Highlights | American Lung Association
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Tobacco use remains the leading cause of preventable death and disease in the United States. The American Lung Association has identified four key actions that federal policymakers must take to help ultimately eliminate the death and disease caused by tobacco use:

  1. Allow the U.S. Food and Drug Administration (FDA) to fully implement the Tobacco Control Act without political interference from the tobacco industry and its champions in Congress.
  2. Clarify and ensure that all smokers have access to a comprehensive tobacco cessation benefit without barriers and copays.
  3. Ensure the Centers for Disease Control and Prevention's (CDC) Tips from Former Smokers Campaign and the Food and Drug Administration's (FDA) Real Cost Campaign continue. 
  4. Pass legislation raising the minimum of age of sales for all tobacco products to 21.

The federal government remains uniquely positioned to act and significantly improve the health of Americans by strengthening and implementing federal tobacco control policies.

The FDA's Center for Tobacco Products took many important steps in 2016, including: enactment of the long-awaited "deeming" rule that gives the FDA authority over e-cigarettes, cigars, hookah and other previously unregulated tobacco products; the issuance of its first 55 warning letters to retailers that violated the deeming rule by selling tobacco products to persons under age 18 – including fruit- and candy-flavored cigars and e-cigarettes; and the launch of two ad campaigns – focused on the dangers of smokeless tobacco among rural teens and reducing tobacco use among LGBT teens.

FDA's ability to continue to act in ways that are appropriate for the protection of the public health is under threat in the U.S. Congress. Leaders in the House of Representatives attached two policy riders to proposed Appropriations bills in 2016. The first would block implementation and enforcement of the entire deeming rule because certain cigars – including those that cost as little as $1.00 – are now under FDA's authority. The second would grandfather all newly deemed products – thereby taking away and guaranteeing that flavored e-cigarettes that appeal to kids and that contain dangerous chemicals like diacetyl – remain on the market indefinitely. The fate of these policy riders will not be settled until Congress finalizes its fiscal year 2017 funding bills in April of 2017.

Millions of Americans continue to want to quit and need help to do so. Despite there being new clinical guidelines for tobacco cessation from the U.S. Preventive Services Task Force (USPSTF) issued in 2015, the Obama Administration failed to appropriately act to clarify coverage requirements for plans and payers in 2016 – first delaying necessary and long-awaited clarifications for tobacco cessation coverage and then ultimately releasing a muddled request for comment on what quit smoking therapies must be covered despite clear legal requirements. The Trump Administration has the clear opportunity to act and do much more to help smokers – two-thirds of whom want to quit – get the help they need to do so.

The CDC's Tips from Former Smokers Campaign marked the fifth year of its highly successful and cost-effective mass media campaign – despite efforts by some in Congress to eliminate it by slashing funding to CDC's Office on Smoking and Health. The Tips Campaign has prompted 400,000 Americans to quit smoking for good, and millions more to make a serious quit attempt. The effectiveness and return on investment of this program demonstrate why it is so important to continue Tips in 2017.

United States Facts

Economic Costs Due to Smoking:


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High School Smoking Rate:


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Smoking Attributable Deaths per Year:


Smoking Attributable Lung Cancer Deaths per Year:


Smoking Attributable Respiratory Disease Deaths per Year:


Adult smoking and tobacco use rates are taken from the 2014 National Health Interview Survey. High school and middle school smoking and tobacco use rates are taken from the 2014 National Youth Tobacco Survey.

Health impact information is taken from the Smoking Attributable Mortality, Morbidity and Economic Costs (SAMMEC) software. Smoking attributable deaths reflect average annual estimates for the period 2005-2009 and are calculated for persons aged 35 years and older. Smoking-attributable health care expenditures are based on 2004 smoking-attributable fractions and 2009 personal health care expenditure data. Deaths and expenditures should not be compared by state.

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