More Diseases Than Thought Linked to Smoking, Federal Report Finds
U.S. Surgeon General Richard Carmona on Thursday released a more than 900-page report that found cigarette smoking "harms nearly every human organ" and is directly linked to "more illnesses than previously known," the Los Angeles Times reports (Gerstenzang, Los Angeles Times, 5/28). Carmona issued the report, which used more than 1,600 scientific studies on smoking, 40 years after the release of the first surgeon general report on smoking, which linked the practice to lung cancer and bronchitis (Kaufman, Washington Post, 5/28). The new report linked smoking to at least 26 diseases, nine of which were not linked to the practice in the 27 previous surgeon general reports (Cox/Arizona Daily Star, 5/28). The report said that "the evidence is sufficient to infer a causal relationship" between smoking and the additional diseases, which include cancers of the kidneys, pancreas, stomach and uterine cervix; acute myeloid leukemia; abdominal aortic aneurysm; cataracts; periodontitis; and pneumonia (Los Angeles Times, 5/28). Carmona added that although some research has linked smoking to erectile dysfunction and liver, prostate and colorectal cancers, more evidence is required to establish a causal relationship (Zuckerbrod, AP/South Florida Sun-Sentinel, 5/28).
In addition, the report found that smoking may not cause breast cancer in women but that some women could increase their risk for the disease by smoking, based on their genetic predisposition (CongressDaily, 5/27). The report also found that nicotine is found in the breast milk of women who smoke and that infants exposed to secondhand smoke are twice as likely to experience sudden infant death syndrome as those not exposed. Infants whose mothers smoked before and after their births are "at three or four times greater risk," according to the report (Los Angeles Times, 5/28). According to the report, individuals who quit smoking at age 65 or older can reduce their risk of death from a related disease by almost 50%, and former smokers have the same risk for stroke as nonsmokers within five to 15 years after they quit (Olson, New York Times, 5/28). The report said that women who smoke die on average 14.5 years before women who do not smoke and that men who smoke die on average 13.2 years before men who do not smoke (Los Angeles Times, 5/28). About 440,000 U.S. residents die of smoking-related diseases each year, and more than 12 million have died from such diseases since the first surgeon general warning about smoking was released in 1964, according to the report. The report said smoking-related diseases cost the United States $75 billion per year in health care expenditures and $82 billion per year in lost productivity (AP/South Florida Sun-Sentinel, 5/28). The report is available online.
Carmona said that the report "documents that smoking causes disease in nearly every organ in the body at every stage of life" (New York Times, 5/28). "We've known for decades that smoking is bad for your health, but this report shows that it's even worse," Carmona said, adding, "The toxins from cigarette smoke go everywhere the blood flows. I'm hoping this new information will help motivate people to quit smoking and convince young people not to start in the first place" (Fox, Reuters/Newark Star-Ledger, 5/28). Carmona also said that research indicates low-tar and low-nicotine cigarettes do not reduce the potential health risks of smoking. "There is no safe cigarette, whether it is called 'light,' 'ultra-light' or any other name. The science is clear: The only way to avoid the health hazards of smoking is to quit completely or to never start smoking," he said (Washington Post, 5/28). "We need to cut smoking in this country and around the world," HHS Secretary Tommy Thompson said, adding, "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" (HHS release, 5/27). Carmona said that Thompson has decided to allocate $25 million to establish a national smoking-cessation telephone line. However, Matthew Myers, president of the Campaign for Tobacco-Free Kids, said, "Neither Congress' nor the administration's actions on tobacco are consistent with the serious findings of the surgeon general's report. Much more needs to be done" (Washington Post, 5/28). Myers said that Medicare and Medicaid should cover smoking-cessation programs and that Congress should raise the federal tax on cigarettes by $2 to help fund such programs. M. Cass Wheeler, president of the American Heart Association, said that the report should prompt state and federal anti-tobacco laws (Los Angeles Times, 5/28). Wheeler said that states "should continue doing what has been demonstrated over and over to be effective: Raise the price of tobacco through excise taxes, ban smoking in all workplaces and other public places and use money from the Master Settlement Agreement (with tobacco companies) to fund comprehensive prevention programs" (Washington Post, 5/28). She added, "At the federal level, a good place to start would be the pending proposals in Congress to give authority to FDA to regulate tobacco just as it regulates other products" (Reuters/Newark Star-Ledger, 5/28). Brendan McCormick, a spokesperson for 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."
In related news, CDC on Thursday released the results of a survey on current U.S. smoking trends (Los Angeles Times, 5/28). The CDC survey of 31,000 U.S. adults found that 22.5% of respondents described themselves as smokers in 2002 (Reuters/Newark Star-Ledger, 5/28). About 22.8% of U.S. adults described themselves as smokers in 2001 (Washington Post, 5/28). Carmona said that the decreased smoking rate provides evidence that "without a doubt, tobacco is one of the most incredible examples of a sea change in American attitudes about a health issue to be inspired by a surgeon general's report" (Cox/Arizona Daily Star, 5/28). CDC estimated that in 2002, for the first time, more U.S. adults described themselves as former smokers -- 46 million -- than smokers -- 45.8 million (Los Angeles Times, 5/28). According to the survey, 25% of men and 20% of women described themselves as smokers; 28.5% of respondents ages 18 to 24 described themselves as smokers; and about 9.3% of respondents older than 65 described themselves as smokers. The survey also found that lower-income and less-educated respondents continued to have higher smoking rates (Reuters/Newark Star-Ledger, 5/28). Smoking rates among U.S. adults with annual incomes lower than the federal poverty level -- $9,310 for an individual and $18,850 for a family of four -- was 32.9%, compared with 22.2% for those with annual incomes at or higher than the federal poverty level. Corinne Housten, a medical officer and epidemiologist for CDC Office on Smoking and Health, said that higher-income individuals have more access to smoking-cessation programs and live in a social environment where smoking is less acceptable. "We need to focus particular attention on these disadvantaged populations," and provide them with more access to smoking-cessation programs, health insurance and local clinics, Housten said (Los Angeles Times, 5/28). The survey is available online. Note: You must have Adobe Acrobat to view the survey.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.