Tobacco use is the leading preventable cause of death in the United States, responsible for 443,000 deaths each year in the US and an estimated 5.4 million worldwide.¹More deaths are caused in the US each year by tobacco than by human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.²

Secondhand smoke contains at least 250 chemicals known to be toxic or carcinogenic, and is responsible for an estimated 50,000 deaths each year among US nonsmokers.³ Secondhand smoke causes heart disease and lung cancer in nonsmoking adults, and sudden infant death syndrome, acute respiratory infections, respiratory symptoms, and slowed lung growth in children.⁴ Recent research has found that even brief exposure to secondhand smoke, such as the duration of exposure a nonsmoker might receive in a bar that allows smoking, may cause blood vessel injury and interfere with the body's ability to repair itself, with some of these effects lasting for at least 24 hours following exposure.⁵

Not only is secondhand smoke associated with death and disease, studies now show that implementation of strong smokefree laws has an immediate effect on hospital admissions.  Nine published studies report that after communities implemented smokefree laws, there was a rapid and sizeable reduction in hospital admissions related to heart attacks.  The most recent study, in Pueblo, Colorado, showed a 41% reduction in heart attack hospitalizations during the three years immediately following enactment of the city’s smokefree law.⁶

The smokefree movement has been called the most successful public health campaign since the invention of sewers. Millions of Americans are now protected from secondhand smoke in workplaces and public places. The benefits of smokefree policy extend beyond protecting nonsmokers from secondhand smoke: the passage of hundreds of state and local laws has spurred a fundamental change in the social acceptability of smoking, prompting smokers to quit and contributing to a sharp decrease in smoking rates.

Research has also confirmed that smokefree laws can prevent childhood tobacco addiction.⁷ By eliminating smoking in workplaces and public places, society has changed the perception of what is "normal" smoking behavior. Predictably, young people who live in communities with smokefree laws or work in smokefree environments are significantly less likely to become smokers.⁸