In the United States some 37.8 million adults arecurrent smokers. Men are more likely to smoke than women, with some 18 percent of adult U.S. men reported to be current smokers, compared to about 14 percent of U.S. women. Furthermore, American Indians and Alaska Natives are the ethnic groups with the highest share of smoking adults. Since the late 90s, smoking among adolescents has steadily decreased.
Nevertheless, smoking does not come without problems. Smoking-related costs for the United States amount to over 300 billion U.S. dollars. One half is for direct health expenditure, while the other is due to lost productivity. Furthermore, the health risks of smoking are well-known. For example, the prevalence of heart diseases and various types of cancer increase dramatically when people start smoking. Most of the U.S. states with the highest smoking rates also have the highest cancer death rates. This is no wonder, since cancer of lung and bronchus are the most prevalent cancer types. It is also a given fact, that secondhand smoke can have the same increased health risks for nonsmokers.
Due to all this, countries increasingly attempt to ban smoking from public facilities and places and use other policies to encourage people to quit smoking. In the United States, almost 80 percent of people who smoke less than one pack a day want to stop smoking. Most smokers try to quit unaided by outside help, however the use of e-cigarettes is becoming increasingly popular, either to quit tobacco altogether or to replace traditional cigarettes. There is however a dilemma, since governments all over the world generate considerable revenues from tobacco products. These amounts are distinctly larger than expenditures on tobacco prevention.