Louisville Medicine Volume 62, Issue 4 | Page 22

SMOKING 50 YEARS AFTER THE LANDMARK 1964 SURGEON GENERAL’S REPORT LaQuandra Nesbitt, MD, MPH T his year marks the 50th anniversary of the landmark 1964 Surgeon General’s Report that first alerted our country to the very significant health hazards of tobacco use. While the prevalence of smoking has declined over the past 50 years - from 42 percent in 1965 to 18 percent in 2012 - it remains the number one cause of preventable death in America today. Each year smoking is responsible for more than 480,000 premature deaths in Americans age 35 and older. Women who smoke have about the same high risk of dying from lung cancer as men. Since the first Surgeon General’s report in 1964, smoking has killed more than 20 million Americans. More than 87 percent of lung cancer deaths, 61 percent of pulmonary disease deaths and 32 percent of all deaths from coronary heart disease are attributable to smoking and exposure to secondhand smoke. More than 10 times as many Americans have died from diseases related to cigarette smoking as have died in all the wars fought by the United Sates in its entire history! According to the 2008 Louisville Behavioral Risk Factor Surveillance Survey, 32 percent of Louisville adults smoke. This is considerably higher than the national rate of 18.1 percent. Not surprisingly, the age adjusted cancer death rate for lung cancer in Louisville from 2006 to 2010 of 63.9 deaths per 100,000 was also considerably higher than the national rate of 51.3 per 100,000. Smoking, among other factors, is having a significant impact on the lifespan of Louisville residents The 2014 Surgeon General’s Report asserts that much still needs to be done to end our country’s tobacco epidemic, particularly to prevent an early death in young people who are now taking up the habit. The report projects that if smoking persists at the current rate among young adults, 5.6 million Americans now younger than 18 years of age will die from a smoking related illness. LOUISVILLE 2014 SURGEON GENERAL’S REPORT A new Surgeon General’s Report published earlier this year expands the long list of diseases and other adverse health effects caused by smoking and exposure of nonsmokers to tobacco smoke. These new findings include: • Liver cancer and colorectal cancer are added to the long list of cancers caused by smoking; • Exposure to secondhand smoke is a cause of stroke; • Smoking increases the risk of dying from cancer and other diseases in cancer patients and survivors; • Smoking is a cause of age –related macular degeneration; • Smoking increases both the risk for tuberculosis and dying from it; • Maternal smoking during pregnancy is a cause of ectopic pregnancy and orofacial clefts in the newborn; • Smoking is a cause of male erectile dysfunction; • Smoking is a cause of diabetes mellitus; • Smoking causes general adverse effects on the body including inflammation and it impairs immune function; and • Smoking is a cause of rheumatoid arthritis. Many of the findings of the 2014 Surgeon General’s report have particular relevance to women who smoke. For the first time, women are now as likely as men to die from many of the diseases caused by smoking. The relative risk of