Greater Number of Diseases Now Attributed to Smoking

Surgeon general cites diabetes, cancers among illnesses

It has long been known that smoking causes lung cancer and heart disease. On Friday, the acting U.S. surgeon general issued a report that says smoking is directly responsible for an even greater number of disease and illnesses, including diabetes, colorectal and liver cancers, erectile dysfunction and ectopic pregnancies.

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Other health problems the report attributes directly to smoking include vision loss, tuberculosis, rheumatoid arthritis, impaired immune function and cleft palates in the children of women who smoke.

While the report does not blame smoking directly for every occurrence of the newly named health problems, the report says that some of the cases would not have happened without smoking. For example, while smoking causes most cases of lung cancer, it is directly responsible for a small fraction of liver and colorectal cancers.

The surgeon general’s report is important because it is widely viewed as a standard for scientific evidence among researchers and policy makers.

Mike Roizen, MD, chief wellness officer and chair of Wellness Institute at Cleveland Clinic, called the report a “very careful look” of all the diseases associated with smoking. “The documentation is pretty specific,” he said.

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The report raises the annual U.S. death toll from smoking by about 37,000, which it said reflects new science about how tobacco harms the body, and that manufacturers are producing more deadly cigarettes.

Dr. Roizen said that higher estimate may still be low.

“Many of us who look at the second-hand smoking data think they are still being conservative,” Dr. Roizen said.“The data are pretty clear that there are huge second-hand smoking effects that are underestimated.”

Acting Surgeon General Dr. Boris D. Lushniak said the evidence emphasizes the need to accelerate and sustain successful tobacco control efforts that have been under way for decades.

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“Tobacco causes disease,” Dr. Roizen said. “What most young smokers don’t understand is that the smoker doesn’t just die. They go through a lot of disability, suffering, pain and disfigurement.”

Other highlights of the surgeon general’s report:

  • Since the first surgeon general’s report on smoking and health was published 50 years ago, more than 20 million Americans have died because of smoking.Of those deaths, 2.5 million were among nonsmokers who died from diseases caused by exposure to secondhand smoke.
  • Cigarette smoking kills nearly half a million Americans a year; an additional 16 million suffer from smoking-related conditions.
  • The price tag of smoking in the United States is more than $289 billion a year in direct medical care and other economic costs.
  • Compared to people who have never smoked, smokers on average suffer more health problems and disability due to their smoking and ultimately lose more than a decade of life.
  • Secondhand smoke exposure is now known to cause strokes in nonsmokers.
  • Smoking increases the failure rate of treatment for all cancers.

Since the seminal 1964 report, the surgeon general has released 31 reports addressing the health consequences of smoking and has added to the list of smoking-related diseases. Bladder cancer was added in 1990 and cervical cancer in 2004.

An introductory note to the report by Health and Human Services Secretary Kathleen Sibelius discusses a proposed 94-cent-per-pack federal tobacco tax, which Dr. Roizen said he supports as a way to deter smoking and pay for the medical and disability costs associated with cigarette use.

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