Sustaining State Programs


for Tobacco Control


D A T A HIGHLIGHT S 

2006 
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Sustaining State Programs for Tobacco Control

Data Highlights, 2006

Department of Health and Human Services 

Centers for Disease Control and Prevention 

safer • healthier • peopleTM 

Table of Contents 

Why Are Tobacco Control and Prevention Important? ..................................................................................7

Data Highlights

Table 1. Smoking Prevalence (Adult and Youth), Percentage of Smokers Who Tried to Quit

Table 3. Secondhand Smoke Policies, Cigarette Price Per Pack, State Tax Per Pack, and

Table 5. State Rankings on Prevalence, Smoking-Attributable Deaths (Adult, Youth),

Data Sources and Definitions

Prevalence (Adult and Youth), Percentage of Smokers Who Try to Quit, Smoking-Attributable

Secondhand Smoke Policies, Cigarette Price Per Pack, State Tax Per Pack, and Per Capita

The Purpose of this Document.......................................................................................................................9

Past Year, Smoking-Attributable Deaths, Projected Deaths ..................................................................10

Table 2. Smoking Prevalence Among Adults (2004) ............................................................................12

Per Capita (Adult) Cigarette Consumption ...........................................................................................14

Table 4. Smoking-Attributable Costs (2004).........................................................................................16

Percentage of Smokers Who Tried to Quit Past Year, Secondhand Smoke Policies .............................18

Table 6. State Rankings on Cigarette Price, Tax, and Smoking-Attributable Costs..............................20

Sample Messages for Data Measures ..........................................................................................................22

Deaths, Projected Deaths.......................................................................................................................25

 Adults..............................................................................................................................................25

 All ...................................................................................................................................................25

 Youth ...............................................................................................................................................25

Smoking Prevalence Among Adults, 2004 ............................................................................................27

Cigarette Consumption..........................................................................................................................27

 Smoking-Attributable Costs ..................................................................................................................28

References....................................................................................................................................................29

5 

Why Are Tobacco Control and Prevention Important?

■ Cigarette smoking is the leading cause of preventable disease and death in the United States, resulting 

in approximately 438,000 deaths annually.1,2 Approximately, 45.1 million U.S. adults—more than 

one in five Americans—are current cigarette smokers.3 Smoking is a major cause of cancer and 

cardiovascular and respiratory diseases.1 For each person who dies from a smoking-related disease, 

an estimated 20 more are living with a smoking-attributable illness.4 

■ The adverse health consequences of tobacco use compromise the quality of life of many Americans 

and impose substantial direct and indirect economic costs on society. Smoking-attributable 

health care expenditures totaled $75 billion in 1998.4 During 1997–2001, these expenditures plus 

productivity losses ($92 billion) exceeded $167 billion annually.2 Without comprehensive, sustained 

efforts to reduce rates of tobacco use, health care and productivity costs related to tobacco will 

continue to increase.5 

■ Each year, an estimated 3,000 lung cancer deaths and 35,000 heart disease deaths among adults 

are caused by secondhand smoke exposure.2 Secondhand smoke is also associated with health 

problems in young children, including risks for chronic middle-ear infections, asthma, bronchitis, 

and pneumonia.6 Smoking bans and restrictions are effective interventions to reduce the amount 

of secondhand smoke and its exposure in various settings.7 These policies are also associated with 

decreased cigarette consumption and may increase smoking cessation rates.7 

■ Smoking cessation greatly reduces the short- and long-term risks of smoking-related disease and death 

for men and women of any age.8,9 Seventy percent of smokers report that they want to quit, but less 

than 5% of smokers who attempt to quit are able to stay tobacco-free for 3–12 months.10 Success rates 

for quitting increase when evidence-based interventions such as health provider reminder systems, 

pharmacologic or behavioral cessation therapies, and telephone counseling (quitlines) are employed.7 

■ Tobacco use among youth continues to be a problem in the United States.11 In 2004, the number 

of people who smoked cigarettes for the first time was 2.1 million; most of these smokers were 

under the age of 18 years (67.8%).12 Twenty-eight percent of high school students reported use 

of any tobacco product and 22.3% reported current use of cigarettes.13 Although these estimates 

demonstrate a successful reduction in youth smoking since the late 1990s, the decline in smoking 

prevalence among middle and high school students may be stalling.13 To achieve continued success 

in preventing the initiation and use of tobacco products among adolescents, the implementation and 

promotion of evidence-based strategies is needed. These strategies include tax increases on tobacco 

products, youth access interventions combined with community mobilization efforts, and countermarketing campaigns combined with other comprehensive tobacco prevention activities.7 

■ Current state funding levels for comprehensive tobacco prevention and control programs are 

sorely inadequate to support effective and sustained tobacco control efforts. Out of a total of the 

potentially available $20 billion from excise taxes and tobacco settlement money, state spending on 

tobacco control has dropped from a high of $749.7 million in 2002 to $551 million in 2006.14 As of 

November 2005, only four states—Maine, Colorado, Delaware, and Mississippi—were spending the 

minimum per capita amount that the Centers for Disease Control and Prevention (CDC) recommends 

for tobacco control programs.14 Recent research demonstrates that the more states spend on 

comprehensive tobacco control programs, the greater the reductions in smoking—and the longer 

states invest in such programs, the greater and faster the impact.5 We have the ability to dramatically 

reduce the health and economic burdens of tobacco use by funding and implementing proven 

strategies. Achieving this goal will require ongoing collaboration among state decision makers, 

public health officials, business leaders, community members, and national partners. 

7 

The Purpose of this Document 

Because CDC is the lead federal agency for comprehensive tobacco prevention and control, a key priority 

for the Office on Smoking and Health (OSH) is supporting states in their efforts to preserve tobacco 

control capacity and infrastructure in the face of decreased funding. OSH’s National Tobacco Control 

Program (NTCP) seeks to reduce disease, disability, and death related to tobacco use by: 

■ Preventing the initiation of tobacco use among young people. 

■ Promoting quitting among young people and adults. 

■ Eliminating nonsmokers’ exposure to secondhand smoke. 

■ Identifying and eliminating the disparities related to tobacco use and its effects among 

different population groups.

Through the coordinated efforts of the NTCP and the activities of the Sustaining States workgroup at 

CDC (officially known as the “Promoting Sustainable Science-Based Comprehensive State Tobacco 

Control Programs at CDC-Recommended Levels priority”), OSH provides technical assistance to state 

tobacco control programs and other partners to help maintain and increase support for essential tobacco 

control activities. 

In response to the decreased funding of state tobacco control programs and partners, OSH has prepared 

the following information to help you emphasize the importance of tobacco control programs. This 

publication provides national and state-specific surveillance data as of 2004 around the four major goal 

areas of NTCP and a broad range of measures that reflect the health and associated economic impact of 

tobacco use. Data Highlights, 2006 also includes sample statements on how to interpret and cite these data 

for the public, press, and decision makers. 

In addition to this publication, OSH also provides many other data resources to aid states and national 

partners in their tobacco control efforts. These resources include, but are not limited to: 

■ The State Tobacco Activities Tracking and Evaluation (STATE) System: an electronic data 

warehouse containing up-to-date and historical state-level data on tobacco use prevention 

and control (www.cdc.gov/tobacco/statesystem).

■ Smoking-Attributable Mortality, Morbidity and Economic Costs (SAMMEC): an online 

application that allows you to estimate the health and health-related economic consequences 

of smoking to adults and infants (www.cdc.gov/tobacco/sammec). 

