Nationwide, youth smoking has declined dramatically since the mid-1990s, but that decline has slowed considerably in recent years. The smoking rate among high school students - 20 percent in 2007 - has not declined significantly since 2003, following a 40 percent decline between 1997 and 2003, from 36.4 percent to 21.9 percent.

In addition, 13.4 percent of U.S. high school males currently use spit tobacco. U.S. adult smoking increased slightly to 20.6 percent (about 46 million) in 2008 from 19.8 percent in 2007, the first increase in adult smoking rate since 1994.

Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined -- and thousands more die from other tobacco-related causes -- such as fires caused by smoking (more than 1,000 deaths/year nationwide) and smokeless tobacco use. No good estimates are currently available, however, for the number of Texas citizens who die from these other tobacco-related causes, or for the much larger numbers who suffer from tobacco-related health problems each year without actually dying.

Amounts do not include health costs caused by exposure to secondhand smoke, smoking-caused fires, spit tobacco use, or cigar and pipe smoking. Other non-health costs from tobacco use include residential and commercial property losses from smoking-caused fires (more than $500 million per year nationwide); extra cleaning and maintenance costs made necessary by tobacco smoke and litter (about $4+ billion nationwide for commercial establishments alone); and additional productivity losses from smoking-caused work absences, smoking breaks, and on-the-job performance declines and early termination of employment caused by smoking-caused disability or illness (dollar amount listed above is just from productive work lives shortened by smoking-caused death).

Published research studies have found that kids are twice as sensitive to tobacco advertising than adults and are more likely to be influenced to smoke by cigarette marketing than by peer pressure, and that one-third of underage experimentation with smoking is attributable to tobacco company advertising.

http://www.tobaccofreekids.org/reports/settlements/toll.php?StateID=TX

More detailed fact sheets on tobacco's toll in each state are available by emailing factsheets@tobaccofreekids.org

tobaccofreekids.org  Copyright © 2002   National Center for Tobacco-Free Kids

The Toll of Tobacco
Sources

Smoking and smokeless rates, deaths, and other state tobacco-related information
CDC, "State-Specific Smoking-Attributable Mortality and Years of Potential Life Lost — United States, 2000-2004," (MMWR) 58(2), January 22, 2009. U.S. Centers for Disease Control and Prevention (CDC), Sustaining State Programs for Tobacco Control, Data Highlights, 2006 (and underlying CDC data/estimates); Adult smoking from CDC 2009 BRFSS; youth smoking from state YRBS, YTS, or other state-specific surveys; California EPA, Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant, June 24, 2005. See also, CDC, “Factsheet: Secondhand Smoke,” September 2006.

New underage daily smoker estimate based on data from U.S. Dept of Health and Human Services (HHS), “Results from the 2009 National Survey on Drug Use and Health,” with the state share of national initiation number based on CDC data on future youth smokers in each state compared to national total.

Kids exposed to second hand smoke
CDC, "State-Specific Prevalence of Cigarette Smoking Among Adults, and Children's and Adolescents' Exposure to Environmental Tobacco Smoke - United States, 1996," Morbidity and Mortality Weekly Report (MMWR) 46(44): 1038-1043, November 7, 1997.

Packs illegally sold to kids or smoked by them
DiFranza, J. & J. Librett, "State and Federal Revenues from Tobacco Consumed by Minors," American Journal of Public Health (AJPH) 89(7): 1106-1108, July 1999; Cummings, et al., "The Illegal Sale of Cigarettes to US Minors: Estimates by State," AJPH 84(2): 300-302, February 1994.

Smoking-caused health expenditures, productivity losses, tax burdens
CDC, Data Highlights 2006  [and underlying CDC data/estimates; CDC's STATE System average annual smoking attributable productivity losses from 1997-2001 (1999 estimates updated to 2004 dollars); CDC, "State-Specific Smoking-Attributable Mortality and Years of Potential Life Lost — United States, 2000-2004," (MMWR) 58(2), January 22, 2009. See also, Zhang, X., et al., "Cost of Smoking to the Medicare Program, 1993," Health Care Financing Review 20(4): 1-19, Summer 1999; Office of Management & Budget, The Budget for the United States Government - Fiscal Year 2000, Table S-8, January 1999; Leistikow, B., et al., "Estimates of Smoking-Attributable Deaths at Ages 15-54, Motherless or Fatherless Youths, and Resulting Social Security Costs in the United States in 1994," Preventive Medicine 30(5): 353-360, May 2000. CDC, "Medical Care Expenditures Attributable to Smoking — United States, 1993," MMWR 43(26): 1-4, July 8, 1994.

Additional information on tobacco-related costs
U.S. Department of the Treasury, The Economic Costs of Smoking in the U.S. and the Benefits of Comprehensive Tobacco Legislation, 1998; F.J. Chaloupka & K.E. Warner, "The Economics of Smoking," in J. Newhouse $ A. Culyer (eds), The Handbook of Health Economics, 2000; CDC, Making Your Workplace Smokefree: A Decision Maker's Guide, 1996; D. Mudarri, The Costs and Benefits of Smoking Restrictions: An Assessment of the Smoke-Free Environment Act of 1993 (H.R. 3434), U.S. EPA report to the Subcommittee on Health & the Environment, Committee on Energy and Commerce, U.S. House of Representatives, April 1994; Hall, J. R., Jr., National Fire Protection Association, The U.S. Smoking-Material Fire Problem, April 2001; National Cancer Institute, Health effects of exposure to environmental tobacco smoke, 1999, op cit.

Tobacco industry marketing
U.S. Federal Trade Commission (FTC), Cigarette Report for 2006 and Federal Trade Commission Smokeless Tobacco Report 2006. State total a prorated estimate based on cigarette pack sales in state. For tobacco marketing influence on youth, see Pollay, R., et al., "The Last Straw? Cigarette Advertising and Realized Market Shares Among Youths and Adults," Journal of Marketing 60(2):1-16, April 1996; Evans, N., et al., "Influence of Tobacco Marketing and Exposure to Smokers on Adolescent Susceptibility to Smoking," Journal of the National Cancer Institute 87(20): 1538-45, October 1995; Pierce, J.P., et al., "Tobacco Industry Promotion of Cigarettes and Adolescent Smoking," Journal of the American Medical Association (JAMA) 279(7): 511-505, February 1998 [with erratum in JAMA 280(5): 422, August 1998].

See, also Campaign factsheets, Increased Cigarette Company Marketing Since the Multistate Settlement Agreement Went into Effect and Tobacco Marketing to Kids