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Washington Value:
Percentage of women ages 18-44 who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days
Washington Rank:
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Percentage of women ages 18-44 who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days
US Value: 12.1%
Top State(s): California: 5.9%
Bottom State(s): West Virginia: 26.2%
Definition: Percentage of women ages 18-44 who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days
Data Source and Years(s): CDC, Behavioral Risk Factor Surveillance System, 2020-2021
Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Smoking cigarettes has an adverse impact on overall health. As the leading cause of preventable death in the United States, cigarette smoking is responsible for the deaths of more than 480,000 Americans every year, including 201,770 women. One study estimated the probability of female smokers living to age 80 to be 38%, compared with 70% for female nonsmokers. Smoking damages nearly every organ and is associated with heart disease and stroke, lung disease and chronic obstructive pulmonary disease (COPD), diabetes, rheumatoid arthritis, multiple types of cancer and more.
Non-smokers are also affected by smoking. Secondhand smoke exposure can lead to sudden infant death syndrome (SIDS), respiratory and ear infections in infants and children and heart disease and lung cancer in adults. Exposure to secondhand smoke is estimated to cause about 41,000 deaths among U.S. adults every year.
Smoking may affect reproductive health. Women who smoke are more likely to have reduced fertility, go through menopause at a younger age and experience adverse birth outcomes, including miscarriage and SIDS. Infants born to women who smoked during pregnancy have a higher risk of preterm birth, low birth weight and issues with lung and brain development that can last into childhood or adulthood.
In recent years, there has been an increase in the popularity of e-cigarettes, especially among youth.
Smoking is estimated to cost the U.S. more than $600 billion dollars annually, including more than $240 billion in healthcare spending and nearly $185 billion from lost productivity due to smoking-related illness.
According to America’s Health Rankings data, the prevalence of smoking is higher among:
Quitting smoking can have profound benefits on current and long-term health, even among heavy and lifelong smokers:
A variety of interventions are effective for smoking prevention and cessation. States that have expanded Medicaid coverage for tobacco cessation programs have shown declines in smoking prevalence. This is a particularly important area for improvement because of the high prevalence of smokers enrolled in Medicaid. Excise taxes and increased prices have been effective in preventing nonsmokers from starting, increasing cessation and decreasing smoking-related health problems. The American Lung Association highlights other policies that support measures to eliminate the tobacco industry’s targeting of women, communities of color, and the LGBTQ community.
Additional smoking prevention and cessation resources include:
Healthy People 2030 has multiple objectives regarding adult tobacco use, including:
Chaloupka, Frank J., Kurt Straif, and Maria E. Leon. 2011. “Effectiveness of Tax and Price Policies in Tobacco Control.” Tobacco Control 20 (3): 235–38. https://doi.org/10.1136/tc.2010.039982.
DiGiulio, Anne, Zach Jump, Stephen Babb, Anna Schecter, Kisha-Ann S. Williams, Debbie Yembra, and Brian S. Armour. 2020. “State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2008–2018.” MMWR. Morbidity and Mortality Weekly Report 69 (6): 155–60. https://doi.org/10.15585/mmwr.mm6906a2.
Gallaway, M. Shayne, S. Jane Henley, C. Brooke Steele, Behnoosh Momin, Ahmed Jamal, Katrina F. Trivers, Cheryll C. Thomas, Simple D. Singh, and Sherri L. Stewart. 2018. “Surveillance for Cancers Associated with Tobacco Use — United States, 2010–2014.” MMWR. Surveillance Summaries 67 (12): 1–42. https://doi.org/10.15585/mmwr.ss6712a1.
Jha, Prabhat, Chinthanie Ramasundarahettige, Victoria Landsman, Brian Rostron, Michael Thun, Robert N. Anderson, Tim McAfee, and Richard Peto. 2013. “21st-Century Hazards of Smoking and Benefits of Cessation in the United States.” New England Journal of Medicine 368 (4): 341–50. https://doi.org/10.1056/NEJMsa1211128.
Moore, Elizabeth, Kaitlin Blatt, Aimin Chen, James Van Hook, and Emily A. DeFranco. 2016. “Relationship of Trimester-Specific Smoking Patterns and Risk of Preterm Birth.” American Journal of Obstetrics and Gynecology 215 (1): 109.e1-109.e6. https://doi.org/10.1016/j.ajog.2016.01.167.
Räisänen, Sari, Ulla Sankilampi, Mika Gissler, Michael R. Kramer, Tuovi Hakulinen-Viitanen, Juho Saari, and Seppo Heinonen. 2014. “Smoking Cessation in the First Trimester Reduces Most Obstetric Risks, but Not the Risks of Major Congenital Anomalies and Admission to Neonatal Care: A Population-Based Cohort Study of 1,164,953 Singleton Pregnancies in Finland.” Journal of Epidemiology and Community Health 68 (2): 159–64. https://doi.org/10.1136/jech-2013-202991.
Ruger, Jennifer Prah, and Karen M. Emmons. 2008. “Economic Evaluations of Smoking Cessation and Relapse Prevention Programs for Pregnant Women: A Systematic Review.” Value in Health 11 (2): 180–90. https://doi.org/10.1111/j.1524-4733.2007.00239.x.
Salihu, Hamisu M., and Roneé E. Wilson. 2007. “Epidemiology of Prenatal Smoking and Perinatal Outcomes.” Early Human Development 83 (11): 713–20. https://doi.org/10.1016/j.earlhumdev.2007.08.002.
Shah, Reena S., and John W. Cole. 2010. “Smoking and Stroke: The More You Smoke the More You Stroke.” Expert Review of Cardiovascular Therapy 8 (7): 917–32. https://doi.org/10.1586/erc.10.56.
U.S. Department of Health and Human Services. 2014. “The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General.” Atlanta, GA: 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. https://www.cdc.gov/tobacco/sgr/50th-anniversary/index.htm.
Whitcomb, Brian W., Alexandra C. Purdue-Smithe, Kathleen L. Szegda, Maegan E. Boutot, Susan E Hankinson, JoAnn E. Manson, Bernard Rosner, Walter C. Willett, A. Heather Eliassen, and Elizabeth R. Bertone-Johnson. 2018. “Cigarette Smoking and Risk of Early Natural Menopause.” American Journal of Epidemiology 187 (4): 696–704. https://doi.org/10.1093/aje/kwx292.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.