Additional resources can also be found on the OSH website (www.cdc.gov/tobacco). 

9 
Data Highlights 

Table 1. Smoking Prevalence (Adult and Youth), Percentage of Smokers Who Tried to 

Quit Past Year, Smoking-Attributable Deaths, Projected Deaths 

Smoking-Attributable 

Adults Deaths (1997–2001) Youth 

Prevalence Try to Prevalence of Number of Projected Projected 

of Smoking Number of Quit Annual Annual Rate Smoking (%) Smokers to Start to Die from 

State (%) Smokers (%) Average (Per 100,000) (Grades 9–12)* (Grades 9–12)* Smoking Smoking 

Alabama 24.9 844,000 47.1 7,400 321.1 24.0 47,000 543,000 174,000 

Alaska 24.9 112,000 54.2 500 296.2 19.2 6,000 56,000 18,000 

Arizona 18.6 766,000 49.4 6,300 248.9 20.9 45,000 328,000 105,000 

Arkansas 25.7 524,000 45.6 4,900 334.1 34.7 44,000 200,000 64,000 

California 14.8 3,869,000 51.4 37,800 261.0 13.2 57,000 1,862,000 596,000 

Colorado 20.1 685,000 42.4 4,300 252.7 25.4 49,000 288,000 92,000 

Connecticut 18.1 468,000 49.0 4,900 253.8 22.0 38,000 237,000 76,000 

Delaware 24.5 154,000 48.7 1,200 296.0 22.4 7,000 57,000 18,000 

D.C. 21.0 93,000 54.2 700 257.3 14.7 2,000 25,000 8,000 

Florida 20.4 2,665,000 44.2 28,700 275.5 18.1 128,000 1,153,000 369,000 

Georgia 20.1 1,288,000 54.8 10,300 312.3 20.9 77,000 576,000 184,000 

Hawaii NA NA NA 1,200 185.1 24.5 12,000 NA NA 

Idaho 17.5 174,000 47.2 1,500 254.1 14.0 10,000 75,000 24,000 

Illinois 22.2 2,094,000 49.3 16,900 278.4 29.2 161,000 991,000 317,000 

Indiana 25.0 1,147,000 47.5 9,800 322.2 21.3 60,000 499,000 160,000 

Iowa 20.8 467,000 42.9 4,500 256.7 19.5 29,000 206,000 66,000 

Kansas 19.8 400,000 43.7 3,900 270.8 21.1 28,000 170,000 54,000 

Kentucky 27.6 876,000 47.6 7,700 378.1 32.7 53,000 334,000 107,000 

Louisiana 23.6 776,000 51.8 6,400 309.1 36.4 79,000 340,000 109,000 

Maine 21.0 214,000 55.3 2,200 303.8 20.5 13,000 85,000 27,000 

Maryland 19.7 805,000 51.1 6,800 279.5 19.3 45,000 338,000 108,000 

Massachusetts 18.5 910,000 52.5 9,000 258.6 20.9 57,000 366,000 117,000 

Michigan 23.4 1,754,000 55.6 14,500 296.3 22.6 105,000 930,000 298,000 

Minnesota 20.7 789,000 43.6 5,500 225.3 32.4 81,000 368,000 118,000 

Mississippi 24.6 521,000 48.9 4,700 343.2 25.0 30,000 216,000 69,000 

Missouri 24.1 1,040,000 43.0 9,800 325.0 24.8 65,000 436,000 140,000 

NA: Not available. Survey data and/or weighted sample not available. 

* See table in Data Sources and Definitions for years of the data 

**Total number of smoking attributable deaths do not include burn, second hand smoke, or infant deaths. 

10 
South Dakota 

Tennessee 

Texas 

Utah 

Vermont 

Virginia 

Washington 

West Virginia 

Wisconsin 

Wyoming 

Median (M), 

Total (T), 

National (N) 

1,100 144.9 7.3 11,000 

9,300 288.7 NA NA 

3,900 361.6 28.5 23,000 

21.7 82,000 700 294.2 26.0 7,000 

20.3 115,000 46.4 1,100 253.8 30.0 12,000 

26.1 1,156,000 46.6 9,500 333.6 27.6 71,000

46.4 

53.7 

55.4 

44.8 

51.6 

46.2 

47.7 

48.5 

47.7 

(M) 

57,000 18,000 

412,000 132,000 

1,573,000 503,000 

82,000 26,000 

39,000 12,000 

475,000 152,000 

386,000 124,000 

142,000 46,000 

402,000 128,000 

36,000 12,000 

19,943,000 6,382,000 

(T) (T) 

20.6 3,291,000 24,200 287.4 24.3 283,000 

10.5 172,000 

20.0 96,000 900 272.2 22.4 7,000 

19.2 886,000 7,600 279.1 NA NA 

22.0 905,000 7,300 258.2 21.0 59,000 

20.9 44,500,000 398,000 284.8 21.7 3,079,000 

(M) (N) (T)** (N) (N) (N) 

20.9 1,171,000 

26.9 382,000 

Table 1. Smoking Prevalence (Adult and Youth), Percentage of Smokers Who Tried to 

Quit Past Year, Smoking-Attributable Deaths, Projected Deaths 

State 

Montana 

Nebraska 

Nevada 

New Hampshire 

New Jersey 

New Mexico 

New York 

North Carolina 

North Dakota 

Ohio 

Oklahoma 

Oregon 

Pennsylvania 

Rhode Island 

South Carolina 

Smoking-Attributable 

Adults Deaths (1997–2001) Youth 

Prevalence Try to Prevalence of Number of 

of Smoking Number of Quit Annual Annual Rate Smoking (%) Smokers 

(%) Smokers (%) Average (Per 100,000) (Grades 9–12)* (Grades 9–12)* 

20.4 142,000 45.4 1,400 292.6 22.9 11,000 

20.3 263,000 46.7 2,400 251.9 24.1 19,000 

23.2 393,000 41.4 3,100 370.4 19.6 19,000 

21.8 213,000 53.2 1,800 294.8 19.1 11,000 

18.9 1,219,000 49.6 11,300 253.1 17.3 71,000 

20.3 279,000 45.6 2,100 250.8 30.1 22,000 

20.0 2,900,000 51.5 25,500 259.6 20.2 157,000 

23.2 1,475,000 49.2 11,900 307.0 27.3 98,000 

19.9 96,000 43.9 900 233.0 30.2 11,000 

25.9 2,216,000 41.3 18,600 310.6 22.2 136,000 

26.1 688,000 45.1 5,800 321.7 26.5 44,000 

20.0 542,000 46.0 5,000 277.5 NA NA 

22.7 2,148,000 47.1 20,100 269.1 27.6 117,000 

21.3 178,000 53.1 1,700 283.0 19.3 9,000 

24.5 773,000 49.1 5,900 303.3 36.0 62,000 

Projected Projected 

to Start to Die from

Smoking Smoking 

57,000 18,000 

111,000 36,000 

146,000 47,000 

96,000 31,000 

526,000 168,000 

118,000 38,000 

1,216,000 389,000 

604,000 193,000 

36,000 11,000 

914,000 293,000 

273,000 87,000 

232,000 74,000 

936,000 300,000 

73,000 23,000 

321,000 103,000 

NA: Not available. Survey data and/or weighted sample not available. 

