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YOUTH TOBACCO It is estimated that more than 48 million adults in the United States smoke cigarettes. Tobacco use is responsible for more than 430,000 deaths each year, or 1 in every 5 deaths. The economic burden of tobacco use is more than $50 billion in medical expenditures alone. Scientific knowledge that smoking can cause chronic lung disease, coronary heart disease, stroke, and cancer of the lungs, larynx, esophagus, mouth, bladder, cervix, pancreas, and kidneys is well documented. Researchers have identified more than 40 chemicals in tobacco smoke that cause cancer in humans and animals. Smokeless tobacco and cigars also have deadly consequences, including lung, larynx, esophageal, and oral cancer. Women who use tobacco during pregnancy are more likely to experience a variety of infant health disorders. Nonsmokers are also adversely affected by environmental tobacco smoke (ETS). Each year, exposure to ETS causes an estimated 3,000 nonsmoking Americans to die of lung cancer and causes up to 300,000 children to suffer from lower respiratory tract infections. Evidence also indicates that exposure to ETS increases the risk of coronary heart disease. Tobacco use remains the leading preventable cause of death in the Un