By Lauran Neergaard
WASHINGTON—
It’s no secret that smoking causes lung cancer. But what about diabetes, rheumatoid arthritis and erectile dysfunction? Fifty years after a U.S. report that launched the anti-smoking movement, scientists still are adding diseases to the long list of cigarettes’ harms.
A new report from the U.S. Surgeon General’s office celebrates decades of progress against smoking but says the country is not yet ready to finish the job.
“We still have a major and tragic catastrophe going on,” said acting Surgeon General Boris Lushniak.
Far fewer Americans smoke today — about 18 percent of adults, down from more than 42 percent in 1964. But the government may not meet its goal of dropping that rate to 12 percent by 2020, the new report warns.
Nearly half a million people will die from smoking-related diseases this year. Each day, more than 3,200 youths smoke their first cigarette. New products such as e-cigarettes, with effects that aren’t yet understood, complicate public health messages.
The report adds more entries to the official list of smoking-caused diseases, including Type 2 diabetes, rheumatoid arthritis, erectile dysfunction, the macular degeneration that can blind older adults, two additional cancers — liver and colorectal — and cleft palate birth defects.
“Enough is enough,” said Lushniak. He urged more tobacco-control measures including price increases for cigarettes.
Here are some ways the smoking landscape has changed between the 1964 surgeon general’s report and the latest one:
•1964: The surgeon general declares that cigarette smoking increases deaths.
2014: About 20.8 million people in the U.S. have died from smoking-related diseases since then, a toll the report puts at 10 times the number of Americans who have died in all of the nation’s wars combined. Most were smokers or former smokers, but nearly 2.5 million died from heart disease or lung cancer caused by secondhand smoke.
•1964: Heavy smoking is declared the main cause of lung cancer, at least in men. “The data for women, though less extensive, point in the same direction.”
2014: Today, lung cancer is the top cancer killer, and women who smoke have about the same risk of dying from it as men. As smoking has declined, rates of new lung cancer diagnoses are declining nearly 3 percent a year among men and about 1 percent a year among women.
•1964: Male smokers were dying of heart disease more than nonsmokers, but the surgeon general stopped short of declaring cigarettes a cause of heart disease.
2014: Today, heart disease actually claims more lives of smokers 35 and older than lung cancer does. Likewise, secondhand smoke is riskier for your heart. Smoke-free laws have been linked to reductions in heart attacks. The newest surgeon general report also found that secondhand smoke increases the risk of a stroke.
•1964: Smoking in pregnancy results in low-birth-weight babies.
2014: The new report said 100,000 of the smoking-caused deaths over the past 20 years were babies who died of sudden infant death syndrome, or SIDS, or complications from prematurity, low birth weight or other conditions related to parents’ smoking. And it adds cleft palate birth defects to that list of smoking risks to babies.
•1964: The more you smoke, the bigger the risk of death.
2014: Smokers are estimated to shorten their life by more than a decade. But stopping can lower that risk; sooner is better.
•1964: That first report focused mostly on lung effects and couldn’t prove whether smoking caused certain other illnesses.
2014: Doctors now know that smoking impacts nearly every organ of the body, and the new report said medical care for smoking-caused illnesses is costing the country more than $130 billion a year. Add to that lost productivity of more than $150 billion a year.
•1964: Cigarettes were the major concern. “The habitual use of tobacco is related primarily to psychological and social drives, reinforced and perpetuated by pharmacological (drug) actions of nicotine.”
2014: “The tobacco industry continues to introduce and market new products that establish and maintain nicotine addiction,” The new report says.
•1964: That first report called for “remedial actions” to reduce smoking. Warning labels on cigarette packaging started appearing a year later.
2014: With warnings now everywhere, the new report says, “We know that increasing the cost of cigarettes is one of the most powerful interventions we can make.” In 2012, the average price of a pack of cigarettes was $6, largely reflecting an increase in state and federal taxes. For every 10 percent increase in the price, there’s a 4 percent drop in smoking. — AP
