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State of Tobacco Control 2019

10 Health Effects Caused by Smoking You Didn't Know About

By 1964, it was official: The U.S. Surgeon General confirmed that cigarette smoking causes lung cancer. But in the 50 plus years that followed, we learned that smoking is responsible for a heap of other awful diseases, contributing to the 480,000 lives lost to tobacco we face today.

Here are some health consequences of smoking you might not have heard before…

  1. Going Blind

    Going Blind

    Smoking doesn't do your peepers any good. Smoking increases your risk of age-related macular degeneration, the leading cause of blindness in adults over the age of 65.

  2. Type 2 Diabetes

    Type 2 Diabetes

    Smoking contributes to type 2 diabetes and increases the risk of complications from the disease— including poor blood flow to legs and feet. This can lead to infection and result in the need to amputate a limb. Yep–you could lose your foot or leg!

  3. Erectile Dysfunction

    Erectile Dysfunction

    Male sexual function is affected when you smoke. Tobacco causes narrowing of blood vessels all over your body, including those that supply blood to the penis. Good news is that quitting will make a big difference.

  4. Ectopic Pregnancy

    Ectopic Pregnancy

    Ectopic pregnancy is a life-threatening reproductive complication in women that is more likely in smokers. It occurs when a fertilized egg implants somewhere other than the uterus. The egg can’t survive and it puts mom's life at serious risk.

  5. Hip Fractures

    Hip Fractures

    Smokers lose bone density at a faster rate than non-smokers which puts you at risk for breaking body parts like your hip. Putting down the cigarettes can help slow down this process and keep you breaking a sweat, not your bones, on the dance floor.

  6. Colorectal Cancer

    Colorectal Cancer

    Colorectal cancer, which forms in your intestines (colon or rectum), is the second leading cause of cancer deaths in the United States. One of the reasons? Yup, cigarette smoking. Smoking is linked to an increased risk of developing and dying from this type of cancer.

  7. Rheumatoid Arthritis

    Rheumatoid Arthritis

    Rheumatoid arthritis is a chronic inflammatory disease more common in women that affects the joints in your hands and feet. It causes painful swelling that can eventually result in bone loss and joint deformity. Smoking is one of the causes, and is also associated with developing the disease at an earlier age.

  8. Cleft Lip and Cleft Palate

    Cleft Lip and Cleft Palate

    These birth defects, commonly called orofacial clefts, occur when a baby’s lip or mouth doesn't develop properly during pregnancy. Women who smoke during pregnancy are more likely to have babies with orofacial clefts.

  9. Fertility Issues

    Fertility Issues

    Moms-to-be take note: Smoking can affect your ability to conceive. It causes reduced fertility in women and can contribute to other problems during pregnancy.

  10. Gum Disease

    Gum Disease

    As if potentially losing a limb isn’t enough (see #2), you also risk losing your teeth from smoking. Smoking contributes to periodontis—a gum infection that destroys the bone that supports the teeth. It is a major cause of tooth loss in adults.


Did You Know?

  1. More than 31% of high school students in the U.S. use at least one tobacco product, including e-cigarettes, according to the 2019 National Youth Tobacco Survey.
  2. 12.4% of middle school students use at least one tobacco product, including e-cigarettes, according to the 2019 National Youth Tobacco Survey.
  3. From 2017 to 2019, high school e-cigarette use increased by 135% and middle school e-cigarette use increased by close to 212% according to data from CDC's National Youth Tobacco Survey.
  4. Smoking is the number one preventable cause of death in the U.S., killing over 480,000 people per year.
  5. Secondhand smoke kills more than 41,000 people in the U.S. each year.
  6. 28 states and Washington D.C. have passed laws making virtually all public places and workplaces, including restaurants and bars smokefree.
  7. The District of Columbia has the highest cigarette tax in the country at $4.50 per pack.
  8. Missouri has the lowest cigarette tax in the country at 17 cents per pack.
  9. The average of all states plus the District of Columbia's cigarette taxes are $1.81 per pack.
  10. One state – Connecticut – provides no state funding at all for tobacco prevention programs.
  11. Three states – Alaska, California and Maine – are funding their tobacco control programs close to CDC-recommended levels (in Fiscal Year 2020).
  12. Illinois was the only state to increase its cigarette tax by a significant amount in 2019.
  13. No state approved a comprehensive smokefree workplace law in 2019.
  14. Twelve states – California, Colorado, Connecticut, Indiana, Kansas, Kentucky, Maine, Massachusetts, Missouri, Ohio, Oregon and South Carolina– offer a comprehensive cessation benefit to tobacco users on Medicaid.
  15. Each of the 50 states and the District of Columbia provide tobacco quitlines, a phone number for quit smoking phone counseling. The median amount states invest in quitlines is $2.14 per smoker in the state.
  16. Thirteen states passed legislation increasing its minimum sales age for tobacco products to 21 in 2019 prior to the federal Tobacco 21 law passing.
  17. Nineteen states and the District of Columbia approved Tobacco 21 laws prior to the federal Tobacco 21 law passing.
  18. Nationwide, the Medicaid program spends more than $39.6 billion in healthcare costs for smoking-related diseases each year – more than 15.2% of total Medicaid spending.
  19. In 2009, the American Lung Association played a key role in the passage of the Family Smoking Prevention and Tobacco Control Act, which gives the U.S. Food and Drug Administration authority over tobacco products.
  20. The American Lung Association played a key role in airplanes becoming smokefree in the 1990s.
  21. 43 states and the District of Columbia spend less than half of what the CDC recommends on their state tobacco prevention programs.
  22. States spend less than three cents of every dollar of the $27.3 billion they get from tobacco settlement payments and tobacco taxes to fight tobacco use.
  23. Each day, close to 1,600 kids under 18 try their first cigarette and close to 200 kids become new, regular smokers.
  24. Each day, close to 1,400 kids try their first cigar. On average, more than 56 kids try their first cigar every hour in the United States – equaling about 493,000 every year.
  25. Smoking costs the U.S. economy over $332 billion in direct health care costs and lost productivity every year.
  26. The five largest cigarette companies spent over $23 million dollars per day marketing their products in 2018.
  27. Secondhand smoke causes $5.6 billion in lost productivity in the U.S. each year.
  28. Smoking rates are over twice as high for Medicaid recipients compared to those with private insurance.
  29. A 2013 study of California's tobacco prevention program shows that the state saved $55 in healthcare costs for every $1 invested from 1989 to 2008.
  30. A 2017 study found that states which expanded Medicaid had a 36% increase in the number of tobacco cessation medication prescriptions relative to the states that did not expand Medicaid. This means more quit attempts with proven cessation treatments are being made. 
  31. A 2019 study found patients in Medicaid expansion states that had a cessation medication ordered, had a 65% higher change of quitting.
  32. In 2019, two states, Idaho and Maine implemented Medicaid expansion, providing more smokers with access to tobacco cessation treatments.
  33. Uninsured Americans smoke at a rate more than two times higher than people with private insurance.
  34. An estimated one-third of Americans living in public housing smoke.
  35. Persons with mental health conditions make up 22% of the population, but consume close to 36% of all cigarettes in the U.S.
  36. Native Americans and Alaska Natives have the highest commercial tobacco smoking rates among any racial/ethnic group.
  37. Massachusetts became the first state to prohibit the sale of all flavored tobacco products in 2019.
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