the truth about
smoking
Smoking remains the most destructive—and costly—public-health problem in the United States.
the health cost
Billions per Year in healthcare Costs
Smoking costs the U.S. more than $300 billion annually, including:
$170+ billion in direct medical care
$156 billion in lost productivity and premature death
(Source: U.S. Department of Health and Human Services, CDC)
productivity losses
Using nationally aggregated data, each pack of cigarettes sold results in $51.52 in healthcare and productivity losses.
(Source: Campaign for Tobacco-Free Kids 2024)
Medicaid Bears the Burden
Medicaid spends more than $39 billion per year treating smoking-related disease. In many states, 15–20% of all Medicaid expenditures can be tied to smoking-related illness.
(Source: CDC, HHS)
the cost for arizona
Leading Cause of Preventable Death
Smoking kills 480,000 Americans every year—more than alcohol, opioids, car crashes, HIV, and firearms combined. (Source: CDC Office on Smoking and Health)
Toxicity of Combustion
Cigarette smoke contains over 7,000 chemicals, including 70+ known carcinogens. (Source: CDC; U.S. Surgeon General)
Chronic Disease Burden
Smoking dramatically increases the risk of:
Lung cancer (accounting for 85–90% of cases)
COPD and chronic bronchitis
Heart disease and stroke
Diabetes complications
Multiple cancers: oral, bladder, pancreatic, liver, colorectal, and cervical
(Source: CDC)
the economic cost
Higher Healthcare Spending
States fund billions every year in:
Cancer treatment
Heart-attack and stroke care
COPD and chronic respiratory conditions
Neonatal care linked to maternal smoking
Lower Workforce Participation
Smoking contributes to:
Higher disability claims
More missed workdays
Reduced long-term workforce productivity
(Source: CDC Workplace Health Division)
Strain on Rural and Underserved Areas
Medicaid spends more than $39 billion per year treating smoking-related disease. In many states, 15–20% of all Medicaid expenditures can be tied to smoking-related illness.
The Status Quo
Isn’t Good Enough
the evidence behind
harm reduction
the Rise of Smoke-Free Alternatives
2007Entry of e-cigarette products into the U.S. market
The arrival of electronic nicotine-delivery systems (ENDS) marked the beginning of offering a non-combustible alternative to cigarettes. This opened a path for smokers who cannot or will not quit nicotine entirely to switch to a less harmful source of nicotine.
2016harm reduction emerges as legitimate public health strategy
The RCP concluded that e-cigarettes and other non-smoke nicotine delivery products have a role in reducing the harm from combustible tobacco. It estimated that e-cigarettes are “unlikely to exceed” around 5% of the harm of smoking. This means harm-reduction is a legitimate public health strategy.
SOURCe: Cancer Research UK (2016)
2019Randomized controlled trial is published on e-cigarettes versus nicotine-replacement therapy
In the landmark RCT by Hajek et al., 18.0% of adult smokers allocated to a refillable e-cigarette achieved one-year abstinence, versus 9.9% in the nicotine‐replacement group (relative risk ~1.83). This provides strong evidence that switching to an e-cigarette can be more effective than traditional NRT when supported.
2019-2024Rapid decline in adult smoking and teen nicotine use
National survey data show adult cigarette smoking fell by ~11 million in five years; teen nicotine vaping and smoking also plunged (teen vaping down ~70% since 2019). These trends coincide with increased access to less-harmful alternatives and broader harm-reduction strategies, although causation is complex.
source: cdc national health interview survey and cdc national youth tobacco survey
TODAYharm reduction repeatedly proven as effective public health strategy
The 2024 RCP report reaffirmed that e-cigarettes represent a valuable aid for adult smokers and emphasised the need to protect youth use while enabling switching for smokers. It strengthens the harm-reduction framework for policy.
