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www http://www.cdc.gov/mmwr

www http://www.cdc.gov/vitalsigns

www http://www.cdc.gov/tobacco

&

40%

4 out of 10 nonsmokers 

(88 million people) are exposed 

to secondhand smoke.

54%

More than 1 out of 2 kids 

(aged 3–11 years) are exposed 

to secondhand smoke. 

Tobacco 

Use

Smoking

Secondhand Smoke

46.6M

About 1 in 5 adults smoke.

Tobacco use is the leading preventable cause 

of death, disease, and disability in the US. 

Each year, around 443,000 people die from 

smoking or exposure to secondhand smoke, 

and another 8.6 million suffer from a serious 

illness from smoking. Two new CDC reports 

indicate that, despite the dangers of tobacco 

use, about 46.6 million adults in the US 

smoke, and 88 million nonsmokers are 

exposed to secondhand smoke.

Want to learn more? Visit—

National Center for Chronic Disease Prevention and Health Promotion 

Office of Smoking and Health

September 2010
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Smoking

The decline in smoking has stalled in 

the past five years.

◊ In 2005, about 20.9% of adults smoked 

cigarettes. In 2009 about 20.6% smoked.

 Some groups smoke more.

◊ More men (nearly 24%) than women (about 

18%) smoke.

◊ Nearly 30% of multiracial adults and 23% 

of American Indian/Alaska Native adults 

smoke. 

◊ Smoking rates are higher among people 

with a lower education level. For example, 

nearly 1 in 2 of all US adults who have a 

GED smoke; only around 6% of people with 

a graduate degree smoke. 

◊ About 31% of people who live below the 

poverty level smoke.

Although the number of teenagers in 

the US who smoke continues to drop 

year after year, progress is slowing.

◊ In 1997, about 36% of high school students 

smoked cigarettes. 

◊ Between 1997–2003, the rates of smoking 

among high school students dropped from 

36% to about 22%. However, between 2003 

to 2009, declines slowed from 22% to 20%. 

Millions of people in the US 

still smoke

Problem

The slowing decline in teen cigarette use 

suggests that smoking and all the health 

problems related to smoking will continue 

as teens become adults.

◊ In 2009, nearly 1 in 5 high school students 

(20%) still smoked cigarettes. 

◊ Monitoring teen smoking is important 

because most adult smokers (about 80%) 

began smoking before the age of 18.

States and regions in the US have 

different smoking rates.

◊ Utah has the lowest smoking rate; fewer than 

10% of adults in Utah smoke cigarettes.

◊ Kentucky and West Virginia have the highest 

smoking rates; nearly 26% of adults smoke in 

both states.

◊ Fewer people smoke in the West (about 16%), 

and more people smoke in the Southeast 

(about 22%) and Midwest (about 23%).
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Lung

Leukemia

Stomach

Pancreas

Kidney

Colon

Cervix

Bladder

Stroke

Blindness

Gum infection

Aortic rupture

Heart disease

Pneumonia

Hardening of the arteries

Chronic lung disease

& asthma

Hip fracture

Reduced fertility

Head or Neck

Cancers Chronic Diseases

Risks from Smoking

Smoking in the US needs to be reduced.

◊ About 1 in 2 adults who continue to smoke 

cigarettes will die from smoking-related 

causes.

◊ Health reform is expected to help increase 

smokers’ access to services and treatments 

that help people quit. This could help more 

smokers quit and may result in fewer adult 

smokers in the US. 

◊ Medicare now covers support for quitting 

services for smokers.

◊ By 2015, an estimated 5 million fewer people 

would smoke if all states funded their tobacco 

control programs at CDC-recommended 

levels. States such as Maine, New York, 

and Washington have recently seen youth 

smoking go down 45% to 60% with sustained 

comprehensive statewide programs.

Smoking can damage every part of the body
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Gender

Men

24%

Women

18%

Education

Less than

High School

26%

High School

graduate

25%

College

graduate

11%

Postgraduate

6%

Poverty level

At/Above

20%

Below

31%

10%

5%

15%

20%

25%

30%

Smoking

Some groups of people in the 

US smoke more than others.

Problem

Current smoking percentages by group
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Alabama

Arizona

Arkansas

California Colorado

Connecticut

Florida

Georgia

Illinois Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Michigan

Minnesota

Mississippi

Missouri

Nebraska

New

Hampshire New York

North Carolina

North

Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

South

Carolina

South

Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West

Virginia

Wisconsin Idaho

Montana

Nevada

New Mexico

Wyoming

Hawaii

Alaska

Alabama

Arizona

Arkansas

California Colorado

Connecticut

Florida

Georgia

Illinois Indiana

Iowa

Kansas

Kentucky

Louisiana

Maine

Michigan

Minnesota

Mississippi

Missouri

Nebraska

New

Hampshire

New York

North Carolina

North

Dakota

Ohio

Oklahoma

Oregon

Pennsylvania

South

Carolina

South

Dakota

Tennessee

Texas

Utah

Vermont

Virginia

Washington

West

Virginia

Wisconsin Idaho

Montana

Nevada

New Mexico

Wyoming

Hawaii

Alaska

US State Info

10–less than 13%

13–16%

16+–19%

19+–22%

23–26%

21 states have less comprehensive laws

or no restrictions

5 states ban smoking in two of these three 

types of locations

25 states ban smoking in worksites,

restaurants, and bars 

Smoking

Adult smoking rates vary across the US, but the states with the most 

smokers are in the Midwest and Southeast regions.

