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50th Anniversary Report on Smoking and Health

Fifty years after the first report, the 2014 Surgeon General’s Report on Smokingand Health reveals new details about the dangers of smoking as well as strategies to curtail the tobacco use epidemic.

Did you think that you already knew everything there was to know about how tobacco smoking affects health? Think again. A new Surgeon General’s Report (SGR) on smoking and health—The Health Consequences of Smoking: 50 Years of Progress—offers startling new details about the dangers of smoking as well as strategies to curtail the tobacco use epidemic that still sickens and kills many Americans. The 2014 report comes out 50 years after the first SGR on smoking was released—a time when about 4 in 10 Americans smoked.

In the early 1960s, tobacco use was the norm. People smoked in restaurants, airplanes, office buildings—even in hospitals. And tobacco marketing was everywhere. The Marlboro Man appeared in magazines and newspapers, children “smoked” candy cigarettes, and tobacco companies sponsored sports events and concerts. Doctors joined in, claiming that some cigarette brands were “safe” and less irritating. Even children’s cartoon characters, such as the Flintstones, peddled cigarettes on TV commercials.

Then on January 11, 1964, U.S. Surgeon General, Dr. Luther Terry released the first report on smoking and health—a landmark federal document report linkingsmoking to lung cancer and heart disease in men. This scientifically rigorous report laid the foundation for tobacco prevention and control efforts in the United States.

50 Years of Research and Progress in Tobacco Prevention and Control

Since 1964, 31 more SGR reports have documented the harmful effects of tobacco use, such as the dangers of secondhand smoke (1986 and 2006), the impact of smoking on minority populations (1998 and 2001), and how to prevent tobacco use by youth and young adults (1994 and 2012). We now know that smoking causes 13 types of cancer and many other illnesses. Smoking is linked to diseases of nearly every organ in the body.

Successes and Challenges in Tobacco Prevention and Control

The good news is that:

• Fewer than 20% of Americans now smoke, compared with 42% in 1964. This success is due to comprehensive tobacco control efforts over the last 50 years.
• Tobacco advertising has been banned from TV and radio in the United States.
• Twenty-six states and the District of Columbia have enacted laws prohibiting smoking in all indoor areas of worksites and public places, including bars and restaurants.

The bad news is that smoking remains the leading preventable cause of disease and death in the United States, killing about 480,000 Americans a year and costing nearly $280 billion a year in health care costs and lost productivity.

Highlights of the 2014 Surgeon General’s Report on Smoking and Health

The 50th anniversary SGR expands our knowledge of the dangers of smoking even further. The report updates the human and financial tolls caused by cigarette smoking, with disturbing findings:

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• 20 million people have died since 1964 from smoking-related illnesses. Most deaths have been among adults with a history of smoking; however, 2.5 million nonsmokers died from diseases caused by exposure to secondhand smoke.
• 5.6 million children alive today will die prematurely from smoking if currentsmoking rates persist. That’s 1 in 13 children in this country.
• The list of illnesses caused by smoking has grown and now includes diabetes, colorectal cancer, and liver cancer. Smoking is also now known to be a cause of rheumatoid arthritis and increase the risk for tuberculosis (TB) and death from TB. Smoking raises the risk for impaired fertility, ectopic pregnancy, and cleft lip and cleft palate (birth defects) in babies of women who smokeduring early pregnancy. Smoking is linked to erectile dysfunction (impotence) and age-related macular degeneration, which is a condition affecting eyesight.Smoking also interferes with cancer treatment. And finally, the report indicates that secondhand smoke exposure causes strokes in nonsmokers.
• Smokers today have a greater risk of developing lung cancer than they did in 1964, even though theysmoke fewer cigarettes. Changes in the design and composition of cigarettes may contribute to this increase in risk. At least 70 of the chemicals and chemical compounds in cigarette smoke are known to cause cancer.
• For the first time, women are as likely as men to die from many of the diseases caused bysmoking. These include lung cancer, chronic obstructive pulmonary disease (COPD), and heart disease.
• Cigarette smoking makes people less healthy, harms immune function, and reduces quality of life.

