Report on the health and economic impact of comprehensive smoke-free laws

Each year, tobacco use causes hundreds of thousands of premature deaths and costs billions of dollars in medical care and productivity losses insmoking-ban the United States. Strong tobacco control policies at the state level can help reduce the burden of tobacco use. Saving Lives, Saving Money: A State-By-State Report on the Health and Economic Benefits of Comprehensive Smoke-Free Laws, provides new information about the public health and economic benefits to states that implement smoke-free laws.
Comprehensive smoke-free laws reduce exposure to secondhand smoke, encourage people to quit or cut down on smoking, and prevent youth from starting to smoke. As these laws reduce smoking and secondhand smoke exposure, data show that they reduce disease and heath care spending, and they improve employee productivity.

The American Cancer Society Cancer Action Network (ACS CAN) commissioned leading experts to derive updated and expanded estimates for the public health benefits and economic savings in the 27 states that currently do not have a comprehensive smoke-free law in place.

The estimates show that in each of these states, a smoke-free law would result in fewer smokers, fewer smoking-related deaths, and fewer youth who become smokers. In addition, a comprehensive smoke-free law in each state would substantially reduce health care costs associated with several smoking-related diseases.


The data show that comprehensive smoke-free laws would decrease the number of adult smokers by tens of thousands in many states. North Carolina, for example, would have 78,100 fewer adult smokers by adopting a comprehensive law that closed the current loophole that allows smoking in non-hospitality workplaces. The results also show that nearly 400,000 fewer young people would become smokers if states without a comprehensive smoke-free law adopted one, further reducing the health and economic burden of smoking. The reduction in smoking-related deaths avoided by implementing smoke-free laws ranges from several hundred in states with smaller populations to more than 110,000 in Texas. Non-smokers’ deaths would be prevented in every state that applies a smoke-free law. If each of the 27 states without a comprehensive smoke-free law had such a law in place, the following estimates of public health benefits would apply:

  • Adults Who Would Quit Smoking: 1.03M
  • Youth Who Would Never Start Smoking: 398,700
  • Reduction in Smoking-Related Deaths: 624,000
  • Reduction in Deaths of Non-smokers: 69,500


The total estimated savings in health care costs from adopting comprehensive smoke-free laws adds up to tens or hundreds of millions of dollars in most states. Seven states would each save at least $80 million in spending on lung cancer, heart attacks and strokes, and pregnancy complications over five years. All together, the 27 states without a comprehensive smoke-free law currently in place could save an estimated $1.32 billion in treatment of those conditions over five years.

  • Lung CancerTreatment Savings: $316.11M
  • Heart Attack and Stroke Treatment Savings: $875.57M
  • States’ Medicaid Program Savings: $42.79M
  • Smoking-RelatedPregnancy Treatment Savings: $128.26M


There is still much work to be done – 27 states have no statewide smoke-free law in effect or have a law that does not cover all workplaces or populations. Hospitality and casino workers, who studies show are exposed to dangerous secondhand
smoke on the job, continue to be denied their right to breathe smoke-free air in a large number of states. Opponents of smoke-free legislation continually battle to weaken existing laws through loopholes and exemptions, further complicating efforts to achieve the benefits of these laws. States in which some residents are covered by city or county smoke-free laws would see greater health and economic outcomes if a strong, comprehensive statewide law were implemented.

ACS CAN recommends that all states aim for statewide laws that are comprehensive and protect all workers from the dangers of secondhand smoke.

  • Smoke-free laws should cover all workplaces.
  • Venues should be 100 percent smoke-free with no exceptions, such as allowing smoking in certain places or at certain times.
  • Statewide smoke-free laws should not preempt local authorities from enacting stronger smoke-free laws in their jurisdictions.

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