Excerpt

Fifty years have passed since publication of the landmark report of the Surgeon General’s Advisory Committee on smoking and health. This report highlights both the dramatic progress our nation has made reducing tobacco use and the continuing burden of disease and death caused by smoking.

Contents

• Message from Kathleen Sebelius
• Message from Howard Koh
• Foreword
• Preface
• Acknowledgments
• 1. Introduction, Summary, and Conclusions
  • Introduction
  • Organization of the Report
  • Development of the Report
  • Scientific Basis of the Report
  • Major Conclusions from the Report
  • Chapter Conclusions
  • References
• 2. Fifty Years of Change 1964–2014
  • Introduction
  • Tobacco Control: Before the 1964 Report
  • Scientific Judgment and the 1964 Report
  • Remedial Action and Change Following the 1964 Report
  • Passive Smoking and Environmental Change
  • Nicotine and Addiction
  • Denormalization and the Tobacco Industry
  • Summary
  • References
• 3. Producing the Surgeon General's Report From 1964–2014: Process and Purpose
  • Introduction
  • Development of a Scientific Consensus
  • Development of the Criteria for Causation Used in the 1964 Report
  • Methods for Reviewing the Evidence and Developing Conclusions
  • Process of Ensuring Consensus and Strength of the Peer Review
  • Separation of Scientific Conclusions and the Formation of Policy
  • References
• 4. Advances in Knowledge of the Health Consequences of Smoking: From 1964–2014
  • Introduction
  • Evolution of Conclusions on Cigarette Smoking and Exposure to Secondhand Smoke as a Cause of Disease
  • Summary
  • References
• 5. Nicotine
  • Introduction
  • Toxicokinetics and Acute Toxicity of Nicotine
  • Pathophysiology of Nicotine Addiction
  • Health Consequences of Nicotine Exposure
  • Evidence Summary
  • Conclusions
  • Implications
  • References
• 6. Cancer
  • Introduction
  • Mechanisms of Cancer Induction by Tobacco Smoke
  • Changing Cigarettes and Risk for Lung Cancer Over Time
  • Liver Cancer
  • Colorectal Cancer
  • Prostate Cancer
  • Breast Cancer
  • Adverse Health Outcomes in Cancer Patients and Survivors
  • Evidence Summary
  • Chapter Conclusions
  • References
• 7. Respiratory Diseases
  • Introduction
  • Chronic Obstructive Pulmonary Disease
  • Asthma
  • Tuberculosis
  • Idiopathic Pulmonary Fibrosis
  • Impact of Smokefree Policies on Respiratory Outcomes
  • Evidence Summary
  • Implications
  • Chapter Conclusions
  • References
• 8. Cardiovascular Diseases
  • Introduction
  • Tobacco Use and Cardiovascular Diseases: Evolution of the Evidence
  • Mechanisms by Which Smoking Causes Cardiovascular Diseases
  • Updated Summaries of the Evidence: Active Smoking
  • Updated Evidence Reviews
  • Impact of Smokefree Laws on Acute Cardiovascular Events
  • Evidence Summary
  • Chapter Conclusions
  • Implications
  • References
• 9. Reproductive Outcomes
  • Introduction
  • Surveillance
  • Cessation
  • Advances in the Understanding of Tobacco and Reproductive Health
  • Updated Evidence Reviews
  • Chapter Conclusions
  • References
• 10. Other Specific Outcomes
  • Introduction
  • Eye Disease: Age-Related Macular Degeneration
  • Dental Disease
  • Diabetes
  • Immune Function and Autoimmune Disease
  • Rheumatoid Arthritis and Systemic Lupus Erythematosus
  • Inflammatory Bowel Disease
  • Chapter Conclusions
  • References
• 11. General Morbidity and All-Cause Mortality
  • Introduction
  • Smoking and General Morbidity and Economic Costs
  • All-Cause Mortality
  • Summary
  • Chapter Conclusions
  • Implications
  • Supplemental Tables
  • References
• 12. Smoking-Attributable Morbidity, Mortality, and Economic Costs
  • Introduction
  • Methodology Used by CDC to Compute Smoking-Attributable Mortality in the United States
  • Methodologic Issues in SAM Calculation
  • 2013 Update to SAMMEC Methodology
  • Smoking-Attributable Mortality in Adults and Infants, United States, 2005–2009
  • Projected Smoking-Related Deaths Among Youth, United States, 2012
  • Smoking-Attributable Morbidity Estimates
  • Total Smoking-Attributable Mortality, 1965–2014
  • Summary
  • Conclusions
  • Implications
  • References
  • Chapter 12 Appendices
    • Appendix 12.1
    • Appendix 12.2
• 13. Patterns of Tobacco Use Among U.S. Youth, Young Adults, and Adults
  • Introduction
  • Historical Trends in Tobacco Use
  • Cigarette Smoking
  • Other Tobacco Products
  • Conclusions
  • Summary and Implications
  • Appendix 13.1 Sources of Data
  • Appendix 13.2 Measures of Tobacco Use
  • References
• 14. Current Status of Tobacco Control
  • Introduction
  • The Changing Public Image of Tobacco
  • Changes in the Tobacco Industry, Products, and Product Regulations
  • Tobacco Control Policies
  • Clinical and Educational Approaches for Tobacco Cessation
  • International Tobacco Control
  • Summary
  • Conclusions
  • References
  • Appendix 14.3 Tobacco Litigation Case Summaries
• 15. The Changing Landscape of Tobacco Control–Current Status and Future Directions
  • Introduction
  • The Tobacco Control Landscape: Over a Hundred Years and Counting
  • Potential End Game Strategies
  • Chapter Summary
  • Conclusions
  • Implications for Ending the Tobacco Epidemic
  • References
• 16. A Vision for Ending the Tobacco Epidemic: Toward a Society Free of Tobacco-caused Death and Disease
  • A Vision for Ending the Tobacco Epidemic
  • Accelerating the National Movement to Reduce Tobacco Use
  • References
• Errata
• List of Abbreviations
• Definitions and Alternative Nomenclature of Genetic Symbols Used in This Report
• Supplemental Evidence Tables

Suggested citation:

U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.