The New England Journal of Medicine recently published a peer reviewed article from our tobacco control colleague, Dr. Israel Agaku, announcing some partially good news: in 2024, cigarette smoking among adults in the United States fell to 9.9%. This is a significant improvement from the 42.4% prevalence rate in 1965 and the 23.3% prevalence rate in 2000 when ASH started to engage in the first global public health treaty – the WHO FCTC.
The 9.9% cigarette smoking prevalence rate is progress but not the complete story. Unfortunately, unless we do more, we are still losing the battle for health against the commercial tobacco and nicotine industry.
It is now well established that cigarettes are the only consumer product that kills when used as intended.
This means that if today, over 9% of the U.S. population smokes cigarettes, between 4-5% of the U.S. population could die because of tobacco. Using a conservative number, that would mean 13.8 million Americans who are currently smoking could die because of tobacco related diseases. And many more Americans will see their quality of life reduced because of these products.
In addition, while there has been a drop in cigarette consumption, the overall consumption of other tobacco products remains at 18%, and even if some of these products may be less harmful than cigarettes, they are not harmless and still addictive. How can any of this be acceptable?
At ASH, we are privileged to work with colleagues in the US and around the world on the implementation of evidence-based measures to reduce tobacco use, like smoke-free environments, advertising bans, health warnings, and increases in tobacco taxes among others. But despite these advances, tobacco use remains the leading cause of preventable death in the United States, responsible for more than 480,000 deaths annually—nearly one in five deaths, according to the Centers for Disease Control and Prevention (CDC). And tobacco use still causes more deaths each year than alcohol, illegal drugs, car accidents, HIV/AIDS, and firearms combined.
Today in the United States, everyone is NOT equally protected from the tobacco industry.
All U.S. states do NOT have comprehensive smoke-free air policies, and in many jurisdictions, tobacco products are cheap, making them extremely affordable to youth who will become addicted before the age of 18. And Americans are less protected than citizens in other countries where tobacco products are sold in plain packaging with large pictorial health warnings.
Furthermore, as Dr. Agaku points out, not only are we far from reaching the U.S. goal of a prevalence at 6.1% or less, but there are also equity challenges when it comes to protecting Americans from tobacco and nicotine addiction. Vulnerable populations are disproportionately impacted by tobacco use; there are much higher prevalence rates among low income and less educated segments of the population.
ASH believes that in addition to accelerating the tobacco control measures that are recommended by the World Health Organization and the WHO Framework Convention on Tobacco Control, elimination of commercial tobacco sales is the next frontier to equitably protect the right to health of all Americans. There is no silver bullet policy that will help solve this major public health catastrophe in the United States. As the 2024 U.S. Surgeon General’s Report concluded, “The time is now to accelerate a whole-of-society effort to reach the tobacco endgame: a world in which zero lives are harmed by or lost to tobacco use.”
ASH has been dedicated to this vision and will continue to do so until no one has to die or be harmed by tobacco products.
Please, join us in this fight for the health of all Americans, no matter where they live. It is time to end this completely preventable epidemic that kills so many Americans every year.