* See table in Data Sources and Definitions for years of the data 

**Total number of smoking attributable deaths do not include burn, second hand smoke, or infant deaths. 

11 
Household 

Race/Ethnicity* (%) Education (%) Income (%) Age (%) 

American 

Indian or 

Alaskan 

Native 

Asian or 

Pacific 

Islander 

African 

American 

< 12 

Years 

12 

Years 

> 12 

State White Hispanic Years <35K 35K+ 18–24 25–44 45–64 65+ 

Alabama 25.5 23.4 21.6 NA 34.5 34.6 26.7 19.4 30.7 19.6 29.1 28.1 26.3 12.1 

Alaska 21.7 35.2 22.3 21.2 45.6 41.9 35.3 18.3 35.3 19.6 23.4 29.9 22.8 12.5 

Arizona 20.7 27.1 15.3 17.3 24.6 19.1 21.4 16.7 22.0 16.3 21.7 21.6 19.8 7.9 

Arkansas 24.7 23.5 27.0 NA 39.9 33.1 29.4 18.3 31.4 21.4 34.7 30.9 25.5 9.3 

California 16.0 24.9 14.0 13.1 22.9 15.2 20.8 11.5 16.8 13.3 18.4 16.3 15.2 6.3 

Colorado 18.3 16.5 23.2 14.2 32.4 35.1 27.0 13.3 29.9 15.5 29.1 22.3 17.7 9.7 

Connecticut 17.8 19.4 20.9 16.7 36.0 28.2 24.1 12.5 24.4 16.5 31.2 20.1 17.8 6.7 

Delaware 22.7 23.5 25.0 14.3 42.0 36.6 31.3 16.9 34.8 20.2 34.6 28.0 23.7 10.2 

D.C. 14.2 25.8 23.5 23.1 NA 27.2 31.3 16.7 30.3 15.5 20.1 24.6 8.1 

Florida 23.7 15.4 19.8 15.3 44.0 30.1 24.4 16.0 25.8 17.1 25.1 

23.5 

26.5 20.9 7.5 

Georgia 22.0 19.7 13.7 21.4 38.0 30.7 20.4 15.9 25.0 17.0 26.5 20.6 20.2 11.2 

Hawaii NA NA NA NA NA NA NA NA NA NA NA NA NA NA 

Idaho 17.3 NA 24.2 14.7 37.2 38.0 22.1 12.6 24.7 12.0 17.8 20.2 19.0 7.4 

Illinois 23.0 25.4 23.0 16.0 26.0 31.1 26.3 16.8 29.8 19.1 31.4 26.2 19.9 9.4 

Indiana 24.9 29.7 25.0 18.7 49.4 39.5 29.7 17.6 32.3 21.1 28.2 30.3 24.6 10.8 

Iowa 21.0 21.9 22.8 18.2 NA 32.6 25.3 15.0 26.3 18.0 26.3 26.3 19.8 8.6 

Kansas 19.6 22.3 21.8 22.1 33.0 28.7 24.9 15.1 26.6 15.5 26.4 21.9 20.2 9.4 

Kentucky 29.1 30.2 16.2 NA 38.7 37.4 32.1 19.4 35.2 20.6 31.1 31.8 28.7 12.5 

Louisiana 26.0 22.7 23.9 26.6 30.3 31.1 25.8 18.7 27.8 20.7 27.3 25.7 25.6 9.8 

Maine 21.9 NA 30.5 NA 44.9 33.5 25.0 14.2 29.0 15.9 34.9 25.2 19.6 6.9 

Maryland 20.2 20.4 16.7 11.7 49.5 34.4 30.8 12.9 29.0 16.7 24.7 21.9 19.4 10.0 

Massachusetts 18.7 17.4 19.4 12.4 42.1 25.9 26.5 13.7 27.1 15.2 24.7 20.8 19.1 8.0 

Michigan 24.3 26.6 25.2 9.4 35.3 33.5 27.2 16.0 31.8 19.0 40.6 25.1 22.0 8.5 

Minnesota 20.5 25.3 23.6 16.2 46.3 26.6 29.3 14.5 28.6 18.0 32.3 23.0 20.0 7.1 

Mississippi 26.7 21.3 32.4 NA 38.6 34.2 27.9 17.9 28.7 19.3 29.0 28.7 25.1 10.4 

Missouri 25.4 23.9 21.8 13.4 56.2 38.2 26.4 18.0 31.5 20.1 31.1 29.2 23.4 9.8 

Table 2. Smoking Prevalence Among Adults (2004) 

NA: Not available. Survey data and/or weighted sample not available. 

*CDC, BRFSS 2003 and 2004. Data are shown only for racial/ethnic groups with at least 50 respondents. 

12 
Table 2. Smoking Prevalence Among Adults (2004) 

Household 

Race/Ethnicity* (%) Education (%) Income (%) Age (%) 

American 

Indian or 

Alaskan 

Native 

Asian or 

Pacific 

Islander 

African 

American 

< 12 

Years 

12 

Years

> 12 

State White Hispanic Years <35K 35K+ 18–24 25–44 45–64 65+ 

Montana 18.4 NA 27.5 NA 45.6 27.5 25.2 15.1 26.5 15.0 30.1 21.3 21.3 9.7 

Nebraska 20.7 22.3 17.6 23.1 41.6 24.5 24.5 16.1 24.3 18.0 25.8 22.6 22.5 7.8 

Nevada 24.7 20.1 22.3 14.4 37.9 32.1 27.6 18.8 26.1 21.3 25.5 24.8 24.4 14.5 

New Hampshire 21.2 NA 16.5 15.3 45.7 43.1 28.9 13.8 35.0 17.0 34.9 25.2 19.0 9.3 

New Jersey 19.6 20.4 18.3 12.3 30.3 22.5 23.6 15.2 22.8 17.8 24.0 22.1 18.6 9.3 

New Mexico 20.5 24.6 23.0 12.7 14.6 31.4 24.1 15.2 26.5 15.3 23.8 23.6 20.2 10.2 

New York 21.4 23.2 18.3 11.0 25.8 27.1 26.0 16.2 24.1 18.3 19.5 24.5 19.7 10.9 

North Carolina 24.5 23.6 18.5 12.3 35.9 30.2 28.8 16.9 30.0 19.1 28.5 26.2 24.0 10.2 

North Dakota 19.0 NA 13.1 NA 53.5 17.6 22.4 16.5 24.1 18.0 28.9 23.5 19.1 7.6 

Ohio 25.1 30.3 24.1 2.7 51.5 44.3 29.5 18.9 33.8 21.6 33.4 31.1 26.4 8.8 

Oklahoma 24.8 27.8 18.2 13.8 36.5 36.2 31.2 19.0 32.4 20.7 32.3 30.8 26.5 10.9 

Oregon 20.4 34.7 13.7 13.4 44.5 27.3 28.2 14.4 29.1 14.6 23.6 24.8 18.8 9.1 

Pennsylvania 23.0 32.3 27.7 12.1 NA 36.6 26.3 15.4 29.8 18.9 31.1 28.0 23.0 8.0 

Rhode Island 21.8 23.3 15.7 21.8 51.7 24.1 24.9 17.2 26.4 18.9 28.4 26.0 20.0 8.8 

South Carolina 24.7 23.2 32.7 13.0 53.2 36.6 29.8 17.2 31.3 20.5 30.3 29.3 24.2 8.7 

