Tobacco Use

Tobacco Control Program

Guam is in the midst of an epidemic of tobacco use. Our people have the highest rate of tobacco consumption among all US States and Territories, and we are paying the price for it. Everyday, at least one person on Guam dies from tobacco.

We have to stop the epidemic of addiction, disease, disability and death from this harmful product. We know what works, and what doesn’t. We need to put this knowledge into action, today…to ensure a healthy future for Guam.


What we are NOT:

We are against smoking and other tobacco use, but we are NOT anti-smoker and anti-tobacco user.

Over 60% of Guam’s smokers want to quit. Other tobacco users want to quit, too, but many need help to overcome the powerful addiction to nicotine. Our program aims to assist these smokers and tobacco users. 

  • Everyday, at least one person on Guam dies from tobacco use.
  • Tobacco use is increasing among Guam’s middle school children.
  • Over 60% of cancers on Guam are due to tobacco.
  • Second hand smoke kills.
  • Nicotine is highly addicting. Majority of Guam’s smokers want to quit, but are addicted.
  • 66% of Guam’s students are exposed to second-hand smoke.
  • In 2001, the tobacco industry spent ~$32 million per day for tobacco advertising in the US alone.
  • Every cigarette takes 7 minutes off your life.

Youth Tobacco USE
Based on the results of the Guam Epidemiological Profile 2021 Update:1
  • In 2017, One in four (25.4% of all students surveyed) Middle School students and, in 2019, two of five (39.6%, nearly 40% of all students surveyed) High School students have already tried using tobacco.
  • One in eight (11.9%) high school students are current smokers.
  • Nearly one in ten (9.3%) middle school students are current smokers.
One in nine or eleven out of hundred, (~11%) middle school students smoked a whole cigarette before the age of 11 years.
One in five (19%) of Guam high school students tried cigarette smoking before the age of 13 years.

67% of high school students who are current smokers tried to quit in the past 12 months (2019); more than half attempted to quit.

What works best to reduce smoking among youth?
  1. Raising tobacco prices through higher level taxes
  2. Making all public places smoke free
  3. Having smoke free role models, especially parents and teachers
  4. Controlling tobacco advertising
  5. Reducing the social acceptability of tobacco use

Tobacco Harm
  • Tobacco Kills
    • Every year, 4.9 million people in the world lose their lives to smoking
    • At least one person on Guam dies everyday because of tobacco use
    • Kids exposed to second-hand smoke at home have a higher rate of asthma, lung, and middle ear infections
  • Tobacco use harms the environment
    • In the  year 2000, smoking caused 10% of all fire deaths in the world
    • Every year, 1,000,000 fires are started by children using cigarette lighters
    • On Guam, over 25% of all litter collected from the beaches consist of cigarette butts
  • Tobacco use is the largest public health threat to Guam. Yet, smoking rates continue to increase
    • The already high cost of health-care for tobacco related diseases continues to increase as more smokers become ill
    • The indirect cost from premature death and lost productivity are even higher
    • Our island cannot afford this additional and significant drain on our community’s resources

We must act quickly in order to stop the tobacco epidemic, and we must start now. Through the Tobacco Control Program, GBHWC is committed to controlling nicotine addiction and reducing tobacco use on our island. Tobacco control is about protecting our people’s rights to a healthy, clean, and smoke-free environment, conserving our island’s economic success, and saving people’s lives.

Second-hand Smoke
  Second hand smoke: a proven health hazard!
  • Second hand smoke is established to cause cancer in humans.
  • Second hand smoke is particularly hazardous to elderly people, those with chronic heart and lung disease, and asthmatics.
  • Infants and children exposed to second hand smoke have higher for Sudden Infant Death Syndrome (SIDS), asthma, lung infections, middle ear infections, developmental abnormalities and cancer.
  • Workers exposed to second hand smoke at work suffer a 25-50% higher risk of heart attack, and higher rates of death from heart disease.

There are wrong solutions, and right solutions.
  • The wrong solution - ventilation: The US EPA states that second-hand smoke cannot be safely reduced by high rates of ventilation. Air filter do not remove the carcinogens and other toxins in smoke.
  • The right solution - healthy policies: Ensuring completely smoke-free homes, schools, workplaces and other public spaces are the best way to protect everyone's health and safety.

Tobacco Use Adverse Health Effects There is a growing list of diseases and adverse health effects that are associated with cigarette smoking. The following table lists down some of the established and suspected health effects of cigarette smoking.
  Adapted from "Cigarettes: What the Warning Label Doesn't Tell You", American Council on Science and Health, 1996

Body System or Organ Established or Suspected Adverse Health Effect of Cigarette Smoking
  • Lung cancer
  • Chronic obstructive pulmonary disease
  • Increased severity of asthma
  • Increased risk of developing various respiratory infections
  • Coronary heart disease
  • Angina pectoris
  • Heart attack
  • Increased risk of repeat heart attack
  • Arrhythmia
  • Aortic aneurysm
  • Cardiomyopathy
Blood Vessels
  • Peripheral vascular disease
  • Thromboangiitis obliterans (Buerger's disease)
  • Earlier wrinkling
  • Fingernail discoloration
  • Psoriasis
  • Palmoplantar pustulosis
  • Lung cancer
  • Esophageal cancer
  • Laryngeal cancer
  • Oral cancer
  • Bladder cancer
  • Kidney cancer
  • Stomach cancer
  • Pancreatic cancer
  • Vulvular cancer
  • Cervical cancer
  • Colorectal cancer
  • Disc degeneration
  • Osteoporosis
  • Osteoarthritis
  • Less successful back surgery
  • Delayed fracture healing
  • Muscoloskeletal injury
  • Infertility
  • Impotence
  • Decreased sperm motility and density
  • Miscarriage
  • Earlier menopause
The unborn child
  • Fetal growth retardation
  • Prematurity
  • Stillbirth
  • Enhanced transmission of HIV to fetus
  • Birth defects
  • Intellectual impairment of offspring
  • Sudden infant death syndrome
  • Transient ischaemic attack
  • Stroke
  • Worsened multiple sclerosis
  • Cataracts
  • Macular degeneration
  • Snoring
  • Periodontal disease
  • Stomach and duodenal ulcers
  • Crohn's disease
  • Impaired immunity