlanta: CDC; 2007. Available from: http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm

10Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Reducing tobacco use: A report of the Surgeon General. Atlanta: CDC; 2000. Available from: http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2000/index.htm

11National Institutes of Health, National Cancer Institute (NCI). The role of the media in promoting and reducing tobacco use. Tobacco Control Monograph No. 19. Bethesda, MD: NCI; 2008 Jun.

12Fiore MC, Jaen CR, Baker TB, et al. Clinical practice guideline: Treating tobacco use and dependence—2008 update. Rockville, MD: US Department of Health and Human Services. Public Health Service; 2008 May.

13Centers for Disease Control and Prevention (CDC), Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The health benefits of smoking cessation: A report of the Surgeon General. Atlanta: CDC; 1990.

14US Department of Health and Human Services (HHS), Public Health Service, Office of the Surgeon General. Women and smoking: A report of the Surgeon General. Rockville, MD: HHS; 2001.

15Family Smoking Prevention and Tobacco Control Act. Public Law No. 111-31 (June 22, 2009). Available from: http://www.gpo.gov/fdsys/pkg/PLAW-111publ31/content-detail.html

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