South Dakota 19.8 NA 24.9 23.3 50.3 27.0 22.1 17.0 27.2 15.9 26.1 23.8 21.1 8.6 

Tennessee 26.9 22.0 20.2 NA NA 40.9 30.7 17.8 35.8 19.4 33.4 30.4 24.9 13.3 

Texas 22.7 19.9 18.7 19.2 25.6 22.4 25.2 16.0 26.1 17.2 27.2 21.4 20.9 10.3 

Utah 10.8 NA 11.7 11.0 15.9 23.1 16.6 6.5 14.8 8.2 12.4 11.8 9.8 4.7 

Vermont 19.2 NA 23.2 20.1 44.2 36.4 26.4 12.9 28.9 15.0 29.1 23.5 18.8 7.9 

Virginia 21.3 21.9 18.6 13.6 41.0 28.8 26.3 15.5 27.1 17.9 28.6 24.8 18.7 8.3 

Washington 19.0 24.5 16.6 16.3 36.5 28.9 26.3 14.3 27.4 14.7 25.8 22.2 17.8 8.7 

West Virginia 26.8 32.9 28.2 NA NA 34.5 29.1 18.0 33.2 21.8 37.6 34.3 25.4 10.0 

Wisconsin 21.4 29.7 22.1 16.8 28.0 29.6 24.5 18.0 27.3 19.6 28.4 26.3 22.0 7.8 

Wyoming 22.2 NA 27.9 NA 55.8 37.2 28.3 15.5 29.3 17.4 27.1 26.3 20.5 9.8 

Median 21.6 23.5 22.0 14.7 38.7 31.3 26.3 16.0 28.6 18.0 28.4 25.0 20.7 9.3 

NA: Not available. Survey data and/or weighted sample not available. 

*CDC, BRFSS 2003 and 2004. Data are shown only for racial/ethnic groups with at least 50 respondents. 

13 
Table 3. Secondhand Smoke Policies, Cigarette Price Per Pack, State Tax Per Pack, and 

Per Capita (Adult) Cigarette Consumption 

People Protected by Cigarette Price Per Pack (2004), State Tax Per Pack (2005), and

Nonsmoking Policies (2001-2002) Cigarette Consumption (2004)

Worksite Home Cigarette Price State Tax Per Capita (Adult) 

State (%) (%) Per Pack Per Pack Cigarette Consumption 

Alabama 66.8 62.1 3.57 0.43 115.15 

Alaska 76.7 69.4 5.03 1.60 88.40 

Arizona 71.6 75.9 3.97 1.18 56.57 

Arkansas 64.2 57.1 3.54 0.57 105.78 

California 80.0 77.5 3.84 0.87 44.64 

Colorado 68.9 70.3 3.43 0.84 80.70 

Connecticut 73.7 70.5 4.71 1.51 69.46 

Delaware 72.2 64.3 3.41 0.55 225.95 

D.C. 76.2 67.5 4.20 1.00 48.65 

Florida 65.7 71.8 3.25 0.34 94.26 

Georgia 63.4 69.1 3.36 0.37 91.04 

Hawaii 62.3 68.3 5.04 1.40 61.82 

Idaho 70.9 74.1 3.50 0.57 81.30 

Illinois 69.1 60.3 4.35 0.98 80.16 

Indiana 60.6 57.3 3.45 0.56 130.49 

Iowa 69.6 61.7 3.27 0.36 108.35 

Kansas 71.8 64.2 3.75 0.79 74.80 

Kentucky 59.1 50.0 3.01 0.30 226.90 

Louisiana 64.2 65.5 3.41 0.36 114.81 

Maine 81.4 63.0 4.06 2.00 91.29 

Maryland 77.8 67.7 4.02 1.00 64.69 

Massachusetts 81.6 70.5 5.03 1.51 56.64 

Michigan 65.5 58.0 5.09 2.00 91.04 

Minnesota 74.7 66.3 3.52 1.23 95.63 

Mississippi 67.0 

66.0 

62.0 

56.6 

3.20 

3.09 

0.18 

0.17 

118.28 

Missouri 137.02 

14 
Table 3. Secondhand Smoke Policies, Cigarette Price Per Pack, State Tax Per Pack, and 

Per Capita (Adult) Cigarette Consumption 

15 

Montana 70.6 67.1 3.94 1.70 86.81 

People Protected by 

Nonsmoking Policies (2001-2002) 

Cigarette Price Per Pack (2004), State Tax Per Pack (2005), and

Cigarette Consumption (2004)

Worksite 

(%) 

Home 

(%) 

Cigarette Price 

Per Pack 

State Tax 

Per Pack 

Per Capita (Adult) 

State Cigarette Consumption

Nebraska 70.3 63.8 3.62 0.64 81.90 

Nevada 51.5 68.7 3.83 0.80 90.46 

New Hampshire 76.5 67.0 3.52 0.80 192.16 

New Jersey 75.2 68.3 5.62 2.40 56.75 

New Mexico 70.9 71.7 3.88 0.91 46.99 

New York 76.9 63.4 5.49 1.50 44.19 

North Carolina 67.4 57.1 3.03 0.30 125.16 

North Dakota 71.6 62.8 3.40 0.44 84.17 

Ohio 66.0 56.4 3.50 1.25 113.19 

Oklahoma 70.5 60.9 3.22 1.03 133.91 

Oregon 74.0 73.5 4.14 1.18 71.66 

Pennsylvania 71.8 60.2 4.30 1.35 89.09 

Rhode Island 77.0 65.5 5.45 2.46 78.51 

South Carolina 65.7 67.6 3.12 0.07 120.47 

South Dakota 65.3 61.1 3.51 0.53 91.38 

Tennessee 66.0 56.1 3.18 0.20 125.00 

Texas 67.9 71.1 3.36 0.41 76.10 

Utah 85.2 83.1 3.76 0.70 48.70 

Vermont 78.1 64.6 4.44 1.19 87.98 

Virginia 71.7 64.5 3.28 0.30 127.25 

Washington 71.7 71.3 4.73 2.03 48.99 

West Virginia 69.3 50.2 3.36 0.55 131.61 

Wisconsin 68.7 61.8 3.76 0.77 91.52 

Wyoming 67.0 60.8 3.62 0.60 61.09 

National (N) 70.9 66.0 3.87 0.92 95.27 

Average (A) (N) (N) (A) (A) (A) 
Smoking-Attributable Costs (2004) 

Medical Costs Medical Costs Productivity Costs Productivity Costs Direct Medicaid Medicaid Costs Medicaid Costs 

State (Total) Per Pack (Total) Per Pack Costs (Total) Per Pack Per Capita (Adult) 

