Photo of cigarette buttSmoking has caused an enormous avoidable public health tragedy with almost 500,000 Americans dying every year due to cigarettes, according to a report released on Friday.

Unless efforts like smoke-free policies and well-funded tobacco cessation programs are bolstered, 5.6 million young Americans who are alive today will die from smoking, according to Acting Surgeon General Rear Admiral Boris Lushniak, who released “The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General” at a White House news conference.

In the last 50 years, the smoking rate in the United States has been cut from nearly 43 percent in 1965 to 18 percent in 2012. But since the first Surgeon General’s report in 1964, more than 20 million premature deaths can be attributed to cigarette smoking. About 7.8 million of those deaths were due to cardiovascular and metabolic diseases, the report said.

“Over the last 50 years, more than 20 million Americans could have lived healthier and longer lives if they had never lit their first cigarette. Even more disturbing is the fact that every one of these deaths was entirely preventable,” said Nancy Brown, chief executive officer of the American Heart Association. “The evidence that smoking kills is now even more overwhelming and undeniable. We must take the bold and urgent actions necessary to wipe out the curse of tobacco forever.”

The report, the most recent of 30 issued on tobacco and smoking, adds to the list of health problems that are associated with smoking, including liver cancer and colorectal cancer. It stated that smoking causes Type 2 diabetes mellitus, age-related macular degeneration, erectile dysfunction and rheumatoid arthritis. In addition,  the report said that smoking can impact the immune system and worsen asthma, while secondhand smoke exposure can cause strokes.

“The conclusions from these reports have evolved from a few causal associations in 1964 to a robust body of evidence documenting health consequences both from active smoking and exposure to secondhand smoke across a range of diseases and organ systems,” Lushniak wrote. “A half century after the release of the first report, we continue to add to the long list of diseases caused by tobacco and exposure.”

Data from the past 50 years shows the loss of life and the economic impact that have stemmed from manufacturing, marketing, selling and consuming tobacco, according to the report. Nearly 25 trillion cigarettes have been consumed in this half-century, despite a significant drop in con­sumption per smoker, Lushniak wrote.

Smoking costs between $289 billion and $333 billion a year in the U.S.. That includes at least $130 billion in direct medical care of adults, over $150 billion for lost productivity due to premature death and more than $5 billion for lost productivity from premature death due to exposure to secondhand smoke.

The report  points out that being in the same room with a smoker can cause irreparable harm. Two and half million of those who died in the last 50 years were non-smokers exposed to secondhand smoke. Ongoing exposure, according to the report, can increase your risk of stroke by 20 to 30 percent.

The report also examines strate­gies that could eradicate the death and disease from tobacco. Smoke-free policies can result in a reduction of coronary events in people younger than 65. In addition, smokers who quit by age 40 can virtually eliminate their risk of heart disease, according to the report.

Brown, who attended the news conference, said the new information boosts efforts to pass smoke-free laws in all 50 states and increase resources to help people quit smoking.

“It is shocking how little we employ the solutions that can help us avert more unnecessary deaths and end this epidemic once and for all. Combined interventions — such as mass media campaigns, well-funded state prevention and cessation programs, increased tobacco taxes, and smoke-free laws — reduce tobacco use among youth and adults,” Brown said. “The association strongly supports all of these interventions.”

The report urges learning important lessons from other successes in confronting epidemics like smallpox and polio with public health strategies that were sustained for decades. Smallpox was eradicated and polio is on the verge of elimination. The report urges a commitment to creating a society free of tobacco-related death and disease “by engaging all sectors of society to an equally single-minded focus.”


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Photo courtesy of Mark Schoeberl