While smoking rates have dropped precipitously since the landmark 1964 Surgeon General’s report, "Smoking and Health," smoking is still the leading cause of preventable disease and death in the United States and is now causally linked to additional diseases and conditions across most organ systems.
A new Surgeon General's report, "The Health Consequences of Smoking – 50 Years of Progress," released at a White House event Jan. 17, synthesizes original and review evidence in an effort to further federal antismoking efforts.
Kathleen Sebelius
The report causally links cigarette smoking to type 2 diabetes, rheumatoid arthritis, ectopic pregnancy, and erectile dysfunction. Secondhand smoke is now causally linked to cancers, respiratory diseases, and cardiovascular diseases, as well as adverse effects on the health of children, the authors wrote.
In addition, the 980-page report establishes that secondhand smoke is a cause of stroke, and that smoking increases the risk of dying in cancer patients and cancer survivors.
Another finding: Cigarette smokers today have a higher risk of lung cancer than did those who smoked in 1964, because of the higher number of chemical additives now used.
Women smokers now have the same risk of death from lung cancer as that of men and a higher relative risk of dying from coronary heart disease than that of men. Because of smoking, the number of women dying from chronic obstructive pulmonary disease (COPD) is now higher than in men.
With this report, the federal government is launching a new effort to prevent children from using tobacco.
Acting Surgeon General Boris Lushniak
"Today, we’re asking Americans to join a sustained effort to make the next generation a tobacco-free generation," Health and Human Services Secretary Kathleen Sebelius said in a statement. "This is not something the federal government can do alone. We need to partner with the business community, local elected officials, schools and universities, the medical community, the faith community, and committed citizens in communities across the country to make the next generation tobacco free."
The report finds that youth smoking rates declined by 50% between 1997 and 2011, but 3,200 children under age 18 still start smoking each day, and an additional 2,100 youth and young adults become daily smokers. The report places most of the blame for continued interest in smoking on the tobacco industry, saying it has used "aggressive strategies" to deliberately mislead the public about the harms of smoking.
Acting Surgeon General Boris Lushniak noted that smoking rates are disproportionately higher among people with less education and lower incomes, among the mentally ill, and among gay, lesbian, bisexual, and transgender individuals.
Dr. Lushniak and other officials at the White House event called for greater tobacco control efforts, including stricter regulation. The Food and Drug Administration was given the power to regulate tobacco through the 2009 Family Smoking Prevention and Tobacco Control Act.
Dr. Margaret Hamburg
FDA Commissioner Margaret Hamburg said that the agency is ready to take action.
"The FDA is funding and conducting regulatory science research on tobacco products, enforcing the laws that reduce the access and attractiveness of tobacco products to young people, and preparing to launch an unprecedented national public education campaign to prevent youth tobacco use," Dr. Hamburg said in a statement.
Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, noted that while states collect some $80 per person a year in tobacco taxes and payments from the 1998 tobacco industry master settlement agreement, they spend an average of $1.50 per person on control.
The CDC has urged states to spend $12 per person on control, Dr. Frieden said.
Dr. Lushniak noted that for current and about-to-start smokers, "the clock is ticking – they can’t wait for slow and steady progress to end the epidemic. Enough is enough."
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