It has been more than 45 years since (then) U.S. Surgeon General Luther Terry, M.D., first informed the nation about the dangers of smoking. Twenty-nine more reports from the surgeon general's office on the topic have followed. Most of those documents have focused on the various diseases linked to smoking, but a report released Dec. 9 by current U.S. Surgeon General Regina Benjamin, M.D., M.B.A., stresses that damage from cigarette smoke -- including secondhand smoke -- is immediate.
"The message from this report for Americans is simple: There is no safe level of exposure to tobacco smoke," said HHS Secretary Kathleen Sebelius during a Dec. 9 news conference(www.visualwebcaster.com) to announce the publication of How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease(www.surgeongeneral.gov).
The report describes in detail how smoking affects the entire body, and it notes that cigarettes have evolved to become increasingly addictive.
Benjamin, a family physician from Bayou La Batre, Ala., said during the news conference that many smokers will need more than one attempt before they are able to successfully quit smoking, and the new data in the report could help cessation efforts.
"We have known that smoking causes a lot of problems, disease and cancer," she said. "We had not known how. I believe it's very important that every American knows exactly what's happening with their body, particularly people who are trying to stop smoking. They need to know there is a biological reason it's hard to quit so they don't give up."
Cigarettes contain more than 7,000 chemicals, including hundreds that are hazardous and at least 69 that cause cancer. Benjamin said those chemicals quickly reach a smoker's lungs every time the smoker inhales. Blood then carries the toxins to every organ in the body.
Twenty percent of U.S. adults and teenagers are smokers, far more than the 12 percent objective set by Healthy People 2010. Healthy People 2020(www.healthypeople.gov), which launched Dec. 2, maintains that 12 percent goal.
When the first surgeon general's report on smoking was released in 1964, more than 40 percent of Americans were smokers. Although that rate has been cut by more than half, there has been little progress on smoking cessation in recent years.
"We need to keep after this until we make a bigger dent in smoking, and that's what this renewed campaign is about," said HHS Secretary Kathleen Sebelius during a Dec. 9 news conference that coincided with the release of a new surgeon general's report on smoking. "We've been stalled at 20 percent for over seven years. That's not a good place to be when 1,000 kids become lifetime smokers every day."
Sebelius said the Family Smoking Prevention and Tobacco Control Act, which was signed into law by President Obama last year, could help decrease smoking rates. The legislation gives the FDA the authority to regulate tobacco products, and it has already moved to stop manufacturers from marketing cigarettes to children. The FDA also announced it will require that cigarette packages and advertisements have larger and more visible graphic health warnings.
The Healthy People 2020 website, which has information and objectives related to more than three dozen health topics, also offers resources for public health professionals(www.healthypeople.gov).
According to the Campaign for Tobacco Free Kids(www.tobaccofreekids.org), more than 20 percent of smokers don't use cigarettes every day, but the report had sobering news for "social smokers," too. Benjamin said just one cigarette is enough to damage blood vessels throughout the body, making blood more likely to clot. One cigarette -- or brief exposure to secondhand smoke -- is enough to trigger a heart attack in a person with heart disease, she said.
Cigarette smoke also
- damages the lining of the lungs, which can hamper a smoker's ability to exchange air effectively and lead to chronic obstructive pulmonary disease;
- damages DNA, which can lead to cancer;
- weakens the immune system;
- decreases the benefits of chemotherapy and other cancer treatments and actually causes tumors to grow;
- makes it more difficult for people with diabetes to regulate their blood sugar, exacerbating health issues resulting from the disease; and
- causes numerous reproductive issues in women and men, as well as adverse development issues in their children.
Benjamin said 70 percent of smokers want to quit, and physicians can play a vital role in helping their patients.
"Patients who have been advised to quit smoking by their doctors have a 66 percent higher rate of success," said Benjamin, whose mother died of lung cancer.
HHS has developed a fact sheet for health care professionals(www.cdc.gov) that provides talking points and key information to help physicians talk to their patients about quitting.
According to Benjamin, quitting gives the body a chance to heal from the damage caused by smoking. When smokers quit, the risk for a heart attack drops sharply after one year. Stroke risk can fall to a level similar to that of a nonsmoker after two to five years. Risks for cancer of the mouth, throat, esophagus and bladder are cut in half after five years; and the risk for dying of lung cancer drops by half after 10 years.
The report on smoking is more than 700 pages. However, a fact sheet(www.surgeongeneral.gov) with key points from the report, a 19-page executive summary(www.surgeongeneral.gov) and a 20-page, plain language booklet for consumers(www.cdc.gov) are available on the surgeon general's website.