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Tobacco use and exposure to second-hand smoke are responsible for more than 480,000 deaths each year in the United States, according to the American Lung Association

10.1016/S0009-9236(96)90217-9 Priem H, Nyssnen K, Grnbk K, Klarlund M, Loft S, Tnnesen P, Salonen JT, Poulsen HE: Randomized controlled smoking cessation study: transient increase in plasma high density lipoprotein but no change in lipoprotein oxidation resistance

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Use of cigars/cigarillos appears to have increased through the 2000s until a peak around 2008, after which prevalence generally declined, although the most recent years suggest a possible reversal of this trend (Figure 4.2)