of all cancer cases and 30 percent of all cancer-related deaths are caused by tobacco products (see Figure 8, p. 40). On average, people who smoke die ten years earlier than those who have never smoked (122,123). Research over the past 50 years has consistently demonstrated that byproducts released from smoking tobacco products, such as cigarettes, cause permanent cellular and molecular alterations which lead to cancer (124). Furthermore, smoking causes many other chronic conditions including chronic obstructive pulmonary disease (COPD), asthma, chronic bronchitis, emphysema, and many types of cardiovascular diseases. Secondhand smoke is estimated to cause 41,000 deaths each year among adults in the United States, with 7,300 of these due to lung cancer (123). Thanks to nationwide tobacco control initiatives, cigarette smoking among U.S. adults has been on the decline. As of 2021, the most recent year for which such data are available, an estimated 46 million U.S. adults reported using any tobacco product (32). Of those, about 35.6 million reported using a combustible tobacco product (e.g., cigarettes, cigars, pipes) (32) (see Sidebar 10, p. 41). Rates of tobacco use among middle and high school students are also declining, with 16.5 percent of high school students (representing 2.51 million) and 4.5 percent of middle school students (representing 530,000) reporting having ever used tobacco products in 2022, which is down from 5.2 million high school students and 1.3 million middle school students in 2021, representing a 51 and 53 percent reduction, respectively (125,126). Despite the downward trends, these numbers are still of concern, as research shows that nine out of 10 adults who smoke cigarettes daily first try smoking by age 18, necessitating appropriate interventions among younger population to reduce the risk of continued tobacco usage as adults (127). There is strong evidence that smoking cessation has both immediate and long-term health benefits (129-131). For instance, those who stop smoking reduce their risk of developing cancers of the larynx, oral cavity, and pharynx by half after 10 years of cessation. After 20 years, the risk of developing these cancers is lowered to the same level as someone who never smokes (132). Modifiable Cancer Risks Research has identified numerous factors that increase an individual’s risk for developing cancer. By modifying behavior, individuals can eliminate or reduce many of these risks and thereby reduce their risk of developing or dying from cancer. Developing and implementing additional public health campaigns and policy initiatives can help further reduce the burden of cancers related to preventable cancer risk factors. Adapted from (1). FIGURE 7 Tobacco Smoking Excess Body Weight Alcohol Consumption Ultraviolet Radiation Exposure Poor Diet Pathogenic Infections Physical Inactivity % U.S. Cancer Cases in Adults Age >30 Attributable to Selected Factors 0 10 20 5 15 UV Lung cancer risk in people who stop smoking is decreased by 39 percent after five years. However, even 25 years after cessation, this group is three times as likely to develop lung cancer compared to those who have never smoked (133). Reducing the Risk of Cancer Development AACR Cancer Progress Report 2023 39
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