Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004

During 2000–2004 approximately 443,000 people in the United States died prematurely from cigarette smoking or exposure to secondhand smoke annually.
This figure is higher than the average annual estimate of approximately 438,000 deaths during 1997–2001 and is predominantly due to population growth. Although deaths from cigarette smoking have not increased significantly they remain high.
Among adults, 160,848 (41%) of deaths were attributed to cancer, 128,497 (32.7%) to cardiovascular diseases, and 103,338 (26.3%) to respiratory diseases.
The three leading specific causes of smoking-attributable death were lung cancer at 128,922, ischemic heart disease at 126,005, and chronic obstructive pulmonary disease (COPD) at 92,915.
An estimated 49,400 lung cancer and heart disease deaths annually were attributable to exposure to secondhand smoke.
Smoking resulted in an estimated annual average of 270,000 deaths among males and 174,000 among females in the United States.
For females, smoking during pregnancy resulted in an estimated 776 infant deaths annually during 2000–2004.
The average annual smoking-attributable mortality estimates also include 736 deaths from residential fires caused by smoking.

On average, during 2000–2004 smoking accounted for an estimated 3.1 million years of potential life lost for males and 2 million years of potential life lost for females annually, excluding deaths from residential fires and adult deaths from secondhand smoke.

During 2000–2004 estimates for average annual smoking-attributable productivity losses were approximately $97 billion ($64.2 billion for men and $32.6 billion for women) during this period.
During 2001–2004 average annual smoking-attributable health care expenditures were approximately $96 billion.
Accounting for direct health care expenditures ($96 billion) and productivity losses ($97 billion), the total economic burden of smoking is approximately $193 billion per year.
- In contrast, investments in comprehensive, state-based tobacco prevention and control programs in fiscal year 2007 were approximately 325-fold smaller.
- Because investments in evidence-based prevention programs have produced larger and faster reductions in cigarette consumption, increased state investments to the levels recommended by CDC are needed to achieve greater health impacts.