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NEWS & VIEWS |
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Five new cancers and four other serious diseases have been added to the list of health problems caused by tobacco.
The 2004 Surgeon General’s Report on the Health Consequences of Smoking states that smoking has been conclusively linked to acute myeloid leukemia and cancers of the cervix, kidney, pancreas, and stomach. Smoking is now also known to cause pneumonia, abdominal aortic aneurysm, cataracts, and periodontitis.
"We’ve known for decades that smoking is bad for your health, but this report shows that it’s even worse than we knew," said Surgeon General Richard Carmona, MD, MPH. "The toxins from cigarette smoke go everywhere the blood flows."
Indeed, smoking harms nearly every organ of the body, the report said, damaging a smoker’s overall health even when it doesn’t cause a specific illness.
Awareness of the dangers of tobacco use has increased enormously since 1964, when the first Surgeon General’s report on smoking was released. In an era when about half of American adults smoked, the findings were so stunning that they were kept a closely guarded secret until their official release on the morning of January 11, 1964. The day, a Saturday, had been carefully chosen to avoid causing a negative reaction on Wall Street.
That first Surgeon General’s report was the first widely publicized, official recognition of the dangers posed by smoking. Its findings were based on more than 7,000 medical articles, including two major ACS studies: the 1952 Hammond-Horn study and the 1959 Cancer Prevention Study 1. The findings showed higher mortality in people who began smoking earlier in life, higher mortality in those who inhaled more deeply than those who didn’t, and fewer deaths in smokers who quit than in those who continued smoking. Based on these and other documents, the 1964 report concluded that smoking caused lung and laryngeal cancer in men, was a probable cause of lung cancer in women, and was the most important cause of chronic bronchitis.
Since that time, the Surgeon General’s report has concluded that "the evidence is sufficient to infer a causal relationship" between smoking and a growing list of illnesses that includes 10 forms of cancer as well as 19 diseases of the cardiovascular, respiratory, reproductive, and other systems.
In another major conclusion, the report confirms that trading in regular cigarettes for "light" or "low tar" brands won’t have any health benefits. Previous studies have determined that smokers who choose these seemingly less harmful brands actually inhale just as many harmful chemicals as smokers of regular cigarettes because they tend to inhale deeper and hold the smoke in their lungs longer.
"There is no safe cigarette, whether it’s called ‘light,’ ‘ultralight,’ or any other name," Carmona said. "The science is clear: the only way to avoid the health hazards of smoking is to quit completely or to never start smoking."
Quitting smoking has immediate health benefits, he noted. Circulation improves and heart rate drops, reducing the risk of heart attack. Quitting can also reduce a smoker’s chance of developing cancer.
"Within minutes and hours after smokers inhale that last cigarette, their bodies begin a series of changes that continue for years," Carmona said.
The staggering human and economic costs of smoking make fighting against tobacco all the more important. The new report confirms that smoking kills about 440,000 Americans each year and drains $157 billion in medical costs and lost productivity.
"We need to cut smoking in this country and around the world," said Health and Human Services Secretary Tommy Thompson. "If we are going to be serious about improving health and preventing disease we must continue to drive down tobacco use, and we must prevent our youth from taking up this dangerous habit."
The Framework Convention on Tobacco Control, the first global treaty designed to curb smoking worldwide, could help in that battle. It requires member nations to implement measures like higher taxes on tobacco products, smoking bans, and restrictions on tobacco advertising.
The United States signed the treaty in May but has not yet ratified it. Although signing is an important first step, this only commits the United States to agreeing not to undermine the treaty and to take unspecified steps toward ratification. Ratification—which would require the President to submit the treaty to the US Senate for its approval, an action that is not expected in the near future—would require the United States to abide by all of the elements of the treaty that are constitutionally allowable (eg, the United States would have to increase the size of cigarette warning labels to cover 30% or more of the pack, but it would not have to ban tobacco advertising because our Constitution would not likely permit that). At least 40 countries must ratify the agreement for it to take effect.
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