According to the 2004 National Survey on Drug Use and Health, an estimated 70.3 million Americans age 12 or older reported current use of tobacco — 59.9 million (24.9 percent of the population) were current cigarette smokers, 13.7 million (5.7 percent) smoked cigars, 1.8 million (0.8 percent) smoked pipes, and 7.2 million (3.0 percent) used smokeless tobacco, confirming that tobacco is one of the most widely abused substances in the United States1. While these numbers are still unacceptably high, they represent a decrease of almost 50 percent since peak use in 19652.
NIDA’s 2005 Monitoring the Future Survey of 8th, 10th, and 12th graders, used to track drug use patterns and attitudes, has also shown a striking decrease in smoking trends among the Nation’s youth. The latest results indicate that about 9 percent of 8th graders, 15 percent of 10th-graders, and 23 percent of 12th graders had used cigarettes in the 30 days prior to the survey3. Despite cigarette use being at the lowest levels of the survey since a peak in the mid-1990s, the past few years indicate a clear slowing of this decline. And while perceived risk and disapproval of smoking had been on the rise, recent years have shown the rate of change to be dwindling. In fact, current use, perceived risk, and disapproval leveled off among 8th graders in 2005, suggesting that renewed efforts are needed to ensure that teens understand the harmful consequences of smoking.
Moreover, the declining prevalence of cigarette smoking among the general U.S. population is not reflected in patients with mental illnesses. For them, it remains substantially higher, with the incidence of smoking in patients suffering from post-traumatic stress disorder, bipolar disorder, major depression, and other mental illness twofold to fourfold higher than the general population, and smoking incidence among people with schizophrenia as high as 90 percent.
Tobacco use is the leading preventable cause of death in the United States. The impact of tobacco use in terms of morbidity and mortality costs to society is staggering. Economically, more than $75 billion of total U.S. healthcare costs each year is attributable directly to smoking. However, this cost is well below the total cost to society because it does not include burn care from smoking-related fires, perinatal care for low birth-weight infants of mothers who smoke, and medical care costs associated with disease caused by secondhand smoke. In addition to healthcare costs, the costs of lost productivity due to smoking effects are estimated at $82 billion per year, bringing a conservative estimate of the economic burden of smoking to more than $150 billion per year.
Nicotine addiction
Alcohol dependence
Drug addiction
Cocaine dependence
Opioid abuse and dependence
Inhalant use disorder
Metabolic syndrome
Alcoholism