Gary A. Giovino, Ph. D., M. S

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Background and Overview

Gary A. Giovino, Ph.D., M.S.


Tobacco use, primarily in the form of cigarettes, has caused more than 14 million premature deaths in the United States since 1964.1,2 Tobacco use remains the single leading preventable cause of death in the United States, with at least 8.6 million Americans living with serious disease(s) caused by their smoking, 400,000 current and former smokers dying annually from smoking-attributable diseases, and 38,000 nonsmokers dying annually because of exposure to tobacco smoke pollution.2–4 Peto and colleagues5 estimate that one-half of all smokers, especially those who began as teens, can expect to die of tobacco use. Of these, approximately one-half will die in middle age, losing on average 20–25 years of life expectancy.

Overall U.S. consumption of tobacco products has been declining for several decades (figure 1). 6–8 From 1995 through 2004, consumption (in pounds) declined for cigarettes (by 24%), smoking tobacco (i.e., pipe or roll-your-own) (by 23%), and chewing tobacco (by 64%); however, consumption increased for cigars (by 78%) and snuff (by 13%).8 The prevalence of cigarette smoking among U.S. adults has decreased substantially, from 42.4% in 1965 to 20.9% in 2004 (figure 2).9–11 Consumption of cigarettes has been increasing in developing nations, while decreasing in the United States and most high income countries.12

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