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August 3, 2004 • Volume 1 / Number 31 E-Mail This Document  |  Download PDF  |  Bulletin Archive/Search  |  Subscribe

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Guest Commentary by Richard H. Carmona

The 40-Year Battle Against Tobacco: Building Knowledge, Identifying Gaps

The work of dedicated public and private partners has produced many positive public health outcomes - such as reducing the use of tobacco. And as we know, public health campaigns are built upon scientific data and research-based evidence. That's why it is so critical that we continue to develop new understanding and identify gaps in our knowledge - such as the effects of smoking on women.

Richard H. Carmona The Office of the Surgeon General has a long history in exposing the risks of tobacco use. In 1964, Surgeon General Dr. Luther Terry issued the groundbreaking report on smoking and health. Dr. Terry called for a fundamental change in how our nation viewed tobacco at the time. He knew that by issuing the results of the research available to him - research that showed causality between smoking and disease - he was taking aim at one of the most pervasive symbols of American life: the cigarette.

In May 2004, we released The Health Consequences of Smoking: A Report of the Surgeon General. This latest report resulted from a collaboration of leading scientists, including Dr. Jonathan Samet of the Johns Hopkins Bloomberg School of Public Health, who served as senior scientific editor, and researchers and staff from the Centers for Disease Control and Prevention, the Office of the Surgeon General, and the Office of the Secretary of Health and Human Services.

This report summarizes four decades of evidence showing that smoking causes disease in nearly every organ of the body. Smoking kills an estimated 440,000 Americans each year, and more than 12 million Americans have died from smoking-related illnesses since 1964. It is estimated that 1 in 5 U.S. women smoke, and 170,000 women die each year from smoking. Smoking costs the United States $75 billion in direct medical costs and $82 billion in lost productivity.

Cancer was one of the first diseases linked to smoking. One of our key findings in the 2004 report is that smoking is associated with the vast majority of lung cancers, along with cancers of the mouth, throat, larynx, esophagus, pancreas, kidney, bladder, cervix, and stomach, as well as acute myeloid leukemia.

Publishing the report is only one step in reaching people with this critical health information. To ensure that we reach as many Americans as possible, we have also produced a consumer's version of the report in easy-to-understand language. It is already being used in community settings, doctors' offices, places of worship, and schools. The "people's piece" is also available online and features a link to an animated, interactive Web site of the human body. We are packaging the people's piece and the Web site with lesson plans for teachers to present smoking and health information using technology that students will find interesting and engaging.

For the medical and scientific community, we now have a new database that will make the 1,600 key scientific articles cited in the report available online. This database will be continually updated as new studies are published.

NCI recently formed the Women, Tobacco, and Cancer Working Group to identify ways to stimulate scientific research and translate knowledge into interventions to prevent tobacco-related cancers in women in the United States and worldwide. The NCI-led Working Group met this past February and produced a report: Women, Tobacco, and Cancer: An Agenda for the 21st Century.

The goals of the NCI Working Group are to bring a greater understanding of how and why women are affected by nicotine addiction. With this information, they will work with the health community to determine the best ways to educate the American people about the dangers of smoking. I hope that this new information and the efforts of all our partners will help motivate people to quit smoking and will convince young people to never start.

Vice Admiral Dr. Richard H. Carmona
Surgeon General
U.S. Public Health Service
Department of Health and Human Services