Alabama 1,499,000,000 3.79 2,051,000,000 5.18 238,000,000 0.60 69.27 

Alaska 169,000,000 4.09 157,000,000 3.80 77,000,000 1.86 164.81 

Arizona 1,287,000,000 5.42 1,492,000,000 6.28 316,000,000 1.33 75.30 

Arkansas 812,000,000 3.70 1,306,000,000 5.95 242,000,000 1.10 116.57 

California 9,142,000,000 7.79 8,585,000,000 7.31 2,959,000,000 2.52 112.52 

Colorado 1,314,000,000 4.76 992,000,000 3.59 319,000,000 1.15 93.21 

Connecticut 1,631,000,000 8.81 1,017,000,000 5.49 430,000,000 2.32 161.36 

Delaware 284,000,000 1.97 304,000,000 2.11 79,000,000 0.55 124.05 

D.C. 243,000,000 11.25 233,000,000 10.79 78,000,000 3.61 175.69 

Florida 6,320,000,000 5.01 6,479,000,000 5.13 1,250,000,000 0.99 93.33 

Georgia 2,252,000,000 3.81 3,082,000,000 5.21 537,000,000 0.91 82.66 

Hawaii 336,000,000 5.64 308,000,000 5.17 117,000,000 1.96 121.35 

Idaho 319,000,000 3.84 333,000,000 4.01 83,000,000 1.00 81.30 

Illinois 4,106,000,000 5.41 4,292,000,000 5.65 1,570,000,000 2.07 165.69 

Indiana 2,084,000,000 3.44 2,495,000,000 4.12 487,000,000 0.80 105.02 

Iowa 1,017,000,000 4.13 963,000,000 3.91 301,000,000 1.22 132.37 

Kansas 927,000,000 6.04 863,000,000 5.62 196,000,000 1.28 95.52 

Kentucky 1,500,000,000 2.09 2,138,000,000 2.98 487,000,000 0.68 153.83 

Louisiana 1,474,000,000 3.83 1,919,000,000 4.99 663,000,000 1.72 197.86 

Maine 602,000,000 6.37 494,000,000 5.23 216,000,000 2.29 208.67 

Maryland 1,964,000,000 7.29 1,783,000,000 6.62 476,000,000 1.77 114.33 

Massachusetts 3,543,000,000 12.63 1,923,000,000 6.86 1,046,000,000 3.73 211.21 

Michigan 3,401,000,000 4.93 3,802,000,000 5.51 1,128,000,000 1.63 148.83 

Minnesota 2,063,000,000 5.59 1,205,000,000 3.26 465,000,000 1.26 120.45 

Mississippi 719,000,000 2.82 1,413,000,000 5.55 264,000,000 

532,000,000 

1.04 

0.89 

122.60 

Missouri 2,137,000,000 3.57 2,417,000,000 4.04 121.74 

Table 4. Smoking-Attributable Costs (2004) 

16 
Smoking-Attributable Costs (2004) 

Medical Costs Medical Costs Productivity Costs Productivity Costs Direct Medicaid Medicaid Costs Medicaid Costs

State (Total) Per Pack (Total) Per Pack Costs (Total) Per Pack Per Capita (Adult)

Montana 277,000,000 4.44 295,000,000 4.73 67,000,000 1.07 93.21 

Nebraska 537,000,000 5.00 499,000,000 4.64 134,000,000 1.25 102.08 

Nevada 565,000,000 3.61 832,000,000 5.31 123,000,000 0.79 71.05 

New Hampshire 564,000,000 2.95 405,000,000 2.12 115,000,000 0.60 115.64 

New Jersey 3,178,000,000 8.56 2,624,000,000 7.07 967,000,000 2.60 147.80 

New Mexico 461,000,000 6.95 467,000,000 7.04 184,000,000 2.78 130.40 

New York 8,171,000,000 12.62 6,018,000,000 9.29 5,471,000,000 8.45 373.33 

North Carolina 2,463,000,000 3.06 3,307,000,000 4.11 769,000,000 0.96 119.73 

North Dakota 247,000,000 5.92 190,000,000 4.56 47,000,000 1.13 94.87 

Ohio 4,375,000,000 4.45 4,658,000,000 4.74 1,426,000,000 1.45 164.29 

Oklahoma 1,162,000,000 3.26 1,556,000,000 4.36 218,000,000 0.61 81.84 

Oregon 1,116,000,000 5.68 1,077,000,000 5.48 287,000,000 1.46 104.66 

Pennsylvania 5,193,000,000 6.09 4,637,000,000 5.44 1,710,000,000 2.01 178.70 

Rhode Island 506,000,000 7.70 364,000,000 5.54 179,000,000 2.72 213.91 

South Carolina 1,095,000,000 2.86 1,835,000,000 4.80 393,000,000 1.03 123.84 

South Dakota 274,000,000 5.17 228,000,000 4.30 58,000,000 1.09 100.00 

Tennessee 2,166,000,000 3.84 2,740,000,000 4.86 680,000,000 1.21 150.79 

Texas 5,831,000,000 4.72 6,445,000,000 5.22 1,620,000,000 1.31 99.86 

Utah 345,000,000 4.30 273,000,000 3.40 104,000,000 1.30 63.07 

Vermont 233,000,000 5.44 197,000,000 4.60 72,000,000 1.68 148.00 

Virginia 2,087,000,000 2.90 2,427,000,000 3.37 401,000,000 0.56 70.91 

Washington 1,957,000,000 8.47 1,743,000,000 7.54 651,000,000 2.82 137.99 

West Virginia 690,000,000 3.66 993,000,000 5.27 229,000,000 1.22 160.06 

Wisconsin 2,024,000,000 5.26 1,642,000,000 4.27 480,000,000 1.25 114.26 

Wyoming 136,000,000 

Average 1,898,000,000 

5.71 

5.31 

155,000,000 6.51 37,000,000 

607,000,000 

1.55 

1.63 

94.97 

1,915,000,000 5.16 129.90 

Table 4. Smoking-Attributable Costs (2004) 

17 
Table 5. State Rankings on Prevalence, Smoking-Attributable Deaths (Adult, Youth), 

Percentage of Smokers Who Tried to Quit Past Year, Secondhand Smoke Policies 

NA: Not available. 

Measures in descending order: Try to Quit, Percentage of People Protected by Nonsmoking Policies at Worksite and Home 

Measures in ascending order: Prevalence of Smoking, Smoking-Attributable Deaths, Youth Prevalence of Smoking 

18 

Adults Youth People Protected by Nonsmoking Policies 

Prevalence 

of Smoking 

(Grades 9–12) 

Prevalence 

of Smoking 

Smoking-Attributable 

State Try to Quit Death Rate Worksite Home 

Alabama 42 29 42 27 37 34 

Alaska 42 5 34 8 9 13 

Arizona 6 17 5 15 21 3 

Arkansas 45 37 47 46 45 45 

California 2 14 18 2 4 2 

Colorado 15 48 8 33 31 12 

Connecticut 4 21 10 21 15 10 

D.C. 26 5 14 4 11 20 

Delaware 39 23 33 23 16 28 

Florida 20 42 22 6 41 6 

Georgia 15 4 41 15 47 14 

Hawaii NA NA 2 30 48 16 

Idaho 3 28 12 3 23 4 

Illinois 32 18 24 40 30 41 

Indiana 44 27 44 20 49 44 

Iowa 24 47 13 11 28 37

Kansas 10 44 20 19 17 29 

Kentucky 50 26 51 45 50 51 

Louisiana 37 11 39 48 45 24 

Maine 26 3 37 14 3 32 

Maryland 9 15 26 9 6 18 

Massachusetts 5 10 16 15 2 10 

Michigan 36 1 35 25 43 43 

Minnesota 23 45 3 44 13 23 

Mississippi 41 22 48 32 35 35 

Missouri 38 46 45 31 38 47 
Table 5. State Rankings on Prevalence, Smoking-Attributable Deaths (Adult, Youth), 

Percentage of Smokers Who Tried to Quit Past Year, Secondhand Smoke Policies 

NA: Not available. 

