Over the past few decades, life expectancy in the United States appears to have stalled,Research News & Latest Pictures From Newsweek.com
Researchers from multiple institutions, including the University of Oxford and the University of Toronto, took a closer look at the trend, which shows that life expectancy has worsened among people with lower levels of education and stalled among people with middle levels of education.
The culprit? According to the researchers, the smoking gun may be… smoking.
The ‘Main Driver’
The study found that the risk of a lower-educated 30-year-old white man dying before the age of 80 increased from 65 percent to 79 percent over the past three decades, while the risk rose from 44 percent to 67 percent among lower-educated women.
Meanwhile, the risk for higher-educated individuals fell across both genders.
According to the study, nearly two-thirds (63 percent) of the deaths were attributable to smoking-related causes.
“Much of the public discussion about rising mortality in the USA has focused on opioids and ‘deaths of despair,’” the study’s senior author Prabhat Jha of Oxford Population Health said in a release.
“Our findings show that smoking is the main driver of premature death.”
In an email to Newsweek, Jha said while opioids remain important, the “conventional wisdom of ‘diseases of despair’—while a clever title—did not seem to explain anything.”
‘Highly improbable’
Notably, while some have argued that cigarettes appear to be enjoying a cultural resurgence among America’s youth, the actual habits of young people continue to eschew cigarettes.
A 2022 study found that 11.6 percent of Americans are smokers, but that number appears to be in freefall.
“The downward trends in youth smoking are quite encouraging, as uptake rates have become quite low,” Jha said.
“This is good news, but only for the second half of the 21st century, because to kill yourself from smoking, start early, don’t quit, and wait a few decades.”
However, not everyone is taking advantage of the drop, according to the recent study, which noted that “the benefits of lifelong never smoking appear predominantly in highly educated individuals.”
The researchers called it “highly improbable” that “speculative” factors such as ultra-processed foods, air pollution, drugs, pesticides and microplastics could be the cause of the drop in expectancy.
That explanation is improbable for two reasons, the researchers said: First because the exposure to harmful agents is not increasing, and second because the difference in exposure between the two groups wasn’t large.
In fact, as the researchers pointed out, “Attention to nonzero but small absolute risks from such exposures may confuse public understanding and divert policy attention from the largest avoidable risks, particularly those from smoking.”
Jha added: “Absent sharp increases in cessation, the gaps between higher and lower education groups will likely persist or even increase.”
Complete State-by-State Prices (2026 Averages)
The full sortable table, including state tax and annual cost, lives on our interactive prices page. Below is the static snapshot for reference.
| State | Avg Price per Pack | Annual Cost (1 pack/day) |
|---|---|---|
| Alabama | $5.85 | $2,135 |
| Alaska | $9.55 | $3,486 |
| Arizona | $7.25 | $2,646 |
| Arkansas | $6.45 | $2,354 |
| California | $9.61 | $3,508 |
| Colorado | $6.25 | $2,281 |
| Connecticut | $11.00 | $4,015 |
| Delaware | $7.00 | $2,555 |
| Florida | $6.65 | $2,427 |
| Georgia | $5.67 | $2,070 |
| Hawaii | $9.85 | $3,595 |
| Idaho | $6.10 | $2,227 |
| Illinois | $10.50 | $3,833 |
| Indiana | $6.15 | $2,245 |
| Iowa | $7.10 | $2,592 |
| Kansas | $6.85 | $2,500 |
| Kentucky | $6.25 | $2,281 |
| Louisiana | $6.55 | $2,391 |
| Maine | $8.50 | $3,103 |
| Maryland | $9.00 | $3,285 |
| Massachusetts | $10.55 | $3,851 |
| Michigan | $7.85 | $2,865 |
| Minnesota | $9.95 | $3,632 |
| Mississippi | $5.95 | $2,172 |
| Missouri | $5.21 | $1,902 |
| Montana | $6.85 | $2,500 |
| Nebraska | $6.40 | $2,336 |
| Nevada | $7.10 | $2,592 |
| New Hampshire | $7.65 | $2,792 |
| New Jersey | $9.25 | $3,376 |
| New Mexico | $7.25 | $2,646 |
| New York | $12.85 | $4,690 |
| North Carolina | $5.95 | $2,172 |
| North Dakota | $6.55 | $2,391 |
| Ohio | $7.15 | $2,610 |
| Oklahoma | $7.05 | $2,573 |
| Oregon | $8.95 | $3,267 |
| Pennsylvania | $9.10 | $3,322 |
| Rhode Island | $11.20 | $4,088 |
| South Carolina | $5.95 | $2,172 |
| South Dakota | $7.05 | $2,573 |
| Tennessee | $6.25 | $2,281 |
| Texas | $6.51 | $2,376 |
| Utah | $7.50 | $2,738 |
| Vermont | $10.25 | $3,741 |
| Virginia | $5.85 | $2,135 |
| Washington | $9.75 | $3,559 |
| West Virginia | $6.40 | $2,336 |
| Wisconsin | $8.15 | $2,975 |
| Wyoming | $6.20 | $2,263 |
| District of Columbia | $11.50 | $4,198 |
| US Average | $9.83 | $3,588 |
Open the interactive table → Sort by price, tax, or region. Click any state for the full breakdown.
