Even though 1 million tobacco-related deaths have been prevented since 1990, tobacco use is still the leading preventable cause of cancer and cancer deaths in the United States. Medical advances and improvements in prevention have saved lives; however, not all states are seeing equal benefits. Tobacco smoke is linked to 12 types of cancer and causes 3 in 10 of all cancer deaths. To curb this, states and communities can put greater, longer efforts into prevention and treatment. Healthcare providers can screen all patients for tobacco use and provide cessation resources and secondhand smoke information. Everyone can also encourage others to quit using tobacco, teach children about the health risks, and make the home a tobacco free environment.