Surgeon General David Satcher announced on 09 August 2000 that smoking rates among teens and adults could be cut in half within the decade if the nation would fully implement anti-smoking programs using effective approaches that are already available.
The announcement came during a news conference at the 11th World Conference on
Tobacco or Health in Chicago, where Dr. Satcher released the Surgeon General's
report on "Reducing Tobacco Use." It is the first-ever report to provide an
in-depth analysis of the effectiveness of various methods to reduce tobacco
use -- educational, clinical, regulatory, economic, and social.
"During the past four decades we have made unprecedented gains in preventing
and controlling tobacco use," Dr. Satcher said. "However, the sobering
reality is that smoking remains the leading cause of preventable death and
disease in our nation, and those who suffer the most are poor Americans,
minority populations, and young people. Although our knowledge remains
imperfect, we know more than enough to address the tobacco control challenges
of the 21st century."
Health and Human Services Secretary Donna E. Shalala noted, "This report of
the Surgeon General comes at a critical moment in the rapidly changing
landscape of tobacco control, both nationally and globally. It offers a
science-based blueprint for achieving our Healthy People 2010 objectives to
reduce tobacco use and its health impact in this country. We must now work to
commit the resources necessary to put this blueprint into action."
The report calls for the widespread use of approaches and methods, especially
in combination, that have proven to be effective in substantially reducing the
number of people who will become addicted to nicotine; increasing the success
rate of young people and adults trying to quit tobacco use; decreasing
nonsmokers' exposure to environmental tobacco smoke; reducing disparities
related to tobacco use and its health effects among different population
groups; and decreasing the future health burden of tobacco-related disease and
Although the report was developed by the Centers for Disease Control and
Prevention primarily to guide decisions about effective tobacco control
programs in the United States, the report's analyses and findings have clear
"We estimate that the number of smoking-related deaths worldwide will rise to
10 million per year by 2030, with 70 percent of these deaths occurring in
developing countries," CDC Director Dr. Jeffrey P. Koplan said. "The CDC is
committed to working side-by-side with other nations and international
organizations, such as the World Health Organization, to create a broad
framework to curb the global epidemic of tobacco-related disease. This report
can be an important tool in supporting this global health initiative."
Key actions that Dr. Satcher outlined to reduce tobacco use, supported by
evidence in the report, include:
- Implementing effective school-based programs, combined with community and
media-based activities, which can prevent or postpone smoking onset in 20 to
40 percent of U.S. adolescents. Unfortunately, fewer than 5 percent of
schools nationwide are implementing the major components of school guidelines
recommended by the federal Centers for Disease Control and Prevention (CDC).
- Changing physician behavior, medical system procedures, and insurance
coverage to encourage widespread use of state-of-the-art treatment of nicotine
addiction. The report shows that brief physician advice to quit smoking can
double or quadruple normal quit rates, while a combination of behavioral
counseling and pharmacological treatment can boost success up to 10 times.
- Passing and enforcing strong clean indoor air regulations, which contribute
to changing social norms and may decrease tobacco consumption among smokers
and increase smoking cessation. The report calls on states to pass laws that
will not restrict local governments from passing even stronger measures to
protect their citizens from secondhand smoke.
- Improving tobacco warning labels in the U.S., which are weaker and less
prominent than those required in other countries such as Canada and Australia.
The report shows that consumers receive very little information regarding the
ingredients, additives, and potential toxicity of tobacco products.
- Increasing tobacco prices and excise taxes. Evidence presented in the
report suggests that a 10 percent increase in price will reduce overall
cigarette consumption by 3 to 5 percent. However, both the average price of
cigarettes and the average cigarette excise tax in the United States are well
below those in most other industrialized countries.
- Changing many facets of the social environment to reduce the broad cultural
acceptability of tobacco use. The report concludes that comprehensive
approaches combining community interventions, mass media campaigns, and
program policy and regulation are most effective in changing social norms and
reducing tobacco use.
"Failure to effectively use every intervention strategy at our disposal could
mean turning back the clock on the efforts we've made since the 1960s to
reduce cigarette smoking, one of the most notable public health
accomplishments of this century," Dr. Satcher said. "We must respond
aggressively to the serious challenges we still face: most importantly, the
tobacco industry's continuing campaign to advertise and promote tobacco
products. We need fair but aggressive measures to regulate these marketing
activities, especially those that influence young people. He noted that the
industry spent $6.7 billion in 1998 -- or more than $18 million a day -- to
market cigarettes, despite the overwhelming evidence of the harm they cause.
A full copy of the Surgeon General's, "Reducing Tobacco Use,"
report is available in today's Vidyya. The report is in the public domain and can be distributed freely. You can obtain copies of the Executive Summary and the report's "At A Glance" fact sheet can also be ordered via fax by calling 1-800-CDC-1311 or by writing the CDC's Office on Smoking and Health, Mail Stop K-50, 4770 Buford Highway, Atlanta, Georgia 30341.