How Much Is a Carton of Cigarettes in 2026— Prices by US State | SmokeCalc
How Much Do Cigarettes Cost in 2026? State-by-State Breakdown
Solutions
The study found that the best way to get life expectancy trends moving in the right direction again would be to find ways to get lower-educated populations away from smoking.
Jha said his solution would be a $2 excise tax on packs of cigarettes.
“Taxes are the closest thing to a silver bullet against smoking, and taxes have a greater impact on the poorer/lower education groups than the upper groups,” Jha said.
“Paired with cessation programs to the lowest social groups, this would lead to the most rapid health gains in the U.S. among all available interventions.”
‘Ridiculously effective’
Jha added that family members should remind smokers that quitting is “ridiculously effective.”
“Those that quit by age 40 (and preferably earlier) avoid 90 percent or more of the risk of continued smoking,” Jha said. “And the benefits of quitting are FAST. About half of the long-term benefit of being an ex-smoker appears within three years.
“But even quitting by age 60 gains back an average of 4-5 years of good life, so quitting at any age is the best thing any smoker can do to enjoy more birthdays ahead.”
Effects of Smoking a Pack of Cigarettes a Day on Your Body
Smoking a pack of cigarettes daily causes immediate and long-term damage to nearly every organ system, increasing your risk of cancer, heart disease, lung disease, and other serious health problems.
Immediate effects
Within seconds of inhaling smoke, nicotine reaches your brain, raising dopamine levels and creating a sense of calm or alertness. At the same time, carbon monoxide displaces oxygen in your blood, reducing oxygen delivery to your heart, brain, and muscles scienceinsights.org. Your heart rate and blood pressure rise, and blood vessels constrict, reducing blood flow to extremities scienceinsights.org.
Short-term changes
- Lungs: Smoke irritates airways, increases mucus production, and damages cilia that clear debris Healthline.
- Skin: Tar and heat can cause premature wrinkles, age spots, and discoloration Keck Medicine of USC.
- Teeth and gums: Heat and tar can stain teeth, gums, and lips Keck Medicine of USC.
- Senses: Nicotine can reduce smell and taste Keck Medicine of USC.
Long-term health risks
Respiratory system: Chronic exposure leads to chronic bronchitis, emphysema, and COPD, with irreversible lung tissue damage Healthline+1.
Cancer: Smoking is linked to cancers of the lung, mouth, throat, esophagus, bladder, kidney, pancreas, and more. Smokers are up to 20 times more likely to develop lung cancer Healthline.
Cardiovascular system: Damage to blood vessel linings accelerates atherosclerosis, increasing the risk of heart attack, stroke, and peripheral artery disease biologyinsights.com.
Other systems: Smoking can harm the digestive tract, weaken the immune system, impair vision (increasing risk of cataracts and macular degeneration), and contribute to diabetes complications Healthline.
Cumulative damage
Even a single cigarette contains thousands of chemicals, many toxic or carcinogenic. Daily smoking compounds this exposure, leading to DNA damage, chronic inflammation, and progressive organ dysfunction biologyinsights.com. Life expectancy for smokers is reduced by at least a decade compared to nonsmokers biologyinsights.com.
Quitting benefits
Quitting reduces exposure to toxins, allowing the body to repair some damage. Within weeks, carbon monoxide levels normalize; within months, lung function improves; and over years, cancer risk declines significantly Healthline.
Bottom line: Smoking a pack a day is a major health hazard, affecting nearly every organ and dramatically increasing the risk of preventable diseases. Quitting is the most effective way to reduce harm.
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