Measures in descending order: Try to Quit, Percentage of People Protected by Nonsmoking Policies at Worksite and Home 

Measures in ascending order: Prevalence of Smoking, Smoking-Attributable Deaths, Youth Prevalence of Smoking 

19 

Nevada 34 49 50 12 51 15 

New Jersey 7 16 9 5 12 16 

Adults Youth People Protected by Nonsmoking Policies 

Prevalence 

of Smoking 

(Grades 9–12) 

Prevalence 

of Smoking 

Smoking-Attributable 

State Try to Quit Death Rate Worksite Home 

Montana 20 39 30 26 25 21 

Nebraska 17 31 7 28 27 30 

New Hampshire 30 8 32 7 10 22 

New Mexico 17 37 6 42 23 7 

New York 12 13 17 13 8 31 

North Carolina 34 19 38 36 34 45 

North Dakota 11 43 4 43 21 33 

Ohio 46 50 40 22 38 48 

Oklahoma 47 40 43 35 26 39 

Oregon 12 36 23 NA 14 5 

Pennsylvania 33 29 19 37 17 42 

Rhode Island 28 9 27 9 7 24 

South Carolina 39 20 36 47 41 19 

South Dakota 17 33 10 41 44 38 

Tennessee 47 32 46 37 38 49 

Texas 22 33 28 29 33 9

Utah 1 7 1 1 1 1 

Vermont 12 2 21 23 5 26 

Virginia 25 41 29 NA 19 27 

Washington 8 12 25 NA 19 8 

West Virginia 49 35 49 39 29 50 

Wisconsin 31 25 15 18 32 36 

Wyoming 29 24 31 34 35 40 
Price and Tax Smoking-Attributable Costs 

Cigarette Price State Tax Medical Costs Productivity Costs Medicaid Costs Medicaid Costs 

State Per Pack Per Pack Per Pack Per Pack Per Pack Per Capita (Adult) 

Alabama 27 39 14 27 3 2 

Alaska 6 7 19 8 38 43 

Arizona 17 16 32 42 30 5 

Arkansas 28 32 13 41 18 24 

California 20 23 45 48 44 20 

Colorado 35 24 25 7 20 9 

Connecticut 9 8 48 35 43 41 

D.C. 13 19 49 51 49 45 

Delaware 36 35 1 1 1 31 

Florida 44 44 28 25 12 11 

Georgia 39 41 15 28 10 8 

Hawaii 5 11 35 26 39 27 

Idaho 32 32 17 10 13 6 

Illinois 11 21 31 40 41 44 

Indiana 34 34 9 13 8 19 

Iowa 43 42 20 9 22 33

Kansas 24 27 39 39 27 14 

Kentucky 51 45 2 3 6 39 

Louisiana 36 42 16 24 36 47 

Maine 15 4 41 30 42 48 

Maryland 16 19 43 44 37 22 

Massachusetts 6 8 51 45 50 49 

Michigan 4 4 26 36 34 37 

Minnesota 29 14 34 4 26 26 

Mississippi 46 49 3 38 15 29 

Missouri 49 50 10 11 9 28 

Table 6. State Rankings on Cigarette Price, Tax, and Smoking-Attributable Costs 

Measures in descending order: Cigarette Price Per Pack, State Tax Per Pack 

Measures in ascending order: Smoking-Attributable Medical Costs Per Pack, Smoking-Attributable Productivity Costs Per Pack, Smoking Attributable Medicaid Costs Per Pack, and 

Smoking-Attributable Medicaid Costs Per Capita 

20 
Table 6. State Rankings on Cigarette Price, Tax, and Smoking-Attributable Costs 

Price and Tax Smoking-Attributable Costs 

Cigarette Price State Tax Medical Costs Productivity Costs Medicaid Costs Medicaid Costs 

State Per Pack Per Pack Per Pack Per Pack Per Pack Per Capita (Adult) 

Montana 18 6 22 20 16 9 

Nebraska 25 30 27 19 24 17 

Nevada 21 25 11 32 7 4 

New Hampshire 29 25 6 2 3 23 

New Jersey 1 2 47 47 45 35 

New Mexico 19 22 42 46 47 32 

New York 2 10 50 50 51 51 

North Carolina 50 45 7 12 11 25 

North Dakota 38 38 38 17 19 12 

Ohio 32 13 23 21 31 42 

Oklahoma 45 18 8 16 5 7 

Oregon 14 16 36 34 32 18 

Pennsylvania 12 12 40 33 40 46 

Rhode Island 3 1 44 37 46 50 

South Carolina 48 51 4 22 14 30 

South Dakota 31 37 29 15 17 16 

Tennessee 47 48 17 23 21 38 

Texas 39 40 24 29 29 15

Utah 22 29 21 6 28 1 

Vermont 10 15 33 18 35 36 

Virginia 42 45 5 5 2 3 

Washington 8 3 46 49 48 34 

West Virginia 39 35 12 31 22 40 

Wisconsin 22 28 30 14 24 21 

Measures in descending order: Cigarette Price Per Pack, State Tax Per Pack 

Measures in ascending order: Smoking-Attributable Medical Costs Per Pack, Smoking-Attributable Productivity Costs Per Pack, Smoking-Attributable Medicaid Costs Per Pack, and 

Smoking-Attributable Medicaid Costs Per Capita 

21 

Wyoming 25 31 37 43 33 13 
Sample Messages for Data Measures 

Table 1 

Prevalence and number of adults who smoke 

■ <X> percent or <Y#> adults in <STATE> smoke. 

Example: Twenty-five percent (25.0%) or 1,147,000 adults in Indiana smoke. 

Number of daily smokers who try to quit 

■ Among those adults who smoke every day in <STATE>, <X> percent tried to quit in 2004. 

Example: Among those adults who smoke every day in New Hampshire, 53.2% tried to quit in 2004. 

Number of deaths attributable to cigarette smoking 

■ Cigarette smoking is the leading cause of preventable death in <STATE>, killing an estimated <X#> people each 

year. 

Example: Tobacco-related illnesses are the leading cause of preventable death in Virginia, killing an estimated 9,300 people 

each year. 

■ For every 100,000 people aged 35 years or older in <STATE>, an estimated <X#> die each year from cigarette 

smoking.

Example: For every 100,000 people aged 35 years or older in Georgia, an estimated 312.3 die each year from cigarette smoking. 

Prevalence and number of youth who smoke (grades 9–12) 

■ Each day, approximately 3,900 youths in the United States aged 12–17 try their first cigarette, and an estimated 

1,500 become daily smokers. In <STATE> alone, <X> percent (or <X#>) of high school students (grades 9–12) 

are current smokers. 

Example: Each day, approximately 3,900 youths in the United States aged 12–17 try their first cigarette, and an estimated 

1,500 become daily smokers. In Missouri alone, 24.8% (or 65,000) of high school students (grades 9–12) are current smokers. 

Number of youth projected to start smoking 

■ If current smoking trends continue, <X#> youth under age 18 in <STATE> could become future smokers. 

Example: If current smoking trends continue, 321,000 youth under age 18 in South Carolina could become future smokers. 

Number of projected deaths among youth who smoke 

■ If current smoking trends continue, <X#> youth under age 18 in <STATE> could die prematurely from cigarette 

smoking. 

Example: If current smoking trends continue, 92,000 youth under age 18 in Colorado could die prematurely from cigarette 

smoking. 

Table 2 

Prevalence of smoking by 

Race/ethnicity* 

■ In <STATE>, the prevalence of cigarette smoking is highest among <Race5> (<V> percent), followed by 

<Race4> (<W> percent), <Race3> (<X> percent), <Race2> (<Y> percent), and <Race1> (<Z> percent).

