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Patterns of tobacco use

Nancy A Rigotti, MD
Section Editor
James K Stoller, MD, MS
Deputy Editor
Judith A Melin, MA, MD, FACP


Cigarette smoking is the leading preventable cause of mortality in the United States and worldwide. Most smoking-related mortality is due to atherosclerotic cardiovascular disease (CVD), lung cancer, and chronic obstructive pulmonary disease (COPD) [1-3]. Tobacco use also increases the risk of many other acute and chronic diseases, including cancers at many sites other than the lung (table 1). Smoking cessation is associated with clear health benefits and should always be a major health care goal [4].

Tobacco products are used by 28 percent of United States adults, according to the initial report (2013 to 2014) of a large longitudinal United States study involving over 45,000 adults and youth. Cigarettes remain the most common tobacco product used in the United States. However, an increasing proportion of tobacco users are using multiple products, most often cigarettes and electronic cigarettes (e-cigarettes) [5].

Screening all patients for tobacco use and providing all smokers a brief smoking cessation intervention are among the most cost-saving clinical preventive services [6]. (See "Overview of smoking cessation management in adults".)

Usage of non-cigarette forms of tobacco is increasing in the United States, and 40 percent of users of tobacco use tobacco in more than one form [5].

The prevalence and patterns of tobacco use in adults are reviewed here. Patterns of smoking in children and adolescents are presented separately. (See "Prevention of smoking initiation in children and adolescents", section on 'Epidemiology'.)

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Literature review current through: Nov 2017. | This topic last updated: Aug 22, 2017.
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