Tobacco in the United States

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Tobacco has a long cultural, economic, and social impact on the United States. Tobacco cultivation in Jamestown, Virginia, in 1610 lead to the expansion of British colonialism in the Southern United States.^[1] As the demand for Tobacco grew in Europe, further colonization in British America and Tobacco production saw a parallel increase.^[2] Tobacco use became normalized in American society and was heavily consumed before and after American independence.

Tobacco distribution is measured in the United States using the term, "tobacco outlet density."^[3] An estimated 34.3 million people, or 14% of all adults (aged 18 years or older), in the United States smoked cigarettes in 2015. By state, in 2015, smoking prevalence ranged from between 9.1% and 12.8% in Utah to between 23.7% and 27.4% in West Virginia. By region, in 2015, smoking prevalence was highest in the Midwest (18.7%) and South (15.3%) and lowest in the West (12.4%). Men tend to smoke more than women. In 2015, 16.7% of men smoked compared to 13.6% of women.^[4] In 2018, 13.7% of U.S. adults were smokers.^[5]

Cigarette smoking is the leading cause of preventable death in the United States, accounting for approximately 443,000 deaths, or 1 of every 5 deaths, in the United States each year.^[6] Cigarette smoking alone has cost the United States $96 billion in direct medical expenses and $97 billion in lost productivity per year or an average of $4,260 per adult smoker.

In 1964 the Surgeon General of the United States published the Smoking and Health report, which identified smoking as the cause of many health problems.^[7] The report greatly changed the public perception of tobacco use from being safe to hazardous.^[7]