Question

Select a personal health behavior and describe how it can impact both individual and population health, as well as the costs of health care delivery in the United States. Consider what efforts are being, or could be, made to lessen negative impacts on individuals and populations, as well as on costs.

Answer 1

Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year. In addition, smoking-related illness in the United States costs more than $300 billion a year, including nearly $170 billion in direct medical care for adults and $156 billion in lost productivity.

In 2018, an estimated 13.7% (34.2 million) of U.S. adults were current cigarette smokers. Of these, 74.6% smoked every day.

Percentage of adults aged ≥18 years who reported cigarette use “every day” or “some days,” by selected characteristics — National Health Interview Survey, United States, 2018

The cigarette smoking rates of adults within the United States, organized by sex.

By Sex	Percentage
Male	15.6%
Female	12.0%

The cigarette smoking rates of adults within the United States, organized by age.

By Age Group (yrs)	Percentage
18–24	7.8%
25–44	16.5%
45–64	16.3%
≥65	8.4%

Cigarette smoking is the leading preventable cause of death in the United States.

• Cigarette smoking causes more than 480,000 deaths each year in the United States. This is nearly one in five deaths.
• Smoking causes more deaths each year than the following causes combined:
  • Human immunodeficiency virus (HIV)
  • Illegal drug use
  • Alcohol use
  • Motor vehicle injuries
  • Firearm-related incidents

• More than 10 times as many U.S. citizens have died prematurely from cigarette smoking than have died in all the wars fought by the United States.
• Smoking causes about 90% (or 9 out of 10) of all lung cancer deaths. More women die from lung cancer each year than from breast cancer.
• Smoking causes about 80% (or 8 out of 10) of all deaths from chronic obstructive pulmonary disease (COPD).
• Cigarette smoking increases risk for death from all causes in men and women.
• The risk of dying from cigarette smoking has increased over the last 50 years in the U.S.

Smoking and Increased Health Risks

Smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer.

• Estimates show smoking increases the risk:
  • For coronary heart disease by 2 to 4 times
  • For stroke by 2 to 4 times
  • Of men developing lung cancer by 25 times
  • Of women developing lung cancer by 25.7 times
• Smoking causes diminished overall health, increased absenteeism from work, and increased health care utilization and cost.

Smoking and Cardiovascular Disease

Smokers are at greater risk for diseases that affect the heart and blood vessels (cardiovascular disease).

• Smoking causes stroke and coronary heart disease, which are among the leading causes of death in the United States.
• Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease.
• Smoking damages blood vessels and can make them thicken and grow narrower. This makes your heart beat faster and your blood pressure go up. Clots can also form.
• A stroke occurs when:
  • A clot blocks the blood flow to part of your brain;
  • A blood vessel in or around your brain bursts.
• Blockages caused by smoking can also reduce blood flow to your legs and skin.

Smoking and Respiratory Disease

Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs.

• Lung diseases caused by smoking include COPD, which includes emphysema and chronic bronchitis.
• Cigarette smoking causes most cases of lung cancer.
• If you have asthma, tobacco smoke can trigger an attack or make an attack worse.
• Smokers are 12 to 13 times more likely to die from COPD than nonsmokers.

Smoking and Other Health Risks

Smoking harms nearly every organ of the body and affects a person’s overall health.

• Smoking can make it harder for a woman to become pregnant. It can also affect her baby’s health before and after birth. Smoking increases risks for:
  • Preterm (early) delivery
  • Stillbirth (death of the baby before birth)
  • Low birth weight
  • Sudden infant death syndrome (known as SIDS or crib death)
  • Ectopic pregnancy
  • Orofacial clefts in infants

• Smoking can also affect men’s sperm, which can reduce fertility and also increase risks for birth defects and miscarriage.
• Smoking can affect bone health.
  • Women past childbearing years who smoke have weaker bones than women who never smoked. They are also at greater risk for broken bones.
• Smoking affects the health of your teeth and gums and can cause tooth loss.
• Smoking can increase your risk for cataracts (clouding of the eye’s lens that makes it hard for you to see). It can also cause age-related macular degeneration (AMD). AMD is damage to a small spot near the center of the retina, the part of the eye needed for central vision.
• Smoking is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30–40% higher for active smokers than nonsmokers.
• Smoking causes general adverse effects on the body, including inflammation and decreased immune function.
• Smoking is a cause of rheumatoid arthritis.

Quitting and Reduced Risks

• Quitting smoking cuts cardiovascular risks. Just 1 year after quitting smoking, your risk for a heart attack drops sharply.
• Within 2 to 5 years after quitting smoking, your risk for stroke may reduce to about that of a nonsmoker’s.
• If you quit smoking, your risks for cancers of the mouth, throat, esophagus, and bladder drop by half within 5 years.
• Ten years after you quit smoking, your risk for dying from lung cancer drops by half.

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