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US tobacco use has decreased but premature deaths from tobacco persist

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Fifty years have passed since publication of the landmark report of the Surgeon General’s Advisory Committee on smoking and health. On January 17, a new Surgeon General’s report was released—the first in more than a decade. The report notes both the dramatic progress our nation has made reducing tobacco use and the continuing burden of disease and death caused by smoking. In the first report, lung cancer was listed as the only disease caused by smoking. New health hazards were added to the list in subsequent reports; the new report adds some new consequences of smoking: liver cancer, colorectal cancer, diabetes, rheumatoid arthritis, and even erectile dysfunction. The report cautions that, if current trends continue, another 5.6 million children are at risk of dying prematurely.

According to the new report, adult smoking rates have fallen to the current 18% from 43% of Americans in 1965; however, each day, more than 3,200 youths under the age 18 try their first cigarette. In notes that, for the US, the epidemic of smoking-caused disease in the 20th Century ranks among the greatest public health catastrophes of the century. The decline of smoking due to anti-smoking campaigns is definitely one of public health’s greatest successes; however, the current rate of progress in tobacco control is inadequate, and much more needs to be done to end the tobacco epidemic. The report cautions that unless changes are made in anti-smoking campaigns, unacceptably high levels of smoking attributable disease and death, as well as the associated costs, will persist for decades. If smoking continues at the current rate among young adults in this nation, 5.6 million of today’s Americans younger than 18 years of age are projected to die prematurely from a smoking-related illness.

Since the release of the first Surgeon General’s report on smoking and health in 1964, more than 20 million Americans have died as a result of smoking. The vast majority were adults with a history of smoking; however, almost 2.5 million were nonsmokers who died from heart disease or lung cancer caused by exposure to secondhand smoke. Another 100,000 were babies who died of sudden infant death syndrome (SIDS) or complications from prematurity, low birth weight, or other conditions caused by parental smoking, particularly maternal smoking.

The report tabulates the number of premature deaths caused by smoking and exposure to secondhand smoke from 1965–2014:

  • Smoking-related cancers: 6,587,000
  • Cardiovascular and metabolic diseases: 7,787,000
  • Pulmonary diseases (e.g., COPD): 3,804,000
  • Conditions related to pregnancy and birth: 108,000
  • Residential fires: 86,000
  • Lung cancers caused by exposure to secondhand smoke: 263,000
  • Coronary heart disease caused by exposure to secondhand smoke: 2,194,000
  • Total: 20,830,000

The above information was obtained from the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. It illustrates that the harms caused by the historic patterns of tobacco use in the US, and particularly by cigarette smoking, are overwhelming. More than 10 times as many US citizens have died prematurely from cigarette smoking than have died in all the wars fought by the nation during its history.

The full report, entitled, “The Health Consequences of Smoking, 50 Years of Progress,” can be viewed at this link.