Example: In Washington, the prevalence of cigarette smoking is highest among American Indian/Alaska Natives (36.5%), 

followed by African Americans (24.5%), non-Hispanic whites (19.0%), Hispanics (16.6%), and Asian/Pacific Islanders (16.3%). 

Education* 

■ <X> percent of <STATE> residents aged 25 and older with less than a high school education smoke, compared to 

<X> percent with more than a high school education. 

Example: Twenty-seven percent (27.0%) of South Dakota residents aged 25 and older with less than a high school education 

smoke, compared to 17.0% with more than a high school education. 

22 
Household income* 

■ <X> percent of <STATE> residents with a household income less than $35,000 per year smoke, compared to 

<Y> percent of <STATE> residents with a household income $35,000 or more. 

Example: Twenty-two percent (22.0%) of Arizona residents with a household income less than $35,000 per year smoke, 

compared to 16.3% of Arizona residents with a household income $35,000 or more. 

Age* 

■ In <STATE>, smoking rates are highest among those aged <AGE1> (<X> percent) and lowest among those aged 

<AGE2> (<Y> percent). 

Example: In Delaware, smoking rates are highest among those aged 18–24 (34.6%) and lowest among those aged 65 and 

older (10.2%). 

*Note: To determine if the differences are statistically significant, tests of significance should be calculated. 

Table 3 

People protected by nonsmoking policies at worksite/home 

■ In <STATE>, <X> percent of employees report that nonsmoking policies protect them from exposure to 

secondhand smoke in the worksite.

Example: In Nevada, 51.5% of employees report that nonsmoking policies protect them from exposure to secondhand smoke 

in the worksite. 

■ <X> percent of residents in <STATE> report they have a rule that smoking is not allowed in their home. 

Example: Sixty-seven percent (67.0%) of residents in New Hampshire report they have a rule that smoking is not allowed in 

their home. 

Cigarette price per pack 

■ In 2004, each pack of cigarettes in <STATE> cost an estimated $<X>. 

Example: In 2004, each pack of cigarettes in Alaska cost an estimated $5.03. 

State tax on cigarettes 

■ In 2005, the tax on one pack of cigarettes was $<X> in <STATE>. 

Example: In 2005, the tax on one pack of cigarettes was $2.00 in Michigan. 

Cigarette consumption 

■ In 2004, an estimated <X> packs of cigarettes per adult were purchased in <STATE>. 

Example: In 2004, an estimated 226.90 packs of cigarettes per adult were purchased in Kentucky. 

Table 4 

Smoking-attributable medical expenditures 

■ In 2004, direct medical expenses due to smoking reached approximately $<X> in <STATE>. 

Example: In 2004, direct medical expenses due to smoking reached approximately $4,106,000,000 in Illinois. 

OR 

In 2004, direct medical expenses due to smoking reached approximately $4.11 billion in Illinois. 

■ In 2004, each pack of cigarettes sold in <STATE> cost an estimated $<X> in direct medical expenses attributable 

to smoking. 

Example: In 2004, each pack of cigarettes sold in the District of Columbia cost an estimated $11.25 in direct medical 

expenses attributable to smoking.

23 
Smoking-attributable productivity loss 

In 2004, the cost of lost productivity due to smoking reached approximately $<X> in <STATE>. 

Example: In 2004, the cost of lost productivity due to smoking reached approximately $1,923,000,000 in Massachusetts.

OR

In 2004, the cost of lost productivity due to smoking reached approximately $1.92 billion in Massachusetts.

■ In 2004, each pack of cigarettes sold in <STATE> cost an estimated $<X> in lost productivity due to smoking 

Example: In 2004, each pack of cigarettes sold in Kansas cost an estimated $5.62 in lost productivity due to smoking. 

Smoking-attributable Medicaid expenditures 

■ In 2004, Medicaid costs for treating smoking-related diseases were approximately $<X> in <STATE>. 

Example: In 2004, Medicaid costs for treating smoking-related diseases were approximately $1,250,000,000 in Florida.

OR

In 2004, Medicaid costs for treating smoking-related diseases were approximately $1.25 billion in Florida.

■ For each pack of cigarettes sold in 2004, <STATE> spent an estimated $<X> in Medicaid costs to treat smokingrelated diseases. 

Example: For each pack of cigarettes sold in 2004, Rhode Island spent an estimated $2.72 in Medicaid costs to treat smokingrelated diseases. 

■ In 2004, Medicaid costs for treating smoking-related diseases were $<X> per adult in <STATE>. 

Example: In 2004, Medicaid costs for treating smoking-related diseases were $63.07 per adult in Utah. 

24 
Data Sources and Definitions 

Prevalence (Adult and Youth), Percentage of Smokers Who Try to Quit, 

Smoking-Attributable Deaths, Projected Deaths 

Adults 

Prevalence of smoking 

■ Source of data: Centers for Disease Control and Prevention. State-specific prevalence of current cigarette smoking 

among adults—United States, 2004. MMWR 2005;54:1124–1127. Current smokers are defined as adults aged 18 

years and older who reported ever smoking at least 100 cigarettes and who currently smoke every day or some days. 

■ Hawaii completed 3 of 12 months of interviews in 2004; these data are not available in the aggregate 2004 dataset. 

For comparison purposes, the median for all states is presented. 

Number of smokers 

■ Source of data: CDC Behavioral Risk Factor Surveillance System (BRFSS) 2004. State population estimates for 

adults 18 years and older are from Claritas (2004). www.claritas.com 

■ Current smokers are defined as adults aged 18 years and older who reported ever smoking at least 100 cigarettes 

and who currently smoke every day or some days. 

■ Hawaii completed 3 of 12 months of interviews in 2004; these data are not available in the aggregate 2004 dataset. 

■ Estimates are rounded to the nearest thousand. 

For comparison purposes, the national estimate published in MMWR (2005;54(44):1122) is presented. 

Percentage who try to quit 

■ Source of data: (BRFSS 2004). 

■ Among current smokers who smoke every day, a quit attempt is defined as those who had stopped smoking for

1 day or longer in the past 12 months. 

For comparison purposes, the median for all states is presented. 

All 

Smoking-attributable deaths (total and rate per 100,000) 

■ Source of data: Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC).

Available at http://apps.nccd.cdc.gov/sammec/login.asp (Last date accessed: 12/5/2005)

■ For both average annual smoking-attributable mortality totals and average annual age-adjusted SAM Rate per 

100,000, data are annual averages among adults aged 35 years and older, from 1997 to 2001. Neither estimate 

includes burn or secondhand smoke, or infant deaths.

■ Smoking-attributable death totals are rounded to the nearest hundreds. 

For comparison purposes, the national estimates for SAM and SAM rates from SAMMEC (1997–2001) are reported. 

Youth 

Prevalence of smoking (grades 9–12) 

■ Source of data: State-specific data are from the Youth Tobacco Survey (YTS) or Youth Risk Behavior 

Surveillance System (YRBS), most recent year (see surveys and dates below). Data from surveys included in this 

report had an overall response rate of at least 60%. Thus, the data were weighted and can be generalized to all 

high school students in the state. 

■ Current smokers are defined as those students who reported smoking cigarettes on 1 or more of the past 30 days 

preceding the survey. Estimates apply to youth in school in grades 9–12. 

