Lung Association Applauds New Surgeon General s Report

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Lung Association Applauds New Surgeon General's Report

NEW YORK, May 27, 2004 -- The following is a statement by John L. Kirkwood, president and CEO of the American Lung Association, on the release of the 2004 U.S. Surgeon General's report on the health consequences of smoking:

The American Lung Association welcomes the release of the 2004 U.S. Surgeon General's report, The Health Consequences of Smoking. This year marks the 40th anniversary of the first Surgeon General's report and is a grave reminder that smoking is still this nation's number one preventable cause of death.

Smoking prevalence was 46 percent when the first Surgeon General's report was released in 1964; now it is around 23 percent. Despite that progress, as Surgeon General Richard H. Carmona, M.D., notes in the new report, approximately 440,000 people die from a smoking-attributable disease each year.

For the first time, the Surgeon General includes pneumonia in the list of diseases caused by smoking. Each year, an estimated 4.8 million cases of this acute lung infection are reported in the United States, with some 1.3 million hospitalizations and 1.3 million emergency department visits. Close to 62,000 pneumonia deaths were recorded in the United States in 2001.

Of special concern to the American Lung Association is the fact that many smoking-related deaths are due to chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.

The COPD facts are grim:

-- 118,000 Americans die from COPD each year; a smoker is 10 times more likely to die from COPD than a nonsmoker.

-- COPD is the fourth-ranking cause of death in the United States and is expected to be the fifth-ranked cause of disability by 2020.

-- Eighty to 90 percent of all COPD is caused by smoking.

-- 11.2 million U.S. adults have been diagnosed with COPD, another 12.8 million are undiagnosed -- for a total of 24 million people.

-- COPD costs this nation an estimated $32.1 billion each year.

Emphysema and chronic bronchitis are slowly progressive diseases characterized by difficulty in breathing. For COPD patients, every breath is a chore. Their quality of life diminishes as their disease progresses. Many eventually require supplemental oxygen and must rely on machines to breathe. Most COPD patients say their condition limits their ability to work, sleep, exercise, do household chores, and enjoy family and social activities. COPD cannot be cured but when diagnosed early, treatment can decrease its symptoms and complications.

Public policy interventions can spare future generations the agony of COPD and other smoking-related illnesses. The American Lung Association supports decisive action on several critical fronts:

Grant FDA authority over tobacco products.

The American Lung Association strongly supports bipartisan legislation (Family Smoking Prevention and Tobacco Control Act, HR 4433/S 2461) to give the federal Food and Drug Administration the authority, tools and resources to effectively regulate the manufacture, marketing, labeling, distribution and sale of tobacco products.

Tobacco products are virtually unregulated, providing decades of special protection to the tobacco industry at the expense of public health.

Cut tobacco use.

Increases in cigarette taxes and enactment of comprehensive smokefree workplace laws contribute to significant reductions in smoking rates. A recent study showed an 11 percent reduction in smoking rates among adults in New York City. In addition to having a strong smokefree air law, the city increased its cigarette tax from 8 cents to $1.50 per pack in 2002. Both contributed to the dramatic decline in smoking. From Maine to California, states and localities throughout the country are acting to restrict smoking in public places to protect the health of smokers and nonsmokers alike.

Higher taxes and smokefree air laws are powerful incentives for smokers to quit.

Ratify the global tobacco treaty.

The American Lung Association recently applauded the U.S. government for signing the world's first tobacco-control treaty, the Framework Convention on Tobacco Control (FCTC). For the treaty to take effect, it also must be ratified -- or approved -- by the U.S. Senate. The American Lung Association is urging President Bush to send the treaty to the Senate for immediate consideration and approval.

By signing AND ratifying the treaty, the U.S. government will show the world that this country is serious about protecting people everywhere from tobacco addiction, disease and death.

Contact: Diane Maple of the American Lung Association, 202-785-3355

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Reference document

News Release


Thursday, May 27, 2004

Contact: HHS Press Office
(202) 690-6343

New Surgeon General's Report Expands List of Diseases Caused by Smoking

U.S. Surgeon General Richard H. Carmona today released a new comprehensive report on smoking and health, revealing for the first time that smoking causes diseases in nearly every organ of the body. Published 40 years after the surgeon general's first report on smoking -- which concluded that smoking was a definite cause of three serious diseases -- this newest report finds that cigarette smoking is conclusively linked to diseases such as leukemia, cataracts, pneumonia and cancers of the cervix, kidney, pancreas and stomach.

"We've known for decades that smoking is bad for your health, but this report shows that it's even worse than we knew," Dr. Carmona said. "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."

