Why is it important to reduce tobacco use?

Tobacco use is the most preventable cause of death and disease in the United States. Each year, tobacco use kills more people than AIDS, alcohol, drug abuse, motor vehicle crashes, and firearms, combined. ^[i]

Not only does tobacco use cause excess deaths in the United States, but exposure to secondhand smoke is also a major cause of disease. Since 1986, the U.S. Surgeon General warned against the dangers and risks of secondhand smoke and more recently the 2006 Surgeon General's The Health Consequences of Involuntary Exposure to Tobacco Smoke report supports past warnings and provides detailed epidemiological evidence on the health effects of secondhand smoke. The report concludes that secondhand smoke contains the same complex mixture of chemicals found in mainstream smoke, many of which are known carcinogens or cancer-causing substances. ^[ii]

Non-smokers who are exposed to secondhand smoke are at risk of developing lung cancer and coronary heart disease. In 2005, it was estimated that more than 50,000 excess deaths result annually from exposure to secondhand smoke. More specifically, 3,400 resulted from lung cancer, 46,000 from cardiac-related illnesses, and 430 from Sudden Infant Death Syndrome (SIDS). ^[ii]

Secondhand Smoke & Children

Fortunately, exposure of secondhand smoke in adults is declining as smoking becomes increasingly more restricted in public places and workplaces. Unfortunately, children continue to be exposed in their homes by smoking parents and adults. This secondhand exposure leads to bronchitis, pneumonia, and worsened asthma.

• Among children younger than 18 years of age, an estimated 22 percent are exposed to secondhand smoke within their homes.
• In addition to increased risk of SIDS, the Surgeon General's report states exposure to secondhand smoke causes in children:
  • between 24,000 and 71,900 low birth weight or pre-term deliveries,
  • 202,300 episodes of childhood asthma (new cases and exacerbations),
  • between 150,000 and 300,000 cases of lower respiratory illness, and
  • about 789,700 cases of middle ear infections.
• Smoking by parents causes respiratory symptoms and slows lung growth in children.

Separating smokers from nonsmokers, cleaning the air, and ventilating spaces cannot eliminate exposure to secondhand smoke. Only eliminating smoking in indoor spaces fully protects nonsmokers, particularly children, from exposure to secondhand smoke. ^[ii]

A pregnant woman who smokes is between 1.5 and 3.5 times more likely than a nonsmoker to have a low birth weight baby. Infants whose mothers smoked during pregnancy have 2.3 times the risk of SIDS than infants of non-smoking mothers. ^[iii] Additionally, first year health care costs for babies whose low birth weight was attributed to their mothers' smoking during pregnancy are estimated to be $1 billion to $1.5 billion. ^[iv] The CDC estimates $367 million in health care costs are attributable to excess neonatal direct health care costs due to maternal smoking in 1996. ^[v] Costs are estimated at $1,142-$1,358 per smoking pregnant woman (90 percent of it for treating infants for smoking-related illnesses such as asthma.) ^[vi]

[i] A. Mokdad, et al., JAMA, 2004.

[ii] Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Secondhand Smoke: A Report of the Surgeon General, 2006.

[iii] [vi] U.S. Department of Health and Human Services. Women and Smoking: a Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General; Washington, DC, 2001.

[iv] Healthy Start in Pittsburgh/Allegheny County, PA, "Cost Savings of Preventing Low Birth Weight Births"

[v] Adams, EK, Miller VP, Ernst, C, Nishimura, BK, Melvin, C and Merrit R. Neonatal health care costs related to smoking during pregnancy; Health Economics, 11, 2002: 193-206.

[vi] Miller, Villa, Hogue et al., "Birth and first-year costs for mothers and infants attributable to maternal smoking", Nicotine & Tobacco Research (2001), Vol. 3 pp.25-35.