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Surgeon General shows how smoking harming children, causing cancer

Wire and Staff Reports | News Center | January 15, 2014

Surgeon General ReportMUSC researchers Drs. K. Michael Cummings, Anthony Alberg (pictured left) and Graham Warren (right) contributed to the 2014 Surgeon General's Report on smoking and health. See their responses below.

About 5.6 million American children alive today – or one out of every 13 children under age 18 – will die prematurely from smoking-related diseases unless current smoking rates drop, according to a new Surgeon General's report.  The report also finds cigarette smoking causes diabetes and colorectal cancer.

Over the last 50 years, more than 20 million Americans have died from smoking. The new report concludes that cigarette smoking kills nearly half a million Americans a year, with an additional 16 million suffering from smoking-related conditions. It puts the price tag of smoking in this country at more than $289 billion a year in direct medical care and other economic costs.

Today’s report, The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, comes a half-century after the historic 1964 Surgeon General’s report, which concluded that cigarette smoking causes lung cancer. Since that time, smoking has been identified as a cause of serious diseases of nearly all the body’s organs. Today, scientists add diabetes, colorectal and liver cancers, rheumatoid arthritis, erectile dysfunction, age-related macular degeneration, and other conditions to the list of diseases that cigarette smoking causes. In addition, the report concludes that secondhand smoke exposure is now known to cause strokes in nonsmokers.

“Smokers today have a greater risk of developing lung cancer than they did when the first Surgeon General’s report was released in 1964, even though they smoke fewer cigarettes,” said Acting Surgeon General Boris Lushniak, M.D., M.P.H. “How cigarettes are made and the chemicals they contain have changed over the years, and some of those changes may be a factor in higher lung cancer risks. Of all forms of tobacco, cigarettes are the most deadly – and cause medical and financial burdens for millions of Americans.”

Twenty years ago male smokers were about twice as likely as female smokers to die early from smoking-related disease. The new report finds that women are now dying at rates as high as men from many of these diseases, including lung cancer, chronic obstructive pulmonary disease (COPD) and heart disease. In fact, death from COPD is now greater in women than in men.

“Today, we’re asking Americans to join a sustained effort to make the next generation a tobacco-free generation,” said Health and Human Services Secretary Kathleen Sebelius. “This is not something the federal government can do alone. We need to partner with the business community, local elected officials, schools and universities, the medical community, the faith community and committed citizens in communities across the country to make the next generation tobacco free.”

Although youth smoking rates declined by half between 1997 and 2011, each day another 3,200 children under age 18 smoke their first cigarette and another 2,100 youth and young adults become daily smokers. Every adult who dies prematurely from smoking is replaced by two youth and young adult smokers.

The report concludes that the tobacco industry started and sustained this epidemic using aggressive marketing strategies to deliberately mislead the public about the harms of smoking. The evidence in the report emphasizes the need to accelerate and sustain successful tobacco control efforts that have been underway for decades.

HHS Assistant Secretary for Health Howard K. Koh, M.D., M.P.H said, “Over the last 50 years tobacco control efforts have saved 8 million lives but the job is far from over. This report provides the impetus to accelerate public health and clinical strategies to drop overall smoking rates to less than 10 percent in the next decade. Our nation is now at a crossroads, and we must choose to end the tobacco epidemic once and for all.”

The Obama Administration’s ongoing efforts to end the tobacco epidemic include enactment of the landmark Family Smoking Prevention and Tobacco Control Act, which gives FDA regulatory authority over tobacco products; significant expansion of tobacco cessation coverage through the Affordable Care Act to help encourage and support quitting; new Affordable Care Act investments in tobacco prevention campaigns like the “Tips from Former Smokers” campaign to raise awareness of the long-term health effects of smoking and encourage quitting; and increases in the cost of cigarettes resulting from the federal excise tax increase in the Children’s Health Insurance Program Reauthorization Act.

For the full report, executive summary, consumer guide and PSA, visit this website. For free help quitting smoking, smokers can call 1-800-QUIT-NOW or visit this site.


Anthony Alberg, Ph.D., Medical University of South Carolina, professor; associate director for Cancer Control at Hollings Cancer Center

  This accomplishment could be celebrated more fully as a public health triumph were it not for the fact that similar estimates indicate that double this number – 20 million deaths – were caused by smoking during this same period.  This latter figure underscores the preeminence of cigarette smoking as a public health threat.  According to the report, in the U.S., today over 440,000 deaths per year are attributable to active and passive smoking. The magnitude of this threat is a function of the fact that 1) many of cigarette smoking’s numerous deleterious health effects are often fatal and 2) the high prevalence of smoking. Sadly, the cigarette companies seem to be unfazed by the evidence that their products are unnecessarily defective and deadly.  As described in the report, tobacco use remains the world’s leading cause of preventable premature death with an estimated 1 billion deaths projected worldwide in this century.  Thus, despite all that is known about its health consequences, cigarette smoking persists as one of the major global health crises of our time. This remains an evolving story, with the final chapter on the scourge of tobacco upon society yet to be written, but let’s hope we don’t have to wait for another 50 years to get to the last chapter.

K. Michael Cummings, Ph.D., Medical University of South Carolina, professor, Psychiatry & Behavioral Sciences; Co-lead Tobacco Research, Hollings Cancer Center

The really frustrating part of this story is that deaths from tobacco are entirely preventable.  The report describes the problem resulting from today’s modern cigarette which has been engineered to allow easy inhalation of nicotine into the lungs making cigarettes highly addictive, but also exposing smokers to thousands of toxins, which are the byproduct of burning tobacco.  Amazingly, the data show that the risks from smoking have actually doubled over the past 50 years, because the addition of filters and additives which has made the smoke in today’s modern cigarette easier to inhale and thus more deadly.

Graham Warren M.D., Ph.D., Medical University of South Carolina; associate professor, vice chairman for research in radiation oncology; Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Hollings Cancer Center

Tremendous progress has been made over the past 50 years understanding the complex addictive nature of tobacco and spectrum of adverse health effects attributed to tobacco use.  However, we are just beginning to understand the effects of continued tobacco use in chronic disease populations such as cancer patients.  Smoking by cancer patients significantly increases cancer recurrence, treatment toxicity and mortality.  The report highlights the benefits of smoking cessation to reduce the adverse health effects caused by tobacco. Given the dismay associated with a cancer recurrence and the ever escalating costs of medical care, it's important to understand that it's never too late to quit smoking.



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