From the NY Times
U.S. Lengthens the List of Diseases Linked to Smoking
By ELIZABETH OLSON
Published: May 28, 2004
WASHINGTON, May 27 - Four decades after the surgeon general's first report on smoking and health linked cigarette use to lung cancer, larynx cancer and bronchitis, the latest annual report has further expanded the list of smoking-related diseases.
The new report, issued Thursday by Surgeon General Richard H. Carmona, concludes that in addition to the many other diseases listed in the intervening years, smoking can cause cancers of the cervix, kidney, pancreas and stomach, as well as abdominal aortic aneurysms, acute myeloid leukemia, cataracts, pneumonia and gum disease.
The report, Dr. Carmona said at a news briefing, "documents that smoking causes disease in nearly every organ in the body at every stage of life."
Among the other disorders listed since the first report, in 1964, are cancers of the esophagus, throat and bladder; chronic lung disease; and chronic heart and cardiovascular diseases.
Government figures show that 440,000 Americans a year are now dying of smoking-related illnesses, and Dr. Carmona said more than 12 million had died since the first report. Smokers typically die 13 to 14 years earlier than nonsmokers, he said.
Treating those diseases costs about $75 billion a year, according to government figures, and an even greater amount is sacrificed in lost productivity.
For the first time, however, the number of Americans who have quit smoking edges out the number who still smoke, the surgeon general said. An estimated 46 million Americans "have managed to beat the habit and quit,'' he said, "while 45.8 million continue to smoke." Of the entire adult population, people 18 or older, smokers now account for only 22 percent.
Still, Dr. Carmona conceded that at the current rate of decline, the federal government would not meet its goal of cutting the number of smokers to 12 percent of adults by 2010.
The report warned that while the number of high school seniors who smoke had been reduced to 24.4 percent last year from 36.5 percent in 1997, trends indicated that the rate of decline in smoking among youths, like that among adults, was slowing.
The surgeon general said that "every day, nearly 5,000 people under 18 years of age try their first cigarette."
Just as disturbing as those trends, the report said, is that the rate of smoking "among some racial and ethnic minority populations and among less-educated Americans remains high.''
Dr. Carmona said he hoped that the message that "toxins from cigarette smoke go everywhere the blood flows" would help "motivate people to quit smoking and convince young people not to start in the first place."
Quitting can have immediate as well as long-term benefits, the report found. Quitting at age 65 or older, it said, can reduce by nearly 50 percent the risk of dying of a smoking-related disease. On the other hand, former smokers have the same stroke risk as nonsmokers 5 to 15 years after quitting.
Smoking cigarettes with lower yields of tar and nicotine, the report said, do not substantially reduce the risk of lung cancer.
"There is no safe cigarette," Dr. Carmona said, "whether it is called 'light,' 'ultralight' or any other name."
The 941-page report was prepared by a team of 20 scientists at the Centers for Disease Control and Prevention, and drew on research reported in 1,600 articles, which are available at
www.cdc.gov/tobacco.
It found that while some research had pointed to an association between smoking and diseases including colon, liver and prostate cancer, as well as erectile dysfunction, the current evidence was not sufficient to establish a link.