According to the report, smoking kills an estimated 440,000 Americans each year. On average, men who smoke cut their lives short by 13.2 years, and female smokers lose 14.5 years. The economic toll exceeds $157 billion each year in the United States -- $75 billion in direct medical costs and $82 billion in lost productivity.

"We need to cut smoking in this country and around the world," HHS Secretary Tommy G. Thompson said. "Smoking is the leading preventable cause of death and disease, costing us too many lives, too many dollars and too many tears. 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."

In 1964, the Surgeon General’s report announced medical research showing that smoking was a definite cause of cancers of the lung and larynx (voice box) in men and chronic bronchitis in both men and women. Later reports concluded that smoking causes a number of other diseases such as cancers of the bladder, esophagus, mouth and throat; cardiovascular diseases; and reproductive effects. Today’s new report, The Health Consequences of Smoking: A Report of the Surgeon General, expands the list of illness and conditions linked to smoking. The new illnesses and diseases are cataracts, pneumonia, acute myeloid leukemia, abdominal aortic aneurysm, stomach cancer, pancreatic cancer, cervical cancer, kidney cancer and periodontitis.

Statistics indicate that more than 12 million Americans have died from smoking since the 1964 report of the surgeon general, and another 25 million Americans alive today will most likely die of a smoking-related illness.

The report's release comes in advance of World No Tobacco Day, an annual event on May 31 that focuses global attention on the health hazards of tobacco use. The goals of World No Tobacco Day are to raise awareness about the dangers of tobacco use, encourage people not to use tobacco, motivate users to quit and encourage countries to implement comprehensive tobacco control programs.

The report concludes that smoking reduces the overall health of smokers, contributing to such conditions as hip fractures, complications from diabetes, increased wound infections following surgery, and a wide range of reproductive complications. For every premature death caused each year by smoking, there are at least 20 smokers living with a serious smoking-related illness.

Another major conclusion, consistent with recent findings of other scientific studies, is that smoking so-called low-tar or low-nicotine cigarettes does not offer a heath benefit over smoking regular or "full-flavor" cigarettes.

"There is no safe cigarette, whether it is called 'light,' ultra-light,' or any other name," Dr. 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."

The report concludes that quitting smoking has immediate and long-term benefits, reducing risks for diseases caused by smoking and improving health in general. "Within minutes and hours after smokers inhale that last cigarette, their bodies begin a series of changes that continue for years," Dr. Carmona said. "Among these health improvements are a drop in heart rate, improved circulation, and reduced risk of heart attack, lung cancer and stroke. By quitting smoking today a smoker can assure a healthier tomorrow."

Dr. Carmona said it is never too late to stop smoking. Quitting smoking at age 65 or older reduces by nearly 50 percent a person's risk of dying of a smoking-related disease.

In addition to the 960-page printed report, The Health Consequences of Smoking, the U.S. Department of Health and Human Services released a new interactive scientific database of more than 1,600 key articles cited in the report, available through the Internet ( The database can be used to find detailed information on the specific health effects of smoking as well as to develop customized analyses, tables and figures.

The database will be continually updated as new critical studies are published, allowing the surgeon general to determine on a regular basis whether the evidence supports a new definitive conclusion about smoking-caused disease. "Using this technology, once a threshold of danger is met, we can quickly alert the American people of new information related to smoking," Dr. Carmona said.

The report found that for a number of diseases and conditions associated with smoking, the evidence is not yet conclusive to establish a causal link. For these illnesses, which include colorectal cancer, liver cancer, prostate cancer, and erectile dysfunction in men, additional studies are needed to reach the threshold of evidence required by the Surgeon General's strict causal criteria to declare that they are causally related to smoking. These criteria were introduced in the 1964 report and have been updated in the 2004 report using new uniform standards.

For breast cancer, the evidence suggests that there is no causal relationship overall to smoking. However, the report notes that on a genetic basis, some women may be at increased risk if they smoke. More research is required to clarify the role of smoking in the cause and progression of breast cancer.

To help communicate the report findings as widely as possible, Surgeon General Carmona also unveiled a new animated Web site for the public showing the hazards of smoking and the benefits of quitting ( In addition, a full-color, easy-to-read summary of the report has been developed for the public.

"The Web site and public summary of the smoking report are something that I am really proud of," Dr. Carmona said. "By preparing materials that people who don't have a medical degree can understand we effectively bring the science to people in a way they can use. Improving the health literacy of Americans by closing the gap between what health professionals know and the public understands will have a lasting positive health impact."

Copies of the full The Health Consequences of Smoking: A Report of the Surgeon General and related materials are available from the Centers for Disease Control and Prevention, Office on Smoking and Health, 1-800-CDC-1311, and on the surgeon general's Web site at

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