To read more about the findings from the 2014 SGR, see the consumer booklet: Let’s Make the Next Generation Tobacco-free[795 KB]. You can also download the complete report[27 MB] and the executive summary[2 MB] from the Surgeon General’s web site.

5.6 million children alive today will die early from smokingunless we take steps to stop the tobacco epidemic. See how many children (ages 0-17) are at risk in your state

The Future of Tobacco Control

The 2014 report makes clear that smoking is deadly for everyone. As Acting Surgeon General Boris Lushniak stated, “Despite 50 years of steady progress in reducing smoking rates, this nation continues to pay a heavy price in both lives and resources because of tobacco use. Without immediate and dramatic action to end the tobacco-use epidemic, the disease and death caused by smoking will continue at unacceptably high rates well into this century.”

During the past 50 years, progress in tobacco control has validated specific strategies that work well to reduce tobacco use. These include:

• Higher prices on tobacco products
• Continued adoption of comprehensive smokefree policies
• Hard-hitting mass-media campaigns
• Funding comprehensive statewide tobacco control programs at CDC recommended levels
• Affordable and accessible cessation help for all smokers who want to quit

A top priority discussed in the new report calls for an end to the use of cigarettes, which is the major cause of tobacco-related disease and death.

If proven strategies are implemented at
the local, state, and federal levels, public health leaders are confident we can reach a point where tobacco use is rare rather than an epidemic. This achievable goal has the potential to save millions of Americans from preventable disease and death.

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3. From CDC:  http://www.cdc.gov/chronicdisease/resources/publications/aag/osh.htm

Tobacco Use

Targeting the Nation’s Leading Killer

At A Glance 2011

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• At A Glance
• Success Stories
• Related Materials

The Burden of Tobacco Use

Tobacco use is the single most preventable cause of disease,
disability, and death in the United States. Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and another 8.6 million live with a serious illness caused by smoking. Despite these risks, approximately 46.6
million U.S. adults smoke cigarettes. Smokeless tobacco, cigars, and pipes also have deadly consequences, including lung, larynx, esophageal, and oral cancers.

The harmful effects of smoking do not end with the smoker.
An estimated 88 million nonsmoking Americans, including 54% of children aged 3–11 years, are exposed to secondhand smoke. Even brief exposure can be dangerous because nonsmokers inhale many of the same poisons in cigarette smoke as smokers.

Secondhand smoke exposure causes serious disease and death,
including heart disease and lung cancer in nonsmoking adults and sudden infant death syndrome, acute respiratory infections, ear problems, and more frequent and severe asthma attacks in children. Each year, primarily because of exposure to secondhand smoke,
an estimated 3,000 nonsmoking Americans die of lung cancer, more than 46,000 die of heart disease, and about 150,000–300,000 children younger than 18 months have lower respiratory tract infections.

Coupled with this enormous health toll is the significant
economic burden of tobacco use—more than $96 billion a year in medical costs and another $97 billion a year from lost productivity.

The Tobacco Use Epidemic Can Be Stopped

The Institute of Medicine (IOM) report,
Ending the Tobacco Problem: A Blueprint for the Nation,
presents a plan to “reduce smoking so substantially that it is no longer a public health problem for our nation.” Foremost among the IOM recommendations is that each state should fund a comprehensive tobacco control program at the level recommended by CDC
in Best Practices for Comprehensive Tobacco Control Programs–2007.
This publication is a guide to help states plan and establish effective tobacco control programs to prevent and reduce tobacco use.

Evidence-based, statewide tobacco control programs that
are comprehensive, sustained, and accountable have been shown to reduce smoking rates, tobacco-related deaths, and diseases caused by smoking. A comprehensive program is a coordinated effort to establish smoke-free policies, reduce the social acceptability
of tobacco use, promote cessation, help tobacco users quit, and prevent initiation of tobacco use. This approach combines educational, clinical, regulatory, economic, and social strategies.

Research has documented the effectiveness of laws and policies
to protect the public from secondhand smoke exposure, promote cessation, and prevent initiation by young people. For example, states can

• Increase the unit price of tobacco products.
• Implement smoke-free policies, regulations, and laws.
• Provide insurance coverage of tobacco-use treatment.
• Limit minors’ access to tobacco products.

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