Fifty years ago, many Americans considered smoking harmless to their health — until Jan. 11, 1964, when the U.S. Surgeon General released the first-ever report on smoking and health and declared smoking to be harmful.
About 5.3 million men and 2.7 million women live longer thanks to tobacco control, according to one of six studies on the topic published Tuesday in the Journal of the American Medical Association. Life expectancy at age 40 for U.S. men and women has increased 2.3 years and 1.6 years, respectively.
The reports highlight how public-health efforts, from cigarette taxes to advertising limits, have helped curtail smoking rates. The reports also identify new trouble spots, including communities whose members have not been able to quit in significant numbers.
“You look back in history to 1964, and in reality the world was a very different place when it came to tobacco use and smoking,” said Acting U.S. Surgeon General Boris Lushniak.
Lushniak believes the next step should be a resolution for a smoke-free generation within the next 50 years. That concept will be part of the 32nd Surgeon General’s report on Jan. 16, he said. It will both celebrate the reduction of smokers from 43 percent of all adult Americans in 1964 to 18 percent in 2012, and emphasize just how much work is left to be done.
As encouraging as the findings are, an additional 17.7 million people died of smoking-related causes between 1964 and 2012, proving that there is still plenty of work to be done. That means for every life saved, more than two were lost.
“It’s fascinating to see the progress made in the last 50 years in terms of lives saved,” Lushniak said. “But 18 percent is still 18 percent. Each and every day I have over 3,000 young adults and kids under the age of 18 who take up smoking …. Over 2,000 of them will become lifetime daily smokers.”
Lushniak and the Centers for Disease Control and Prevention place the burden of addressing that remaining 18 percent directly on states. Currently, states spend less than 2 percent of tax revenue derived from tobacco excise taxes and tobacco industry taxes on tobacco prevention and control programs.
It’s important to note that the rate has not been steady over time, says Theodore Holford, a Yale biostatistics professor and lead author of the study. In the first decade following the study, only 11 percent of tobacco-related deaths were successfully prevented. Today, that number is closer to 50 percent.
“That’s pretty encouraging, and we’ve come quite a long way,” Holford said. “It’s just that there is still a lot to be done. There are still hundreds of thousands of people that are dying from an avoidable cause.”
The reports did not pinpoint what have been the most effective measures to induce people to quit smoking. But public health advocates say the combination of tobacco taxes, smoke-free air laws, youth education campaigns and adequately funding state tobacco and anti-smoking programs has made a difference over time.
“Very few smokers — less than 10 percent — start smoking as adults,” said Mariell Jessup, MD, president of the American Heart Association. “We really need to focus on keeping kids from smoking.”