CDC: Tobacco Use Still Surprisingly Common

Although the dangers of tobacco are commonly known, the use of the substance remains surprisingly widespread.

According to the federal Centers of Disease Control and Prevention (CDC), tobacco use is the leading cause of preventable disease, disability, and death in the United States. As of 2018, about 34 million US adults smoke cigarettes.

The use of tobacco products declined among young people between 2019 and 2020, the CDC said. However, the National Youth Tobacco Survey (NYTS) data analysis also found that about 1 in 6 (nearly 4.5 million) students were current users of some type of tobacco product in 2020.

Other statistics from the CDC:

Every day, about 1,600 young people under 18 try their first cigarette, and nearly 200 become daily cigarette smokers.

Cigarette smoking causes more than 480,000 deaths annually, including 41,000 deaths from secondhand smoke.

For every American who dies because of smoking, at least 30 are living with a serious smoking-related illness.

Smoking-related illness costs society over $300 billion each year, including more than $225 billion in direct medical costs. These costs could be reduced if we prevent young people from starting to smoke and help smokers quit. CDC and its partners work to reduce tobacco-related diseases and deaths by:

Preventing young people from starting to use tobacco.

Promoting quitting among adults and young people.

Reducing exposure to secondhand smoke.

Identifying and eliminating tobacco-related health disparities.

Cigarette smoking leads to disease and disability and harms nearly every organ of the body. Smoking causes cancer, heart disease, stroke, lung diseases, type 2 diabetes, and other chronic health conditions. The impact also extends beyond the smoker. For example, smoking during pregnancy increases the risk of premature birth (being born too early) and sudden infant death syndrome (SIDS).

Secondhand smoke, which affects 58 million nonsmoking Americans, also causes stroke, lung cancer, and coronary heart disease in adults. Children who are exposed to secondhand smoke are at increased risk of Sudden Infant Death Syndrome (SIDS), impaired lung function, acute respiratory infections, middle ear disease, and more frequent and severe asthma attacks.

Probably the most widely known health hazard of tobacco is that it causes several forms of cancer, including about 90% of lung cancer deaths. Nonsmokers who are exposed to secondhand smoke at home or work have a 20% to 30% higher risk of getting lung cancer.

Smoking also causes cancers of the voice box (larynx), mouth and throat, esophagus, bladder, kidney, liver, pancreas, cervix, colon, rectum, and stomach, as well as a type of blood cancer called acute myeloid leukemia. In addition, it can interfere with cancer treatment, increasing the risk of recurrence, more serious complications, and death.

Cigarette smoking is a major cause of heart disease and stroke and causes 1 in every 4 deaths from heart disease and stroke. The risk is not confined to smokerks: Nonsmokers who breathe secondhand smoke at home or work have a 25% to 30% higher risk of heart disease and a 20% to 30% higher risk of stroke. Smoking can damage the body by:

Raising triglycerides (a type of fat in the blood) and lowering high-density lipoprotein (HDL) or “good” cholesterol.

Making blood sticky and more likely to clot, which can block blood flow to the heart and brain.

Damaging cells that line blood vessels, increasing the buildup of plaque (fat, cholesterol, calcium, and other substances) in blood vessels, and causing blood vessels to thicken and narrow.

Lung Disease

Cigarette smoking can cause lung disease by damaging the airways and the small air sacs (alveoli) found in the lungs. It can cause chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking accounts for as many as 8 in 10 COPD-related deaths. If you have asthma, tobacco smoke can trigger an asthma attack or make an attack worse.


The risk of developing type 2 diabetes is 30% to 40% higher for current smokers than nonsmokers. The more cigarettes a person smokes, the higher their risk of type 2 diabetes. People with diabetes who smoke are more likely than nonsmokers to have trouble controlling their blood sugar and to have serious complications, including:

Heart disease and kidney disease.

Poor blood flow in the legs and feet that can lead to infections, ulcers, and amputation (surgery to remove a body part, such as toes or feet).

Retinopathy (an eye disease that can cause blindness).

Peripheral neuropathy (nerve damage in the arms and legs that causes numbness, pain, weakness, and poor coordination).

Tobacco Use During Pregnancy

Cigarette smoking during pregnancy increases the risk of pregnancy complications, including premature birth, low birth weight, certain birth defects, and SIDS. Smoking can also make it harder for a woman to get pregnant. Exposure to secondhand smoke is also dangerous for infants and increases the risk of SIDS, slowed lung growth, and middle ear disease.

CDC supports programs to help people stop using tobacco, such as 1-800-QUIT-NOW. This toll-free telephone line routes callers to their state quitlines, which provide free counseling and, in many states, limited supplies of free smoking cessation medications for certain populations. CDC also promotes the national Spanish Language Quitline portal, which routes Spanish-speaking callers to free Spanish-language services, and the national Asian Language Quitline, which provides free services in Chinese, Korean, and Vietnamese.

Despite the good news that cigarette smoking is decreasing among young people, 3.6 million middle and high school students used electronic cigarettes (e-cigarettes) in 2020. This is a concern because any tobacco use among young people—whether smoked, smokeless, or electronic—is unsafe. Nicotine, which is found in almost all e-cigarettes, is addictive and can harm the developing brain.

In addition to monitoring tobacco use among young people, CDC also helps parents, educators, health care providers, and other youth influencers understand and talk to young people about the dangers of tobacco products. CDC activities include developing easy-to-understand materials using the best available science and leveraging social media platforms to create and deliver information where young people and youth influencers seek information.

For more information, click here to find resources specifically for young people, and here for help for any age group.

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