Smoking-Related Cancer Deaths by State, 2020

April 4, 2024

Cigarette smoking is responsible for 480,000 premature deaths[i] and more than $240 billion in U.S. health care spending annually and nearly $185 billion in lost productivity[ii],[iii] These numbers do not take into account cancer deaths caused by secondhand smoke which causes nearly 42,000 deaths among people who do not smoke, including up to 7,300 lung cancer deaths.[iv],[v]  Tobacco use causes about one-third of cancer deaths in the nation overall, but the burden varies by state.

The 15 states with the greatest proportion of smoking related cancer deaths in 2020 - Alabama, Arkansas, Indiana, Kentucky, Louisiana, Maine, Michigan, Mississippi, Missouri, Ohio, Oklahoma, North Carolina, South Carolina, Tennessee, and West Virginia – also have historically higher tobacco use rates, excluding Maine. West Virginia had the greatest proportion of smoking related cancer deaths – 37.8 percent or or 1,339 adults – caused by cigarette smoking.  

[i] U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

[ii] Xu X, Shrestha SS, Trivers KF, Neff L, Armour BS, King BA. U.S. Healthcare Spending Attributable to Cigarette Smoking in 2014. Preventive Medicine 2021 (150): 106529.

[iii] Shrestha SS, Ghimire R, Wang X, Trivers KF, Homa DM, Armour BS. Cost of Cigarette Smoking Attributable Productivity Losses, United States, 2018. Forthcoming at Am J Prev Med 2022.

[iv] HHS, 2014.

[v] American Nonsmokers' Rights (ANR) Foundation. BRIDGING THE GAP: Status of Smokefree Air in the United States 2022, retrieved from