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What's New - Smoking Diseases

Portland researcher at Kaiser Permanente wrote key chapter on health burdens of smoking and benefits of reduced smoking

New Surgeon General's report on smoking expands list of smoking-caused diseases

(PORTLAND, Ore.) - The list of diseases linked to smoking has been greatly expanded in the latest report on smoking from the U.S. Surgeon General, key portions of which were written by Jeffrey Fellows, PhD, a senior research associate with Kaiser Permanente's Center for Health Research in Portland, Ore. Fellows also reports that Oregon ranked below the national average in deaths from smoking.

"Oregon ranked 31st in deaths from smoking per 100,000 people," says Fellows. "Of every 100,000 Oregonians, 273.6 die from a smoking-related condition each year, well below the national average of 289 deaths per 100,000. Yet smoking still cost the state $1.8 billion in added medical care and lost productivity."

The first Surgeon General's Report on Smoking, issued in 1964, stated that smoking caused cancers of the lung and larynx (voice box) in men, was a likely cause of lung cancer in women, and caused chronic bronchitis in both sexes. Forty years later, the 28th report of the Surgeon General documents that smoking causes disease in nearly every organ of the body in both men and women. Other major conclusions of the2004 Report include the following: ·

• The list of diseases caused by smoking has been expanded to include acute myeloid leukemia, cataract, pneumonia, gum disease, abdominal aorta rupture, and cancers of the cervix, kidney, pancreas, and stomach.
• Quitting smoking has immediate as well as long-term benefits, reducing risks for diseases caused by smoking and improving health in general.
• Smoking so-called law-tar and low-nicotine cigarettes does not offer a health benefit over smoking regular cigarettes. The only way to avoid the health hazards of smoking is to quit completely or to never start smoking.

"We've known for decades that smoking is bad for your health, but this report shows that it's even worse than we thought," says U.S. Surgeon General Richard Carmona. "The toxins from cigarette smoke go everywhere the blood flows. I'm hoping this new information will help motivate many more people to quit smoking and help convince many more young people not to start in the first place."

"Smoking is still the leading preventable cause of premature death in the United States," says Fellows, author of chapter seven of the Report, entitled 'The Impact of Smoking on Disease and the Benefits of Smoking Reduction.'

"There have been more than 12 million premature deaths since the first Surgeon General's Report in 1964," Fellows says. "Based on the latest death statistics available, we can now say that smoking killed an estimated 440,000 Americans every year from 1995 to 1999. Without substantially stronger national and state efforts to reduce smoking, we can expect deaths from smoking to remain at this level for several decades."

In the United States, the average rate of deaths attributable to smoking is 289.5 for every 100,000 people, Fellows reports. Nevada has the highest rate (398.8/100,000) and Hawaii the lowest (167.8). Washington State ranks 28th with 279.4 deaths per 100,000.

Big economic impact

According to Fellows, the total economic costs of diseases attributable to smoking were $157 billion every year from 1995 to 1999. This total includes $75 billion in direct medical costs for adults (ambulatory and hospital care, prescription drugs, and nursing home and other care), $82 billion in lost productivity among men and women smokers, and $366 million in 1996 for neonatal care. Each year, smoking costs Oregon $1.8 billion and Washington $3 billion in added medical care costs and lost productivity.

"We have proven strategies to help prevent youth initiation and to help current smokers quit," Fellows says. "These strategies are highly cost effective and are considered the 'gold standard' for preventive care. What is now needed is commitment from state and local governments, health plans, and employers to expand access to evidence-based smoking prevention and cessation services. This commitment is necessary if we are to reach the Healthy People 2010 goals of reducing adult smoking rates to 12 percent and youth smoking rates to 16 percent. Compared to 1998 smoking rates, achieving these goals would prevent 7.1 million future deaths from smoking-related diseases after 2010."

Kaiser Permanente's Center for Health Research, founded in 1964, is a non-profit research institute whose mission is advancing knowledge to improve health.

Kaiser Permanente Northwest, founded in 1945, is a prepaid group practice health care organization serving the medical needs of 445,000 people in Oregon and Southwest Washington.

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Released: May 27, 2004