Wildfire smoke is becoming America's next silent health crisis — Experts warn

Wildfire smoke contributes to tens of thousands of deaths annually in the U.S., according to a new study published in Nature that warns the toll could increase significantly by mid-century as climate change intensifies fire activity.

The research, led by Minghao Qiu, a climate and public health scientist at Stony Brook University, found that smoke exposure levels could reach two to three times current averages within decades. The study analyzed climate change, wildfire patterns, and smoke transport across North America.

"The numbers are quite striking," Qiu said. By 2050, annual smoke exposure could match levels seen during 2020, one of the smokiest years on record, when Western wildfires burned 10 million acres.

Researchers examined smoke exposure data from 2006 to 2019 across U.S. counties, analyzing the correlation between smoke exposure and death rates over time. The study determined that higher death rates continued for up to three years following smoke exposure. Previous research has documented significant health impacts from wildfire smoke, including a 2024 California study that found smoke PM2.5 contributed to over 52,000 premature deaths from 2008 to 2018.

"We don't see smoke-related written on the death certificate," said Marshall Burke, a climate expert at Stanford University and study co-author. "We see heart attacks or COPD or some other complication from chronic disease."

Wildfire smoke particles can enter the bloodstream and cross the blood-brain barrier, triggering inflammation that persists even after the smoke clears. The tiny particles aggravate heart disease, brain disease, and other health conditions. The Environmental Protection Agency identifies vulnerable populations as including pregnant women, children under 18, adults over 65, people with cardiovascular or respiratory disease, and outdoor workers.

"Smoke particles tend to be more toxic than your average urban pollution," said Loretta Mickley, an atmospheric scientist at Harvard University who was not involved in the study.

The study predicts that wildfire activity will increase across North America, particularly in the western states, Canada, and Mexico. Even with aggressive climate action that significantly reduces fossil fuel use, smoke levels are expected to double by mid-century. Without effective climate measures, levels could triple.

Under the high warming scenario, annual smoke-related deaths could rise to 71,420 people in the U.S. by 2050, representing a 73% increase from 2011-2020 averages, according to the research.

Yiqun Ma, an epidemiologist at UC San Diego who conducted similar research last year, said Americans must create adaptation strategies for a smokier future, including better home air filtration and clean air centers during smoke events. The Centers for Disease Control and Prevention provides guidance on protecting against wildfire smoke, while the EPA offers a comprehensive smoke-ready toolbox for communities.

Residents can monitor current air quality using the EPA's AirNow Fire and Smoke Map and receive emergency alerts through the free FEMA mobile app. Federal agencies recommend accessing resources at Ready.gov for wildfire preparedness and California's ReadyForWildfire.org for comprehensive safety planning.

The economic impact from climate-worsened wildfire smoke alone will surpass current government estimates of total U.S. climate change damages, including infrastructure losses and reduced productivity, Burke said. 

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2. Health officials urge precautions as wildfire pollution spreads
3. As Canada wildfires choke US with smoke, Republicans demand action. But not on climate change
4. How to protect yourself from the bad air caused by wildfires
5. Wildfire smoke exposure may shorten lung cancer survival