When the Surgeon General’s Report on Smoking and Health in 1964 drew attention to the link between lung cancer and smoking, the fateful warning didn’t just change things for the ad men of Madison Avenue.
A new study from the National Cancer Institute estimates that nearly 800,000 people did not die from lung cancer between 1975 and 2000 who otherwise would have, thanks to tobacco-control programs and policies that went into place after the surgeon general’s report. And that's just lung cancer--the report did not look at heart disease, emphysema, stroke, or the other forms of cancer that smoking is known to cause.
Moreover, the analysis finds that if all cigarette smoking had ceased after the surgeon general’s report, 2.5 million people would have been spared from lung cancer deaths in the 36 years that followed.
“These findings provide a compelling illustration of the devastating impact of tobacco use in our nation and the enormous benefits of reducing rates of smoking,” Robert Croyle, director of the Division of Cancer Control and Population Sciences at the National Cancer Institute, said in a statement. “Although great strides have been made, we cannot relax our efforts. The prevention and cessation of tobacco use continue to be vital priorities for the medical, scientific, and public health communities."
The findings should also give new impetus to public health officials, who have been struggling to maintain the policies credited with saving so many lives. Many states and localities have instituted smoking bans and cigarette taxes, but many others have not. The 1998 Tobacco Master Settlement Agreement between tobacco companies and the attorneys general of 46 states who sued for the costs of treating Medicaid patients who smoked generated $206 billion, supposedly for smoking-prevention efforts, but many states have used the cash for other purposes.
Smoking rates have fallen by more than half in the United States since 1965, from 42 percent of the population to just under 20 percent in 2010. The Centers for Disease Control and Prevention estimates that 43 million Americans now smoke.
The study was released on Wednesday in the Journal of the National Cancer Institute, part of the National Institutes of Health. Researchers used a comparative modeling approach to analyze the cigarette-smoking histories for individuals born from 1890 through 1970, relating those histories to lung cancer mortality and the effects of tobacco control activities on lung cancer deaths.
The study was broken down into three different scenarios in which U.S. tobacco-control programs were in place as they were; no tobacco-control programs existed; and a scenario in which all smoking in the United States ceased as of 1965.
Researchers estimated that without tobacco-control programs and policies, an additional 552,000 men and 243,000 women would have died of lung cancer from 1975 through 2000.
“This is the first attempt to quantify the impact of changes in smoking behaviors on lung cancer mortality based on detailed reconstruction of cigarette smoking histories,” the study’s lead author, Dr. Suresh Moolgavkar of the Fred Hutchinson Cancer Research Center in Seattle, said in a statement.
Some of the tobacco-control efforts in the United States since the 1964 surgeon general's report have included increases in cigarette excise taxes, restrictions on smoking in public places, limits on underage access to cigarettes, and overall efforts to increase public awareness of the hazards of smoking.
“An overwhelming majority of lung cancer deaths can be prevented by eliminating cigarette smoking,” Eric Feuer, chief of NCI’s Statistical Methodology and Applications Branch, said in a statement.
Lung cancer is by far the biggest cancer killer in the United States. The American Cancer Society projects that lung cancer will kill 160,000 Americans this year, with virtually all cases linked to smoking.