No-Smoking Laws

Smoke-free indoor air laws for bars, restaurants, 

and private worksites vary from state to state.
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Secondhand Smoke

Secondhand smoke contains toxic 

chemicals and causes disease.

◊ Secondhand smoke contains toxic and 

cancer-causing chemicals.

◊ Secondhand smoke causes heart disease 

and lung cancer in nonsmoking adults.

◊ Secondhand smoke causes sudden infant 

death syndrome (SIDS) and a number of 

health conditions in children, including 

middle ear infections, more severe asthma, 

and respiratory infections.

About 4 in 10 nonsmokers in the US 

(40%, or 88 million people) continue to 

be exposed to secondhand smoke. 

◊ Almost everyone who lives with somebody 

who smokes indoors is exposed to secondhand 

smoke. Children and teens are more likely 

than adults to live in homes where someone 

smokes indoors. 

◊ About 54% of children (aged 3–11 years) are 

exposed to secondhand smoke. Children 

are most heavily exposed at home. 

◊ About 47% of youth (aged 12–19 years) are 

exposed to secondhand smoke.

◊ About 56% of black nonsmokers are exposed 

to secondhand smoke compared with about 

40% of white nonsmokers and 29% of 

Mexican-American nonsmokers.

Levels of secondhand smoke exposure 

in the US have greatly dropped during 

the last 20 years. 

◊ Nearly 88% of nonsmokers in the US were 

exposed to secondhand smoke during 

1988–1991.

◊ That number greatly dropped to about 

53% by 1999–2000.

◊ About 40% of US nonsmokers were exposed 

to secondhand smoke during 2007–2008. 

Even brief exposure to secondhand 

smoke can be harmful.

Problem
Risks from 

Secondhand 

Smoke

7

Americans 

Aged 3+

25%

35%

45%

55%

65%

Black White Children Adults Below At/Above

Aged 3-11 Aged 20+ Poverty Level

Ammonia

Used in

household cleaners

Toluene

Found in

paint thinners

Cadmium

Used in making

batteries

Hydrogen Cyanide

Used in

chemical weapons

Benzene

Found in gasoline

Smoke-free laws that completely ban 

smoking in indoor workplaces and 

public places are needed to protect 

nonsmokers from secondhand smoke.

◊ The only way to fully protect nonsmokers is 

to ban smoking in indoor places.

◊ About 47% of Americans live under state or 

local laws that make workplaces, restaurants, 

and bars completely smoke-free. That means 

that more than 1 in 2 Americans still live in 

areas where they are not fully protected by 

smoke-free laws.

◊ Physicians need to educate patients and 

parents about secondhand smoke dangers.

Exposure to secondhand smoke

by group

Millions of people in the US are exposed to secondhand 

smoke in homes, workplaces, public places, and vehicles. 

Black Americans, children (aged 3–11 years), and people 

living below the poverty level are heavily exposed.

Some of the toxic 

chemicals in smoke
CS216570-B

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What Can Be Done

Smokers and smokeless tobacco users 

can

◊ Quit. Ask your doctor for help in making a 

plan to quit or call 1-800-QUIT-NOW 

(800-784-8669; TTY 800-332-8615).

◊ Never smoke in your home, vehicles, or 

around nonsmokers, especially children, 

pregnant women, and persons with heart 

disease or respiratory conditions.

Parents and nonsmokers can

◊ Quit if you smoke. Children of parents who 

smoke are twice as likely to become smokers.

◊ If you can’t stop yet, never smoke or allow 

others to smoke in your home, vehicles, or 

around your children.

◊ Teach your children about the health risks of 

smoking and secondhand smoke.

◊ Not start, if you aren’t already using tobacco.

Employers can

◊ Establish a policy banning the use of any 

tobacco product indoors or outdoors on 

company property by anyone at any time.

◊ Provide all employees and their dependents 

with health insurance that covers support for 

quitting without copayment.

Retailers can

◊ Learn the new FDA restrictions on youth 

access to tobacco products and tobacco 

marketing to youth, and closely follow them.

◊ Check the photo ID of any customer trying to 

buy tobacco products who appears to be 26 

years of age or younger, and never sell any 

tobacco product to customers younger than 

18 years of age.

Doctors, nurses, and other health care 

providers can

◊ Ask all patients and parents of pediatric 

patients whether they use tobacco, and advise 

those who do to quit.

◊ Advise everybody to make their homes and 

vehicles 100% smoke-free 24/7.

◊ Advise nonsmokers to avoid being exposed 

to secondhand smoke, especially if they are 

pregnant or have heart disease or respiratory 

conditions.

State and community leaders can

◊ Consider the World Health Organization’s 

MPOWER strategies in efforts to prevent 

and control tobacco use. 

Monitor tobacco use and prevention policies

Protect people from tobacco smoke

Offer help to quit

Warn about the dangers of tobacco use

Enforce bans on tobacco advertising

Raise taxes on tobacco

◊ Establish comprehensive tobacco control 

programs funded at CDC-recommended 

levels and sustain them over time.

◊ Reduce tobacco use by making tobacco 

products less accessible, affordable, desirable, 

and accepted.

www http://www.cdc.gov/mmwr

For more information, please contact 

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: http://www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: 09/07/2010