NEJM: Smoking Rate Decreased Markedly During Obama’s Tenure


But Will Future Administrations Address the High Death Toll from Smoking?

The seven years of the Obama Administration has been associated with an accelerated rate of decline in smoking rates, according to a paper published today in the New England Journal of Medicine. But, will future Administrations keep it going?

Since Obama took office in 2009, the U.S. age-adjusted prevalence of adult cigarette smoking has fallen markedly — from 20.6% in 2009 to 15.3% today. That’s a decrease of about 0.78 percentage points per year, more than double the annual rates of decline during the George W. Bush (.36 percentage points per year) and Bill Clinton (.28 percentage points per year) administrations.

At the pace set during the Obama era, adult smoking in the US would end in about 20 years. But only if future administrations continue or exceed that pace, said paper author Dr. Michael Fiore, Director of the University of Wisconsin Center for Tobacco Research and Intervention.

“We lose almost 500,000 Americans a year to smoking, about 20% of all deaths in our country,” Fiore said. “That huge loss of life is something future Administrations should not ignore – the recent progress we have made must continue.”

Fiore associated the striking decline in smoking during the Obama Administration to several purposeful initiatives, including:

  • Raising the federal cigarette excise tax rate from $0.39 to $1.01 per pack (Children’s Health Insurance Program Reauthorization Act of 2009).
  • Regulation of tobacco products (The Family Smoking Prevention and Tobacco Control Act of 2009). This law for the first time gave the FDA the authority to regulate tobacco products including cigarettes.  In 2016, the FDA asserted its authority to expand that regulation to include e-cigarettes, cigars, pipe tobacco, and hookah.
  • Mandating insurance coverage of evidence-based counseling and medication treatments for smoking without barriers (Affordable Care Act of 2010) and providing funding to help people quit (National Prevention Council as well as the Prevention and Public Health Fund).

“Through concerted actions, the current administration has helped smokers break their addiction,” Fiore said. Smokers in America have free access to assistance through the national tobacco quitline by calling 1-800-QUIT-NOW and online at

Encouragement helps, too. In March 2012, the CDC launched the first paid national tobacco education campaign—Tips From Former Smokers™ (Tips™), which features compelling stories of former smokers living with smoking-related diseases and disabilities. CDC estimates that the Tips™ campaign has helped at least 400,000 Americans to quit smoking for good since 2012 and is projected to prevent at least 17,000 premature deaths.

The FDA’s Center for Tobacco Products (CTP) has also:

  • Banned the manufacture and sale of fruit- or candy-flavored cigarettes.
  • Prohibited the use of misleading claims such as “low,” “light,” and “mild.”
  • Conducted more than 600,000 retailer inspections to ensure compliance with laws restricting sales of tobacco products to youth.
  • Required tobacco manufacturers to report ingredients.
  • Launched youth-focused information campaigns, such as “The Real Cost.”

Even with this progress, more than 36 million Americans continue to smoke, putting millions of lives at risk. The question remains: Will the next Administration maintain that momentum?


Contact: Chris Hollenback, 608-262-3902