Tobacco Control:

A Winnable Battle

U.S. Department of Health and Human ServicesCenters for Disease Control and Prevention

Tobacco use damages virtually every part of the body

Smoking Secondhand Smoke

Tobacco use is still the leading preventable cause of death in the U.S. 46.6 million U.S. adults smoke Tobacco causes nearly 1 in 5 deaths

in U.S.• >440,000 deaths/year, >1,200/day

For each death, it is estimated that 20 more suffer tobacco-related illnesses

Annual costs: $96 billion in medical expenses plus $97 billion in lost productivity

Many Americans left unprotected, especially service industry workers• 26 states still lack comprehensive smoke-free

laws

Tobacco kills about 443,000 in the U.S. every year

Average annual number of deaths, 2000-2004.Source: Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses – United States, 2000-

2004. MMWR 2008;57(45):1226-1228.

The decline in adult cigarette smokinghas stalled

Civilian, non-institutionalized adults, aged 18 years of age and over, who currently smoked cigarettes. Source: National Health Interview Surveys, 1965-2009 .

Smoking rates vary widely by race/ethnicity

Note: Question wording changed in 1992 in order to identify smokers who smoked less than daily. This graph includes all smokers, regardless of frequency.

Source: National Health Interview Survey, 1978-2009; data aggregated for selected years.

Smoking rates vary widely by state/region

Note: Persons who have smoked at least 100 cigarettes in lifetime and currently smoke everyday or some days.Source: Behavioral Risk Factor Surveillance Survey, NCCDPHP, CDC, 2009.

Heart disease deaths are closely aligned with smoking

Heart Disease Death Rates, 2000-2004Adults ages 35 Years and Older by County

Source: Vital Records; National Center for Health Statistics, CDC, 2000-2004.Division for Heart Disease and Stroke Prevention: Data Trends & Maps Web site. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, 2010. Available at http://www.cdc.gov/dhdsp/.

Short-term impact of a comprehensive approach:

Youth and adult smoking rates in NYC

Source: BRFSS 1993-2001; NYC Community Health Survey 2002-2009; NYC YRBS 2001-2009.

Long-term impact of a comprehensive approach:

Lung and bronchus cancer incidence rates in CA

California: A 15 year investment of $1.8 billion in

tobacco control reduced health care costs by $86

billion

Rates are per 100,000 and age-adjusted to the 2000 U.S. standard (19 age groups).* The annual percent change is significantly different from zero (p<0.05).Source: Cancer Surveillance Section. Prepared by: California Department of Public Health, California Tobacco Control Program, 1988-2005. 2010.

We know what works

Sustained funding of comprehensive programs

Excise tax increases 100% smoke-free

policies Aggressive media

campaigns Cessation access Comprehensive

advertising restrictions

The tobacco industry is outspending tobacco prevention efforts 20:1

Sources: Campaign for Tobacco Free Kids; Federal Trade Commission; CDC Office on Smoking and Health.

When tobacco control funding increases,

high school smoking decreases

Source: Project ImpacTEEN; University of Illinois at Chicago; State University of New York at Buffalo; Youth Risk Behavior Survey, 1993-2009.

* Adjusted to 2009 CPI.† High school students (grades 9-12) who smoked on 1 or more of the 30 days preceding the survey.

When cigarette prices increase, cigarette sales decrease

Source: ImpacTeen Chartbook: Cigarette Smoking Prevalence and Policies in the 50 States.

Increased tobacco excise taxesincrease price

10% increase in cigarette prices 4% drop in adult cigarette consumption

Youth much less likely to start smoking when prices are high

Adjust taxes to offset inflation and tobacco industry attempts to control retail prices• E.g., promotional discounts for retailers who

reduce cigarette prices Tobacco taxes are the single most

effective component of a comprehensive tobacco control program

Smoke-free policies save lives Prevent heart attacks

• Up to 17% average reduction in heart attack hospitalizations in places that enact smoke-free laws

Help motivate smokers to quit Worker safety issue – not “personal

nuisance”• All workers deserve equal protection• Only way to protect non-smokers from

secondhand smoke Smoke-free workplace laws don’t

hurt business No trade-off between health and

economics

25 states and D.C. have comprehensive

smoke-free indoor air lawsLaws in effect as of November 10, 2010

Source: CDC, Office on Smoking and Health. State Tobacco Activities Tracking and Evaluation (STATE) System.

Almost 50% of U.S. population is covered by comprehensive state or

local smoke-free laws

Population figures are as of December 31 of each given year; July for 2010. All population figures are from the United States Census. Source: American Nonsmokers’ Rights Foundation, 2000-2010.

Aggressive media campaigns work

Media campaigns work to:

Reduce youth initiation

Encourage cessation Increase negative

attitudes toward tobacco use

Increase support for policy change

The impact of cessation services

Currently: 46.6 million U.S. smokers• 70% of smokers want to quit• 40% try to quit each year• Only 2% call state or national quitlines• Medicaid coverage for cessation varies

widely among states Tobacco cessation can be achieved

through:• Significant tax and price increases• Comprehensive smoke-free policies• Aggressive counter-advertising

State and federal policy activities (2009-2010)

Excise Tax Increases• 21 state increased cigarette taxes

Smoke-Free Policies• 10 additional states achieved comprehensive

status Federal Legislation

• Federal excise tax increase• Family Smoking Prevention and Tobacco

Control Act • Prevent All Cigarette Trafficking (PACT) Act• Affordable Care Act

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.govThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Closing Statement

U.S. Department of Health and Human ServicesCenters for Disease Control and Prevention