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  Chapter Eight:

  Health of Children
  Health of Adults
  STDs and AIDS
  Illegal Drugs
  Accidental Deaths
  Hospital Patients
  Health Care Costs
  Mental Patients
  Disabled Persons



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Cigarette consumption increased enormously during the first half of the century but declined when the health effects became known.
The cigarette habit spread from a small circle of urban men in 1900 to about half of the adult population in 1950. The per capita consumption of cigarettes in 1950 was sixty-six times greater than in 1900. Among twenty-five- to forty-four-year-olds in 1955, seven of ten men and four of ten women were smokers. Among other factors, this reflects the adoption of smoking by women; the substitution by men of cigarettes for cigars, chewing tobacco, and snuff; and the impetus given to smoking by the free distribution of brand-name cigarettes to members of the armed forces during World War II. 

The consumption of cigarettes staggers the imagination. The 48 million smokers in the United States in 1997—about 25 percent of the adult population—consumed an average of about twenty-seven cigarettes per day. By coincidence, there were also 48 million smokers in the United States in 1970—37 percent of the adult population at that time—and they averaged about thirty cigarettes per day. 

As research evidence of the harmful effects of smoking emerged, it became clear that cigarettes were far more dangerous to their users than any other legal consumer product. By the end of the century, about 430,000 deaths were attributed to smoking annually. Lung cancer, other pulmonary diseases, and cardiovascular diseases caused most of these deaths. Various studies reported that the life expectancy of nonsmokers exceeded that of smokers by six to nine years. One study found that lifelong nonsmokers lived eighteen years longer than lifelong smokers. 

After the first Surgeon General’s warning in 1964, smoking came under increasing regulatory pressure. Cigarette advertising was dropped from television and radio in 1971. Smokers began to be segregated in restaurants and hotels, and on common carriers around 1983. By 1990, smoking was barred altogether on commercial aircraft and soon afterward in most offices, stores, and schools. The U.S. military, which had distributed free cigarettes for decades, became a virtually smoke-free organization. 

As smoking slowly declined in response to this pressure, it developed an inverse correlation with income and education. On average, smokers at the end of the century had lower incomes and much less education than nonsmokers.

Chapter 8 chart 6

Source Notes
Source Abbreviations

SA 1959, table 1073. See also Epidemiology and Statistics Unit, American Lung Association, Trends in Cigarette Smoking (December 1999), at (accessed July 15, 2000); R. T. Ravenholt, “Tobacco’s Global Death March,” Population and Development Review 16 (June 1990):213–240; SA 1979, table 201; and SA 1998, table 238. For the life expectancy of thirty-year-old smokers, see G. H. Miller, Charles E. Chittenden, and Robert J. Myers, “Life Expectancy at Age 30: Nonsmoking versus Smoking Men,” Contingencies (May/June 1990):30, at (accessed September 19, 2000).


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