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For the first time in two decades, cigarette sales increased last year, according to a new report from the Federal Trade Commission. Its annual Cigarette Report shows that manufacturers sold 203.7 billion cigarettes in 2020, a 0.4% increase from 202.9 billion in 2019. The report does not include sales of e-cigarettes.

Marketing increased from $7.62 billion in 2019 to $7.84 billion in 2020, with the bulk of spending on price discounts paid to cigarette retailers and wholesalers.

The commission looked at sales data from four major tobacco companies:

  • Altria Group (Marlboro)
  • ITG Holdings USA (Winston, Kool)
  • Reynolds American (Camel, Pall Mall)
  • Vector Group Ltd. (Pyramid)

The cigarette report was released just days before November, which is lung cancer awareness month. Dr. Matthew Schabath, a lung cancer epidemiologist at Moffitt Cancer Center, says the growing numbers are concerning because cigarette smoking is directly linked to over 15 types of cancer.

“There is not one single health benefit associated with cigarette smoking,” said Schabath. “For many of these cancers we’ve seen firsthand the reductions in cancer incidence rates over the last several decades attributed to drastic reductions in cigarette consumption.  Reversing the public health successes of the decline in cancer incidence rates and cigarette consumption rates would be disappointing and tragic.”

Reversing the public health successes of the decline in cancer incidence rates and cigarette consumption rates would be disappointing and tragic.
Dr. Matthew Schabath, lung cancer epidemiologist

Could this uptick in smoking lead to an increase in lung cancer cases down the road? Schabath believes it’s possible, especially if these trends continue.

“In the early 20th century as tobacco consumption drastically increased in the U.S., it took around 20 years before incidence rates started to climb,” said Schabath. “But tobacco consumption fell drastically in the U.S. following publication of the landmark 1964 U.S. Surgeon General’s Report that concluded cigarette smoking is responsible for lung cancer among men.  Again, it took around 20 years before incidence rates started to drop. Hopefully what we are seeing today is just a brief blip.”

Erika Sward, assistant vice president of advocacy for the American Lung Association, called the report “very troubling,” adding that the sales increase was probably driven by people who had previously quit smoking but started again during the pandemic, noting that stress is a primary driver of relapses.

“When it comes to lung cancer, the historical data from the last 100+ years has shown there is about a 20-year lag from increases in tobacco consumption and increases in incidence rates,” said Schabath. “If the current uptick in cigarette smoking we are seeing today is largely among former smokers taking up smoking again, that time may be much shorter since former smokers have a slightly elevated baseline risk compared to someone who never smoked.”

Schabath is a military veteran who is a former smoker. He understands the difficulties that come with trying to quit smoking.

“It’s important to stress that it’s never too late,” said Schabath. “A former smoker will always have a lower risk of cancer than a current smoker. Addiction to nicotine is a disease, but there are programs available everywhere in the U.S. to help smokers quit. Don’t be discouraged if it takes several attempts to quit. You are not alone and not the only person to struggle with this.”