Fitful Progress in the Antismoking Wars

Fifty years ago this Saturday, on Jan. 11, 1964, a myth-shattering surgeon general’s report on smoking and health brushed aside years of obfuscation by tobacco companies and asserted, based on 7,000 scientific articles, that smoking caused lung cancer and was linked to other serious diseases. Those findings expanded as more data was gathered.
Research since then has shown that tobacco can cause or exacerbate a wide range of diseases, including heart disease, stroke, multiple kinds of cancer, chronic obstructive pulmonary disease, emphysema, asthma and diabetes, and can injure nonsmokers who breathe in the toxic fumes secondhand. The death toll from tobacco remains stubbornly high but can be driven down by using a range of new and proven tactics.
By some measures, the 50-year campaign to rein in tobacco use has been an enormous success. The percentage of American adults who smoke dropped from 42 percent in 1965 to 18 percent in 2012. A study published in the Journal of the American Medical Association this week estimated that tobacco control measures adopted since 1964 have saved eight million Americans from premature death and extended their lives by an average of almost 20 years.
Experts attribute the gains to vigorous campaigns to educate people about the dangers of smoking; increases in cigarette taxes; state and local laws that protect half the nation’s population from tobacco fumes in workplaces, bars and restaurants; restrictions on advertising; prohibition of sales to minors; and various prevention and cessation programs financed by states or private insurance.
Despite these gains, nearly 44 million American adults still smoke, more than 440,000 Americans die every year from smoking, and eight million Americans live with at least one serious chronic disease from smoking. Medical costs connected to smoking are nearly $96 billion a year, with an additional $97 billion lost in productivity because of illness.
On Wednesday, several health organizations, including the American Heart Association, the American Lung Association, the American Cancer Society, the American Academy of Pediatrics, and the Campaign for Tobacco-Free Kids called for a new national commitment to drive smoking among adults down to less than 10 percent over the next decade; protect all Americans from secondhand smoke within five years by having every state enact laws against smoking in all workplaces, bars and restaurants; and ultimately eliminate death and disease caused by tobacco.
It won’t be easy. The tobacco industry spends more than $8 billion a year to market cigarettes and other tobacco products in this country, with much of its marketing slyly aimed at young people.
The industry is also invading foreign markets, often in less developed countries, in an effort to make addicts of millions more customers to replace those in industrialized nations. Although smoking rates among adults around the globe have fallen sharply since 1980, the number of smokers has increased significantly along with population growth and will continue to increase as national incomes and populations rise. The United States government must help counter the tobacco industry’s efforts to spread its noxious products around the world.