Antismoking Policies Have Saved More Than 8 Million Lives

According to a new study, the smoking rate has been cut by 58 percent.

NEW YORK, NY - DECEMBER 19: Catharine Candelario, an employee at the newly opened Henley Vaporium, vapes, or smokes an electronic cigarette, on December 19, 2013 in New York City. The New York City Council on Thursday will vote on a bill that would add electronic cigarettes to the city's strict smoking ban. If the Mayor Bloomberg backed ban is approved, the city would give businesses and restaurants a year to put up signs indicating there is no smoking or vaping allowed. The Henley Vaporium features a smoking bar and a coffee bar where tea and snacks are served in a relaxed environment.
National Journal
Clara Ritger
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Clara Ritger
Jan. 8, 2014, 8:58 a.m.

An­t­i­s­moking policies have saved more than 8 mil­lion lives in the 50 years since a land­mark sur­geon gen­er­al’s re­port con­nect­ing smoking to can­cer and oth­er dis­eases, ac­cord­ing to a new study from the Journ­al of the Amer­ic­an Med­ic­al As­so­ci­ation.

The 1964 re­port from Sur­geon Gen­er­al Luth­er Terry cata­pul­ted ef­forts to stop smoking by an­ti­to­bacco or­gan­iz­a­tions, in­clud­ing high­er to­bacco taxes, nonsmoking spaces, and pub­lic fund­ing for pro­grams aimed at help­ing smokers quit.

Since then, the smoking rate has been cut by 58 per­cent, and the ini­ti­at­ives have in­creased life ex­pect­ancy by more than 2 years for men and more than 1.5 for wo­men.

Now, pub­lic-health and an­t­i­s­moking groups are pivot­ing off the an­niversary to push for more strin­gent reg­u­la­tions.

“We now know that this first re­port of the sur­geon gen­er­al dra­mat­ic­ally un­der­stated the ef­fects of smoking,” said Mat­thew My­ers, pres­id­ent of the Cam­paign for To­bacco Free Kids. “We can­not and will not claim vic­tory un­til every child in the United States is to­bacco free and we will not wait an­oth­er 50 years to ac­com­plish that goal.”

The smoking rate cur­rently sits at 18 per­cent, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion, but the groups hope to bring it be­low 10 per­cent in the next dec­ade.

“The to­bacco in­dustry re­mains a huge obstacle in our ef­forts to pass good, smoke-free laws, to in­crease ex­cise taxes, to se­cure full fund­ing for to­bacco ces­sa­tion and pre­ven­tion pro­grams, and to in­crease reg­u­la­tion of to­bacco-re­lated products, such as e-ci­gar­ettes,” said Cyn­thia Hal­lett, ex­ec­ut­ive dir­ect­or of Amer­ic­ans for Nonsmokers’ Rights.

Roughly 44 mil­lion adults and 3.6 mil­lion chil­dren smoke in the United States, CDC says. Smoking is re­lated to one of every five deaths in the coun­try, amount­ing to more than 17.7 mil­lion deaths between 1964 and 2012, ac­cord­ing to JAMA. People who smoke are two to four times more likely to de­vel­op coron­ary heart dis­ease, the Amer­ic­an Heart As­so­ci­ation says, and twice as likely to suf­fer a stroke. Smoking ac­counts for at least 30 per­cent of all can­cer deaths, ac­cord­ing to the Amer­ic­an Can­cer So­ci­ety, and 87 per­cent of all lung-can­cer deaths.

Still, half the pop­u­la­tion does not live in areas of the coun­try with smoke-free laws in work­places, res­taur­ants, and bars, ac­cord­ing to Amer­ic­ans for Nonsmokers’ Rights, and CDC says smoking costs the U.S. roughly $193 bil­lion an­nu­ally in health care ex­pendit­ures and lost pro­ductiv­ity.

To reach their goal, the or­gan­iz­a­tions are call­ing on the pres­id­ent and Con­gress to grant the Food and Drug Ad­min­is­tra­tion au­thor­ity to reg­u­late all to­bacco products, in­clud­ing e-ci­gar­ettes and ci­gars, and es­tab­lish a com­pre­hens­ive ces­sa­tion be­ne­fit through the Af­ford­able Care Act, which would al­low covered Amer­ic­ans ac­cess to all forms of coun­sel­ing, a quit line, and sev­en FDA-ap­proved med­ic­a­tions without bar­ri­ers or re­stric­tions for smokers who have made pre­vi­ous at­tempts to quit.

They also want to see packs of ci­gar­ettes carry a graph­ic warn­ing la­bel and a high­er ex­cise tax, which av­er­ages $1.53 in states and an ad­di­tion­al $1.01 on the fed­er­al level.

More-strin­gent smoking laws are pop­ping up throughout the coun­try, with Hawaii and New York City ad­opt­ing meas­ures to raise the to­bacco pur­chas­ing age to 21, a move which will help keep ci­gar­ettes out of the hands of high school stu­dents, the or­gan­iz­a­tions said.

Such re­stric­tions are help­ing the U.S. and oth­er wealthy coun­tries, but those pub­lic-health meas­ures are out­paced by a rise in the num­ber of smokers in the de­vel­op­ing world, an­oth­er JAMA study re­ports. The Uni­versity of Wash­ing­ton has found the total adult smoking pop­u­la­tion to have in­creased to over 1 bil­lion in 2012 from 721 mil­lion in 1980. Total ci­gar­ettes smoked has topped 6.25 tril­lion, up from 5 tril­lion, in that same peri­od. While glob­al smoking rates have de­creased to 18.7 per­cent from 26 per­cent due to world­wide pop­u­la­tion growth, the rise in num­bers sig­nal a per­sist­ent pres­ence of the to­bacco in­dustry.

New products — such as e-ci­gar­ettes — are gain­ing pop­ular­ity with some who say they are bet­ter for pub­lic health. But the an­ti­to­bacco or­gan­iz­a­tions wer­en’t ready to give the green light to the de­vel­op­ment.

“Whatever po­ten­tial e-ci­gar­ettes have to re­duce the death and dis­ease caused by smoking needs to be heav­ily reg­u­lated by the FDA,” My­ers said.

Hal­lett ad­ded that some smoke-free en­vir­on­ments al­low e-ci­gar­ettes, a prac­tice Amer­ic­ans for Nonsmokers’ Rights does not con­done be­cause of the va­pors re­leased by the product and the lack of evid­ence and sci­entif­ic res­ults about their safety.

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