Cigarette smoking remains the leading cause of death and illness among Americans. Every year, roughly 430,000 Americans die from illnesses caused by tobacco use, accounting for one-fifth of all deaths. Tobacco use costs the nation about $100 billion each year in direct medical expense and lost productivity. About 25% of all American adults, 46.3 million people, smoke. This number has remained constant for several years. Slightly more men (28.1%) smoke than women (23.5%). Hispanics (20.4%) smoke less than whites (25.3%) or African Americans (26.7%). Nevertheless, significant progress has been made since 1964, when the Surgeon General issued the first report outlining the health dangers of smoking. Since that time, the prevalence of smoking
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