IMPORTANCE Tobacco use is the leading preventable cause of disease, disability, and death in
the US. In 2014, it was estimated that 480 000 deaths annually are attributed to cigarette
smoking, including second hand smoke exposure. Smoking during pregnancy can increase
the risk of numerous adverse pregnancy outcomes (eg, miscarriage and congenital
anomalies) and complications in the offspring (including sudden infant death syndrome and
impaired lung function in childhood). In 2019, an estimated 50.6 million US adults (20.8% of
the adult population) used tobacco; 14.0% of the US adult population currently smoked
cigarettes and 4.5% of the adult population used electronic cigarettes (e-cigarettes).
Among pregnant US women who gave birth in 2016, 7.2% reported smoking cigarettes
while pregnant.
OBJECTIVE To update its 2015 recommendation, the USPSTF commissioned a review to
evaluate the benefits and harms of primary care interventions on tobacco use cessation in
adults, including pregnant persons.
POPULATION This recommendation statement applies to adults 18 years or older, including
pregnant persons.