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After researchers started demonstrating the harmful nature of smoking and second-hand smoke in the 1960s, smoking became less and less popular in the United States. For example, in 1964, 42 percent of U.S. adults were cigarette smokers. By 2007, this had fallen to only 20 percent. Much of this dramatic decline was the result of anti-tobacco campaigns, which have a long history in the United States.

Tobacco and Health

According to the World Health Organization (WHO), no other consumer product is as dangerous, or kills as many people, as tobacco. There are 4.9 million tobacco-related deaths in the world each year. Tobacco use is also the leading cause of preventable death in the United States, making cigarettes the most commonly recognized defective product in the United States. According to the Centers for Disease Control and Prevention, smoking “harms nearly every organ of the body; causing many diseases and reducing the health of smokers in general.” Cigarette smoking kills roughly 430,000 people every year in America (accounting for about one in five deaths) and is more deadly than human immunodeficiency virus (HIV), motor vehicle injuries, suicides, murders, and all deaths caused by alcohol and all illegal drugs combined. Smokers will die, on average, 14 years earlier than nonsmokers. The greatest number of smoking-related deaths are the result of lung cancer (124,000 deaths), heart disease (108,000 deaths), and emphysema, bronchitis, and chronic airways obstruction (90,000 deaths).

Cigarette smoking has many other adverse effects, including reproductive and early childhood effects such as an increased risk for infertility, pre-term delivery, stillbirth, low birth weight, and sudden infant death syndrome (SIDS). Smoking during pregnancy has also been associated with pregnancy complications, premature birth, low-birth-weight infants, and stillbirth. Studies also show that children born to mothers who smoked while pregnant have increased risks of antisocial behavior, juvenile delinquency, and even adult criminality.

In addition, second-hand smoke—which is also commonly referred to as “environmental tobacco smoke”—contains at least 250 chemicals known to be toxic, including more than 50 that can cause cancer. The detrimental health effects of exposure to second-hand smoke include heart disease and lung cancer; immediate harm to the cardiovascular system; respiratory distress in children; and SIDS, acute respiratory infections, ear infections, and severe asthma attacks in children. Exposure to second-hand smoke at home or work can increase the risk of lung cancer by 20–30 percent, leading to an estimated 3,000 lung cancer deaths every year. Second-hand smoke also leads to increase risks of heart disease, and the CDC estimates that second-hand smoke kills between 22,700 and 69,600 people from heart disease every year.

Early Anti-Tobacco Efforts

The earliest anti-tobacco campaigns were not based on medical concerns. Instead, early anti-smoking messages emphasized concerns about hygiene (i.e., smoking is a dirty habit) and morality (e.g., any form of drug use is immoral). According to the National Library of Medicine in 2010, “Anti-tobacco crusaders saw the cigarette as ungodly and unhealthy.” The earliest efforts to restrict smoking included a 1632 law in the Massachusetts Colony that forbade public smoking, heavy taxes on tobacco in Virginia in 1676, and a 1683 Massachusetts law banning smoking outdoors because the danger of fire.

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