Health Risks From Smoking More Widespread, Report Says
Cigarette smoking harms nearly every human organ and is increasingly a habit of the poorest Americans, the federal government reported Thursday in its most comprehensive look at the dangers of tobacco in three years.
Forty years after the ground-breaking surgeon general’s study that alerted Americans to the cancer risk of cigarettes, the current surgeon general issued a report that linked smoking to more illnesses than previously known. Dr. Richard H. Carmona also reported that cigarettes offering lower tar and nicotine than conventional-strength cigarettes provide no clear health benefits.
Taken together, the surgeon general’s study and a report from the Centers for Disease Control and Prevention portray a nation making small gains in its fight against tobacco: For the first time, more people who say they have smoked count themselves as former smokers rather than as current smokers. And over four decades, the percentage of smokers has been cut nearly in half.
Earlier reports have documented the greater propensity of the poorest, least-educated Americans to smoke. But the CDC report found that the poorest Americans are having a more difficult time giving up the habit than those who are better off.
The surgeon general’s report found that as scientific knowledge has expanded, the dangers of cigarettes have grown more apparent. They go far beyond circulatory and respiratory illnesses to include risks to reproductive organs, kidneys and vision, Carmona said. His report also found that a higher number of specific types of cancer are fueled by smoking than earlier reports had stated.
To the list of illnesses and conditions linked to smoking, the surgeon general added cataracts, pneumonia, acute myeloid leukemia, abdominal aortic aneurysms, periodontitis (an inflammation of gum tissue) and cancers of the stomach, pancreas, cervix and kidney.
Nicotine is found in breast milk, Carmona said, and babies exposed to secondhand smoke are twice were likely to be victims of sudden infant death syndrome as those not exposed to it. Infants whose mothers smoked before and after birth were “at three or four times greater risk,” the report said.
The report said women who smoke shorten their lives by an average of 14.5 years, and that the average loss for male smokers is 13.2 years.
“We’ve known for decades that smoking is bad for your health, but this report shows that it’s even worse,” Carmona said. “The toxins from cigarette smoke go everywhere the blood flows.”
And, he added, “there is no safe cigarette, whether it is called ‘light,’ ‘ultra-light’ or any other name.”
M. Cass Wheeler, president of the American Heart Assn., said the surgeon general’s report should inspire stronger antitobacco action by the federal and the state governments.
“Tobacco remains the nation’s most unregulated consumer product,” he said, noting that Congress was considering legislation that would give the Food and Drug Administration the authority to regulate tobacco products.
On the state level, he called for increased taxes, comprehensive smoking bans and the use of money from the settlement agreement between the states and tobacco companies to fund more antismoking programs.
Brendan McCormick, a spokesman for cigarette maker Philip Morris USA, said, “We agree with the medical and scientific conclusions that cigarette smoking causes serious diseases in smokers, and that there is no such thing as a safe cigarette.”
The data on smoking trends were included in the CDC’s weekly newsletter on developments in public health.
The agency estimated that in 2002, the most recent year for which it has figures, 46 million adult Americans counted themselves as former smokers. That figure represented 50.1% of adults who had ever smoked.
The agency also estimated that 45.8 million adult Americans, or 22.5% of the adult population, were smokers. The percentage of the population considered smokers dropped from 24.1% in 1998 and from 22.8% in 2001.
The government has set a goal that by 2010, smokers will account for less than 12% of the population. The CDC said its surveys indicated that at the current pace at which people were quitting, the United States would not reach this target.
According to the CDC, 22.2% of adult Americans living at or above the poverty level were smokers in 2002, down from 31.5% of that population in 1983. That represented a decrease of 29%. Smoking among the poorest Americans dropped 18%, from 40.2% of that segment of the population to 32.9%.
The federal poverty level for an individual is $9,310 in annual income; for a family of four, it is $18,850.
Corinne Housten, a medical officer and epidemiologist at the CDC’s office of smoking and health, said that wealthier people had greater access to programs designed to help people quit smoking and lived in a social environment in which smoking was less acceptable.
“We need to focus particular attention on these disadvantaged populations,” providing access to treatment, health insurance and local clinics providing help in breaking the smoking habit, she said.
Her views were supported by Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, who called for coverage for smoking cessation programs under Medicare and Medicaid, the government healthcare programs for the elderly and the poor. He also encouraged Congress to raise the federal cigarette tax by $2 and use a portion of the proceeds for quit-smoking initiatives.
“What is most disturbing about this report is the wide gulf between the devastation caused by smoking and what our country is doing to reduce it,” Myers said in a statement.
In California, the average price of a pack of cigarettes is more than $4, according to his organization.
Although some of the previous 27 surgeon general’s reports on smoking have raised the likelihood, or certainty, that smoking increased the risk of a variety of diseases, the new document goes further, stating in case after case that “the evidence is sufficient to infer a causal relationship” between smoking and a specific condition.
One by one, the reports have added to the breadth of concerns about smoking, which they count as the greatest avoidable cause of death in the United States. The executive summary of Thursday’s report said smoking causes about 440,000 deaths a year and costs approximately $157 billion in annual health-related economic losses.
The summary of the 900-page report stated: “An increasingly disturbing picture of widespread organ damage in active smokers is emerging, likely reflecting the systemic distribution of tobacco smoke components and their high level of toxicity.
“This new information should be an impetus for even more vigorous programs to reduce and prevent smoking.”
