Tobacco Addiction

According to the 2010 National Survey on Drug Use and Health, an estimated 69.6 million Americans aged 12 or older reported current use of tobacco—58.3 million (23.0 percent of the population) were current cigarette smokers, 13.2 million (5.2 percent) smoked cigars, 8.9 million (3.5 percent) used smokeless tobacco, and 2 million (0.8 percent) smoked pipes, confirming that tobacco is one of the most widely abused substances in the United States. Although the numbers of people who smoke are still unacceptably high, according to the Centers for Disease Control and Prevention there has been a decline of almost 50 percent since 1965.

Trends in Prevalence of Cigarette Use for 8th-, 10th-, and 12th-Graders Source: University of Michigan, 2011 Monitoring the Future Survey.

NIDA’s 2011 Monitoring the Future survey of 8th-, 10th-, and 12th-graders, which is used to track drug use patterns and attitudes, has also shown a striking decrease in smoking trends among the Nation’s youth. The latest results indicate that about 6 percent of 8th-graders, 12 percent of 10th-graders, and 19 percent of 12th-graders had used cigarettes in the 30 days prior to the survey—the lowest levels in the history of the survey.

The declining prevalence of cigarette smoking among the general U.S. population, however, is not reflected in patients with mental illnesses. The rate of smoking in patients suffering from post-traumatic stress disorder, bipolar disorder, major depression, and other mental illnesses is twofold to fourfold higher than in the general population; and among people with schizophrenia, smoking rates as high as 90 percent have been reported.

Tobacco use is the leading preventable cause of death in the United States. The impact of tobacco use in terms of morbidity and mortality to society is staggering.

Economically, more than $96 billion of total U.S. healthcare costs each year are attributable directly to smoking. However, this is well below the total cost to society because it does not include burn care from smoking-related fires, perinatal care for low-birthweight infants of mothers who smoke, and medical care costs associated with disease caused by secondhand smoke. In addition to healthcare costs, the costs of lost productivity due to smoking effects are estimated at $97 billion per year, bringing a conservative estimate of the economic burden of smoking to more than $193 billion per year.