Smoking is the number one cause of preventable disease and death worldwide. In the United States, more than 490,000 deaths are attributed to cigarette smoking and exposure to secondhand tobacco smoke. While cigarette smoking has declined from 12.5% in 2020 to 11.5% in 2021, the lowest prevalence recorded since 19655, the cost associated with smoking in the U.S. costs at least $289 billion each year, including at least $151 billion in lost productivity and $130 billion in direct healthcare expenditures.1

Key Facts about Smoking

  • Cigarette smoke contains more than 7,000 chemicals, at least 69 of which are known to cause cancer.2 Smoking is directly responsible for approximately 90 percent of lung cancer deaths and approximately 80 percent of deaths caused by chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis.1
  • Among adults who have ever smoked daily, 78% had smoked their first cigarette by the time they were 18 years of age, and 94% had by age 21.3
  • Among those who currently smoke, 73% of their diagnosed smoking-related conditions are chronic lung diseases. Even among those who previously smoked who have quit, chronic lung disease still accounts for 50% of smoking-related conditions.4
  • Smoking harms nearly every organ in the body, and is a main cause of lung cancer and COPD. It also is a cause of coronary heart disease, stroke and a host of other cancers and diseases.1See more of the health effects caused by smoking.

Smoking Rates among Adults & Youth

  • In 2021, an estimated 35.6 million adults 18 years or older (14.5%), used tobacco products, with more than one in nine (11.5%) of U.S. adults using cigarettes.5
  • People who identify as male use commercial tobacco products at a rate of 24.1%, which is higher than those who identify as female. For cigarette smoking specifically, 13.1% of people who identify as males smoke, compared to that 10.1% of those who identify as female.5,6
  • Prevalence of any commercial tobacco product in 2021 shows that adults ages 25 – 44 (22.1%) and 45 – 64 (21.1%) had the highest rates of use. Following this sociodemographic, studies have shown that commercial tobacco use was highest among those who have less then 12 years of education (20.1%), have a lower annual income (18.3%), live in rural areas (26.2%), identify as a member of the LGBTQIA+ community (27.4%) and are living with one or more mental health disorders (37.6%).5,6

Facts about Quitting Smoking

  • Nicotine is the chemical in cigarettes that causes addiction. People who smoke and use tobacco products not only become physically addicted to nicotine; they also link smoking with many social activities, making it an extremely difficult addiction to break.7
  • In 2017, an estimated 55.2 million adults were former smokers. Of the 34.3 million current adult smokers, 48.4% stopped smoking for a day or more in the preceding year because they were trying to quit smoking completely.5
  • Quitting smoking for good often requires multiple attempts. Using counseling or medication alone increases the chance of a quit attempt being successful; the combination of both is even more effective.8
  • There are seven medications approved by the U.S. Food and Drug Administration to aid in quitting. Nicotine patches, nicotine gum and nicotine lozenges are available over the counter, and a nicotine nasal spray is currently available by prescription. Bupropion SR (Zyban®) and varenicline (Chantix®) are non-nicotine pills.8
  • Individual, group and telephone counseling are effective. Telephone quitline counseling is available in all 50 states and is effective for many different groups of people who smoke and use tobacco products.8

Learn about the American Lung Association's programs to help you or a loved one quit and join our advocacy efforts to reduce tobacco use and exposure to secondhand smoke. Call the Lung HelpLine at 1-800-LUNGUSA (1-800-586-4872).

  • The Health Effects of Smoking

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  1. U.S. Department of Health and Human Services. The Health Consequences of Smoking - 50 Years of Progress: A Report of the Surgeon General. 2014.

  2. U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease A Report of the Surgeon General. 2010.

  3. Substance Abuse and Mental Health Services Administration. National Survey on Drug Use and Health, 2017. Analysis by the American Lung Association Epidemiology and Statistics Unit using SPSS software.

  4. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General, 2004.

  5. Tobacco Product Use Among Adults—United States, 2021 | Smoking and Tobacco Use | CDC

  6. Burden of Cigarette Use in the U.S. | Data and Statistics | Campaign Resources | Tips From Former Smokers | CDC

  7. National Institute on Drug Abuse. Tobacco/Nicotine Research Report: Is Nicotine Addictive? January 2018.

  8. Fiore M, Jaen C, Baker T, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Vol 35. Rockville, MD; 2008.

Page last updated: November 20, 2024

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