25 
YTS YRBS YTS YTS YRBS 

2004 2003 2003 (other years) (other years) 

Alabama Alaska California Colorado (2000) Arkansas (2001) 

Delaware Arizona Connecticut (2002) Louisiana (1997) 

Indiana Florida D.C. (2000) New Mexico (1991) 

Iowa Georgia Hawaii (2000) South Carolina (1999) 

New Hampshire Idaho Illinois (2002) 

New Jersey Kentucky Kansas (2002) 

North Carolina Maine Maryland (2002) 

Vermont Massachusetts Minnesota (2000) 

Wisconsin Michigan Pennsylvania (2001) 

Mississippi 

Missouri 

Montana 

Nebraska 

Nevada 

New York 

North Dakota 

Ohio 

Oklahoma 

Rhode Island 

South Dakota 

Tennessee 

Texas 

Utah 

West Virginia 

Wyoming 

For comparison purposes for youth smoking prevalence, the national estimate from the 2004 National Youth Tobacco

Survey (NYTS) is presented. 

Number of smokers (grades 9–12) 

■ Source of Data: State-specific data are from the YTS or YRBS, most recent year (see surveys and dates above). 

■ Current smokers are defined as those students who reported smoking cigarettes on 1 or more of the past 30 days 

preceding the survey. Estimates apply to youth in school in grades 9–12. 

■ Figures are rounded to the nearest thousand. 

For comparison purposes for total number of smokers, the national prevalence estimate is multiplied by total school 

enrollment (grades 9, 10, 11, 12) in the 2003–2004 academic year from the National Center for Education Statistics: 

http://nces.ed.gov/ccd/bat/index.asp (Last date accessed: 11/9/2005)

Youth projected to start smoking 

■ Source of Data: The average prevalence of smoking among adults aged 18–30 years for each state from the 

2003–2004 BRFSS was used to estimate the future prevalence of smoking during early adulthood for the birth 

cohorts currently aged 0–17 years of age. The number of people aged 0–17 years in each state was obtained 

from U.S. Census Bureau data (July 1, 2004 estimates). The following source also provides a more complete 

description of methodology: Centers for Disease Control and Prevention. Projected Smoking-Related Deaths 

Among Youth—United States. MMWR 1996;45(44):977-984. 

■ Hawaii completed 3 of 12 months of interviews in 2004; these data are not available in the aggregate 2004 dataset. 

■ Figures are rounded to the nearest thousand. 

For comparison purposes, the total for all states is presented. 

26 
Youth projected to die from smoking 

■ Source of Data: This measure is calculated from the estimates of Youth Projected to Start Smoking as well as 

estimates of premature deaths attributable to smoking among continuing smokers and among those who quit 

after age 35. The following source also provides a more complete description of methodology: Centers for 

Disease Control and Prevention. Projected Smoking-Related Deaths Among Youth—United States. MMWR

1996;45(44):977–984. 

■ Hawaii completed 3 of 12 months of interviews in 2004; these data are not available in the aggregate 2004 dataset. 

■ Figures are rounded to the nearest thousand. 

For comparison purposes, the total for all states is presented. 

Smoking Prevalence Among Adults, 2004 

Race/ethnicity 

■ Source of Data: CDC. BRFSS 2003 and 2004. Data are shown only for demographic groups with at least 50 

respondents. 

Education 

■ Source of Data: CDC. BRFSS 2004. Data on education are presented for people aged 25 years or older. 

Household income, age 

■ Source of Data: CDC. BRFSS 2004. 

For comparison purposes, the median for all states is presented. 

Note 1: A broad range of measures reflect the impact of tobacco use. Although prevalence of current cigarette smoking is 

presented, it is only one of many measures used to identify tobacco-related disparities. 

Note 2: Hawaii completed 3 of 12 months of interviews in 2004; these data are not available in the aggregate 2004 dataset. 

Secondhand Smoke Policies, Cigarette Price Per Pack, State Tax Per Pack, 

and Per Capita Cigarette Consumption 

Worksite, home 

■ Source of Data: Worksite and home data were calculated using Current Population Survey data from 2001–2002. 

■ For worksites, the data were collected from self-respondents 15 years and older who reported having a worksite 

policy stating that smoking was not allowed in indoor public or common areas and work areas. 

■ For homes, data were collected from self-respondents 15 years and older who reported having a rule that 

smoking was not allowed anywhere in their home. 

For comparison purposes, the national prevalence is presented from the Current Population Survey 2001–2002. 

Cigarette price per pack 

■ Source of data: Orzechowski W, Walker RC. Tax Burden on Tobacco, Historical Compilation. Arlington, 

Virginia, 2004; Volume 39. 

For comparison purposes, the state average for 2004 is presented. 

State tax per pack 

■ Source of Data: Centers for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation 

(STATE) System. 4th quarter, 2005 data. Available at: www.cdc.gov/tobacco/statesystem.

For comparison purposes, the state average tax for 2005 is presented. 

Per capita (adult) cigarette consumption 

■ Source of data: Orzechowski W, Walker RC. Tax Burden on Tobacco, Historical Compilation. Arlington, 

Virginia, 2004; Volume 39.

■ Cigarette consumption per capita is the quantity of cigarettes consumed by each adult aged 18 years and older in 

2004. It is measured as total tax paid sales divided by the state’s adult population aged 18 years and older using 

Census Bureau population numbers. 

For comparison purposes, the state average for 2004 is presented. 

27 
Smoking-Attributable Costs 

Smoking-attributable medical costs (total and per pack) 

■ Source of data: Centers for Disease Control and Prevention. Tobacco Control State Highlights 2002: Impact and 

Opportunity. Atlanta, GA: U.S. Department of Health and Human Services; 2002. 

■ State cost per pack accounts for direct medical expenses. Direct medical expenses are updated from 1998 to 2004 

dollars using the Medical Consumer Price Index. 

■ Total figures are rounded to the nearest million. 

For comparison purposes, the state average for 2004 is presented for both measures. 

Smoking-attributable productivity costs (total and per pack) 

■ Source of Data: Centers for Disease Control and Prevention. Tobacco Control State Highlights 2002: Impact and 

Opportunity. Atlanta, GA: U.S. Department of Health and Human Services; 2002. 

■ State cost per pack accounts for lost productivity due to premature death. Direct productivity expenses are 

updated from 1997 – 2001 average to 2004 dollars using the Medical Consumer Price Index.

■ Total figures are rounded to the nearest million. 

For comparison purposes the state average for 2004 is presented for both measures. 

Note: Smoking-attributable total costs can be calculated by simply adding smoking-attributable medical costs and smokingattributable productivity costs for each state. 

Smoking-attributable Medicaid costs [total, per pack, per capita (adult)] 

■ Source of data: Centers for Disease Control and Prevention. “Tobacco Control State Highlights 2002: Impact and 

Opportunity.” Smoking-attributable Medicaid costs are updated from 1998 to 2004 dollars, using the Medical 

Consumer Price Index. 2004 Census Bureau state population numbers for adults aged 18 years and older are used 

for per capita estimates. 

■ Total figures are rounded to the nearest million. 

For comparison purposes, the state average for 2004 is presented. 

28 
References 

1. U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the 

Surgeon General. Atlanta, GA: Centers for Disease Control and Prevention; 2004. 

2. Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, 

and economic costs—United States, 1997–2001. MMWR 2005;54:625–628. 

3. Centers for Disease Control and Prevention. Tobacco use among adults—United States, 2005. MMWR 

2006;55:1145–1148. 

4. Centers for Disease Control and Prevention. Cigarette smoking-attributable morbidity―United States, 2000. 

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Centers for Disease Control and Prevention 

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