Tobacco's Decline

Over 20 million Americans have died prematurely as a result of smoking and smoking-related illness since the first Surgeon General Report was released 50 years ago. Smoking has been widely known to increase risk for illnesses including cancer, cardiovascular disease, diabetes, immune and autoimmune disorders, and eye disease. Smoking is also known to cause reproductive issues and diminished overall health. However, despite increased tobacco control measures and education around the dangers of smoking, an estimated 42 million adults and 3.5 million middle and high school students still choose to smoke.

In order to help ensure that tobacco smoking nears its end in America, the Surgeon General Report calls for additional “end game strategies.” Among these strategies are suggestions for implementing increased education through national media campaigns, raising excise cigarette taxes to deter both current and new smokers, providing smokers with smoking cessation treatment programs through the Affordable Care Act, and extending “smoke free indoor protections” to all Americans.

According to the Star Tribune, recent polls have shown that smoking tobacco is now considered a taboo pastime and that smoking cigarettes is less popular among teenagers than using marijuana. CVS, one of American’s largest pharmacy chains, recently announced its plan to stop selling cigarettes and other tobacco products in more than 7,600 stores across the country. In addition, the U.S. Food and Drug Administration announced in a press release earlier this month that it is planning to launch an unprecedented campaign designed to reduce and prevent tobacco use among youth. The FDA stated that tobacco use is one of the most preventable causes of death and disease in the United States today.

The new measures outlined in the Surgeon General Report, coupled with the FDA’s new educational initiatives and national support from retailers like CVS, leads many to believe that tobacco smoking could be nearing its end in America. Tobacco is thought to contribute to about 480,000 deaths each year, but some are quick to remind folks that, even if tobacco use stopped today, it may take decades to realize the health benefits.

Smoking rates have declined steadily for decades, according to the report by the Centers for Disease Control and Prevention (CDC). Last year's decrease – down to 18% – ends a smoking rate stall that hovered at 20% to 21% for more than seven years, then froze at about 19% in 2010 and 2011.

"We are a long way from the end game on tobacco use," says Thomas Novotny, professor of global health at San Diego State University. "It is too early to declare victory."

Smoking is the leading cause of preventable illness and death in the USA, accounting for one in five deaths and direct medical costs ranging from $50 billion-$73 billion per year, the CDC says. It causes more than 80% of all lung cancer deaths and coronary heart disease, the leading cause of death in the country, according to a CDC report.

It's unclear what caused last year's smoking rate to decline. Historically, rising taxes on tobacco products, smoking restrictions and mass media and school-based educational campaigns have helped push down the smoking rate, says Joshua Yang, a tobacco control researcher at the University of California-San Francisco.

The preliminary report, released Tuesday, did not include data on teens. The rate was about 9% for adults over 65 compared with about 20% for all other adults. Men are more likely to smoke than women across all age groups.

The data were collected from a survey of 35,000 U.S. adults. Adults who have smoked more than 100 cigarettes in their lifetime and smoke every day or some days are considered smokers.

Almost half of states require smoke-free indoor air, a well-studied deterrent to smoking, says Richard Grucza, an associate professor of psychiatry at Washington University. He says declines could be the result of stricter tobacco control policies.

Last year, the CDC launched a controversial advertising campaign featuring graphic photos, stories and videos of smokers to budge the smoking rate down. The TV and radio spots triggered 200,000 additional calls by smokers about quitting, according to the CDC.

Yang acknowledges the significance of the CDC's effort – one of the agency's most graphic and largest anti-smoking campaigns – but says other tobacco control efforts can't be discounted.