National Institutes of Health State-of-the-Science Conference Statement: Tobacco Use: Prevention, Cessation, and Control

National Institutes of Health (NIH) consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of 1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), 2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session, 3) questions and statements from conference attendees during open discussion periods that are part of the public session, and 4) closed deliberations by the panel during the remainder of the second day and the morning of the third. This statement is an independent report of the panel and is not a policy statement of the NIH or the federal government.

The statement reflects the panel's assessment of medical knowledge available at the time the statement was written. Thus, it provides a “snapshot in time” of the state of knowledge on the conference topic. When reading the statement, keep in mind that new knowledge is inevitably accumulating through medical research.

Tobacco use is the leading preventable cause of premature death in the United States. Each year, more than 440 000 Americans die of tobacco-related disease, accounting for 1 in every 5 deaths. Cigarette smoking is responsible for more than 30% of cancer deaths annually in the United States. Smoking also contributes substantially to deaths from heart disease, stroke, and chronic obstructive pulmonary disease. According to current estimates, 21% of American adults (44.5 million individuals) and 22% of American high school students (3.75 million individuals) smoke. Cigarettes are the predominant form of tobacco that Americans consume, but tobacco consumption also includes smokeless tobacco, cigars, and pipes. In addition to the toll in human lives, tobacco use is an enormous economic burden on society. From 1995 to 1999, estimated annual smoking-attributable economic costs …