Fifty years after the first surgeon general's report
declared smoking a hazard to human health, the new study adds
conditions ranging from colon cancer to diabetes and arthritis to
the tally of tobacco-related diseases.
The report, the first in more than a decade, found that smoking has
killed more than 20 million Americans prematurely in the last half-century.
Although adult smoking rates have fallen to the current 18 percent
from 43 percent of Americans in 1965, each day, more than 3,200
youths under the age 18 try their first cigarette, according to the
report published on Friday.
"Enough is enough," acting Surgeon General Dr Boris Lushniak said in
a telephone interview. "We need to eliminate the use of cigarettes
and create a tobacco-free generation."
Federal health officials are calling on businesses, state and local
governments, and society as a whole, to end smoking within a
generation through hard-hitting media campaigns, smoke-free air
policies, tobacco taxes, unhindered access to cessation treatment
and more spending by state and local governments on tobacco control.
"It's not just the federal lead on this anymore," said Lushniak. "To
get this done, we have to go to industry. We have to go to
healthcare providers and remind them that this problem is not yet
The report, dubbed The Health Consequences of Smoking, 50 Years of
Progress, details the growing science showing the diseases and
health conditions caused by smoking since Dr Luther Terry issued the
landmark report on January 11, 1964, that first confirmed smoking
tobacco caused lung cancer.
In that first report, only lung cancer was associated with smoking.
Now there are 13.
"We're still a country very much addicted to tobacco," U.S. Health
and Human Services Secretary Kathleen Sebelius said at a White House
event to mark the anniversary.
The new report adds liver and colorectal cancer to that list, but it
also details several other conditions caused by smoking, including
diabetes, rheumatoid arthritis and impaired immune function, and
cleft palate in infants.
And in a startling statistic, the report found that exposure to
secondhand smoke increases the risk of stroke by 20 to 30 percent.
"It really is astonishing that even 50 years in, we are finding new
ways that tobacco maims and kills people," Dr Thomas Frieden,
director of the U.S. Centers for Disease Control and Prevention,
said in a telephone interview.
He said the report found that smoking costs the nation $130 billion
in direct medical expenses each year.
Frieden reiterated that tobacco control efforts have saved as many
as 8 million lives in the past five decades, but stressed that much
more needs to be done to eliminate smoking, which remains the
leading cause of preventable death in the United States.
At the White House, officials pointed squarely at the tobacco
industry continued efforts to promote their products.
"This is not an accident," Assistant Health Secretary Howard Koh
said. "These deaths do not occur just by chance. Each year, the
tobacco industry spends $8 billion — nearly $1 million an hour — to
advertise and market cigarettes and smokeless tobacco products."
As a result, Lushniak urged public health officials to take tougher
action to curb tobacco use: "It's all about getting more aggressive
than we have been."
Officials called on states to increase their investment in smoking
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CDC's Frieden said states get $80 per capita from tobacco companies
related to a major legal settlement in 1998, in which big tobacco
makers agreed to pay $206 billion to 46 states to help pay the costs
of treating ailing smokers.
Although CDC recommends that states spend at least $12 per person on
tobacco control, states "actually only spend about $1.50, and it's
been decreasing in recent years," he said.
Harold Wimmer, president and chief executive of the American Lung
Association, said the new report, coming on the heels of the 50th
anniversary of the landmark 1964 report, present an opportunity for
renewed political commitment to ending the tobacco epidemic.
On Wednesday, his group will release its own report grading state
and federal efforts to control tobacco.
"Only a recommitment to a heightened level of action will enable us
to finish the job," Wimmer said.
Last week, the group and other advocacy organizations called on
political leaders to commit to cutting smoking rates to less than 10
percent of the population in a decade and to protect all Americans
from secondhand smoke within five years.
Friday's report briefly touched on the increasingly controversial
topic of electronic or e-cigarettes — devices designed to deliver
nicotine through vapor instead of tobacco smoke. It noted that major
tobacco companies, including Altria Group Inc, best known for its
Marlboro brand; Reynolds American Inc, maker of Camel cigarettes;
and Lorillard Inc, maker of Newport cigarettes, have invested in the
Previous studies have suggested that people can use the devices as
smoking cessation tools, but some public health advocates worry that
e-cigarettes might introduce more people to nicotine, the addicting
chemical found in tobacco. Electronic devices that feature fruit and
candy flavors are even more worrying, critics say, because they
could introduce children to smoking.
And there are still questions about the safety of the vapors
released by the devices. Health groups and state attorneys general
have been pressuring the FDA to impose regulations on the devices.
CDC's Frieden urged caution as the industry comes up with various
new products given the known dangers about tobacco.
"If we're talking about tobacco products ... they are guilty until
proven innocent, not the other way around," he said at the White
House. "All of these products may have an positive role is
appropriately regulated but not in the way that they are being sold
now with widespread marketing, over the Internet, with bubble gum
and cotton candy flavors, with free samples."
Altria said in a statement that it supports the FDA's authority to
regulate e-cigarettes as an extension of its power to regulate
"Our tobacco companies continue to focus on developing lower-risk
products that appeal to adult tobacco consumers and see this as an
important business opportunity under FDA regulation," the company
(Reporting by Julie Steenhuysen in Chicago.
additional reporting by
Susan Heavey in Washington. editing by Andre Grenon and Andrew Hay)
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