The Health and Economic Burden of Tobacco Use
Cigarette Smoking-Attributable Burden of Cancer
One-fifth of US adults are using tobacco products and most of them smoke cigarettes. Cancer is the second leading cause of death in the US1 and about 29% of all cancer deaths in the US are attributable to cigarette smoking, making it the single most preventable cause of cancer death and associated economic loss.2 In 2021, an estimated 309,170 deaths were attributed to smoking-related cancers, 207,505 (67.1%) of which were due to lung, bronchus and tracheal cancers only (Maps 3.3.1 and 3.3.2).
Cancers caused by cigarette smoking include cancers of the oral cavity, pharynx, esophagus, stomach, colon and rectum, liver, pancreas, nasal cavity and paranasal sinuses, larynx, lung, kidney and renal pelvis, ureter, urinary bladder, cervix, ovary (mucinous subtype), and myeloid leukemia.3 Smoking cessation significantly reduces the excess risk of cancer mortality (Figures 3.3.5 and 3.3.6).
Smoking-related cancers impose a heavy burden on the nation’s healthcare system and expenditure. In 2014, an estimated 461,295 hospitalizations were attributed to smoking-related cancers causing excess healthcare cost of $8.2 billion accounting for 45% of total cancer hospitalizations and associated costs.4 Continued smoking by patients with cancer tends to increase the risk of first-line cancer treatment failure implying significant incremental costs for subsequent treatment.5 In 2019, cigarette smoking-associated cancer deaths accounted for 2.2 million person-years of life lost among 25-79-year-olds and lost earnings of $20.9 billion (Maps 3.3.3 and 3.3.4).6
Cancers caused by cigarette smoking include cancers of the oral cavity, pharynx, esophagus, stomach, colon and rectum, liver, pancreas, nasal cavity and paranasal sinuses, larynx, lung, kidney and renal pelvis, ureter, urinary bladder, cervix, ovary (mucinous subtype), and myeloid leukemia.3 Smoking cessation significantly reduces the excess risk of cancer mortality (Figures 3.3.5 and 3.3.6).
Smoking-related cancers impose a heavy burden on the nation’s healthcare system and expenditure. In 2014, an estimated 461,295 hospitalizations were attributed to smoking-related cancers causing excess healthcare cost of $8.2 billion accounting for 45% of total cancer hospitalizations and associated costs.4 Continued smoking by patients with cancer tends to increase the risk of first-line cancer treatment failure implying significant incremental costs for subsequent treatment.5 In 2019, cigarette smoking-associated cancer deaths accounted for 2.2 million person-years of life lost among 25-79-year-olds and lost earnings of $20.9 billion (Maps 3.3.3 and 3.3.4).6
Sources
- Deaths: Leading Causes for 2021. National Vital Statistics Reports. Vol.73, No.4. April 8, 2024. Available from https://www.cdc.gov/nchs/data/nvsr/nvsr73/nvsr73-04.pdf accessed May 8, 2024.
- Islami F, Marlow EC, Thomson B, McCullough ML, Rumgay H, Gapstur SM, Patel AV, Soerjomataram I, Jemal A. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States, 2019. CA Cancer J Clin. 2024 Sep-Oct;74(5):405-432.
- Secretan B, Straif K, Baan R, Grosse Y, Ghissassi FE, Bouvard V, et al. A revie of human carcinogens—Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. The Lancet Oncology. 2009; 10(11):P1033-P1034.
- Tai EW, Guy GP Jr, Steele CB, Henley SJ, Gallaway MS, Richardson LC. Cost of Tobacco-related Cancer Hospitalizations in the U.S., 2014. American Journal of Preventive Medicine 2018 Apr; 54(4): 591–595.
- Warren GW, Cartmell KB, Garrett-Mayer E, Salloum RG, Cummings KM. Attributable Failure of First-line Cancer Treatment and Incremental Costs Associated With Smoking by Patients With Cancer. JAMA Network Open 2019 Apr 5;2(4):e191703.
- Islami F, Marlow EC, Zhao J, et al. Person-years of life lost and lost earnings from cigarette smoking-attributable cancer deaths, United States, 2019. International Journal of Cancer 2022; 1-12.