CDC grand rounds: current opportunities in tobacco control.

Tobacco use is the world's leading single preventable cause of death. Worldwide tobacco-related deaths now exceed 5 million a year. Left unchecked, the number is expected to exceed 8 million a year by 2030, and 80% of those tobacco-related deaths will occur in low- and middle-income countries. In the United States, tobacco use is the single leading preventable cause of disease, disability, and death. Each year, 443,000 U.S. residents die from cigarette smoking and exposure to secondhand smoke, and another 8.6 million have a serious illness caused by smoking. In 2008, 20.6% (approximately 46 million) of U.S. adults were current smokers. Smoking costs the United States $96 billion in medical costs and $97 billion in lost productivity annually. A particular concern is that progress in reducing smoking rates among young persons and adults has stalled. After a substantial decline from 1997 (36.4%) to 2003 (21.9%), the decline in smoking rates among high school students slowed and remained relatively unchanged from 2003 (21.9%) to 2007 (20.0%). Adult smoking prevalence declined steadily from 1965 (42.4%) through the 1980s; however, the decline in smoking rates among adults began to slow in the 1990s and remained relatively unchanged from 2004 (20.9%) to 2008 (20.6%). By achieving a modest decline in smoking prevalence worldwide (from 25% to 20%) through further use of tobacco control measures, 100 million deaths can be prevented by 2020.