In January 1964, Luther L. Terry, M.D., the ninth Surgeon General of the United States, released the first report on the health hazards of smoking. The statement marked the beginning of an anti-smoking campaign, which – by conservative estimates – may have saved at least 8 million lives, according to new studies cited by the U.S. Surgeon General’s office.
But 50 years after that landmark report, too many Americans, especially younger people, are lighting up, ignoring stern public service announcements on TV and endless published findings that chronicle nicotine’s adverse affects on the body.
More than 20 million premature deaths can be attributed to cigarette smoking since the 1964 report, according to federal data. There is still much more work to be done to help more people quit smoking, or to help prevent them from starting, the most recent update from the Surgeon General says.
Last week, CVS Caremark jumped into the anti-smoking movement. The company announced that it will stop selling cigarettes and other tobacco products at its CVS/pharmacy stores by October 1 of this year.
“There has been tremendous progress,” says Baptist Health pulmonologist Rodney Benjamin [1], M.D. “Most people who can do it have stopped smoking. But people who still smoke are just addicted. They are no different than other drug addicts. The approach to helping them should be an addiction-focused approach, not a behavioral approach.”
Nicotine was found to be addicting in the 1988 Surgeon General’s report.
The Health Hazards
Currently, one-in-five deaths in the U.S. can be attributed to cigarette smoking, according to the Centers for Disease Control and Prevention. Smoking causes about 90 percent of male and 80 percent female lung cancer deaths. And smoking is a major risk factor for heart disease.
Smoking increases coronary heart disease and stroke risk two to four times, according to the CDC. The known carcinogens produced by burning cigarettes make blood vessels thicken and narrow. That makes the heart beat faster and blood pressure to increase. Clots can also form and block blood flow, causing a heart attack or a stroke.
In addition, cigarette smoking causes nine out of 10 deaths from chronic obstructive pulmonary disease (COPD).
“We can do a simple COPD screening for former smokers to determine if more testing is needed,” says Dr. Benjamin, referring to patients who may be concerned about their health following years of smoking.
According to the American Lung Association, tobacco kills more Americans in a single year than did World War II — “more than AIDS, cocaine, heroin, alcohol, vehicular accidents, homicide and suicide combined.”
That’s approximately 443,000 people who die prematurely from smoking or exposure to secondhand smoke each year, says the ALA.
The Good News Since 1964
More than 42 percent of U.S. adults smoked in the years preceding the 1964 report. That rate has dropped to about 18 percent. Along with smoking rates, mortality rates have declined for some diseases caused by smoking, such as heart disease and lung cancer for which smoking is the major cause.
There has been significant progress in controlling the spread of tobacco. During the past 50 years, the anti-smoking campaign has moved from small-scale measures, such as small text-only, cigarette-pack warnings, to more broader measures such as indoor smoking bans, support for cessation programs, restrictions on advertising and promotion, media campaigns involving ex-smokers and tax hikes on tobacco products.
The newest Surgeon General report says tobacco restrictions have contributed substantially to increases in U.S. life expectancy. For example, life expectancy for 40-year-olds has surged by more than five years since 1964, with tobacco control representing about 30 percent of that gain.
The Demographics of Smoking
Although cigarette smoking has declined significantly since 1964, last month the U.S. Surgeon General reported that very large disparities in tobacco use remain “across groups defined by race, ethnicity, educational level, and socioeconomic status and across regions of the country.”
Dr. Benjamin says that smoking is a bigger problem among the lesser-educated.
“Those with less education tend to start smoking earlier and have a tougher time quitting,” he says. “The better-educated may take up the habit, but they are more likely to overcome the addiction.”
Despite decades of warnings on the dangers of smoking, nearly 42 million adults and more than 3.5 million middle and high school students continue to smoke cigarettes, the Surgeon General reported last month.
Educating Younger People
This month, The Food and Drug Administration announced plans to launch its first national tobacco-prevention campaign targeted at adolescents. Dubbed “The Real Cost” campaign, the five-year initiative will include television ads highlighting that cigarettes come with a “cost” that is more than just financial.
“Early intervention is critical,” says FDA Commissioner Margaret A. Hamburg, M.D., in a statement.
That’s because most smokers pick up the habit in their teens. The CDC said that 88 percent of adult daily smokers started buying cigarettes before they were 18 years old. Every day, almost 4,000 kids under the age of 18 smoke their first cigarette. An additional 1,000 adolescents make the move to become daily smokers.
“The problem is that young people think they are immortal,” Dr. Benjamin says. “They think they are immune to the health-related consequences from smoking. But nicotine is addictive and we have to approach the problem with younger smokers as we do other forms of addiction.”