The NY Times  says that on Thursday, the U.S. Surgeon General’s office released a report on smoking cessation highlighting the variety of proven smoking cessation tools available to smokers. U.S. Surgeon General Dr. Jerome Adams “urged smokers to use a range of cessation methods that have been proven effective – and cautioned that e-cigarettes have not.”

In an interview, Dr. Adams said, 40% “of smokers don’t get advised to quit. That was a shocking statistic to me, and it’s a little embarrassing as a health professional.” The report also “recommended that doctors and public health officials devote more attention to offering smoking cessation assistance to gay and transgender people, Native Americans, people with mental illness diagnoses and several other groups with high smoking rates.”

Dr Adams said  that the number of smokers who do not receive such counsel from their physicians “jumped out” at him. The article says that “behavioral counseling has been found to increase chances of quitting smoking and seven medications have been approved for helping adults quit smoking: five forms of nicotine replacement therapy and two non-nicotine medications, varenicline and bupropion, according to advice from the surgeon general.”

MedPage Today reports that “the percentage of Americans who smoke – 14%, or 34 million people – is at an all-time low, but smoking still remains the number one cause of preventable disease, death, and disability” in the U.S., according to the report from the Surgeon General.

BLOGFINGER MEDICAL COMMENTARY:  Paul Goldfinger, MD, FACC

When I was a medical intern in the mid 1960’s at a major teaching hospital in New York, I saw doctors smoking during chart rounds, and patients smoking in their rooms.  But thanks to the 1964 Surgeon General’s Report, the percent of the population that believed smoking to be a health risk rose from 45% to 80%:

“The report highlighted the deleterious health consequences of tobacco use. Smoking and Health: Report of the Advisory Committee to the Surgeon General held cigarette smoking responsible for a 70 percent increase in the mortality rate of smokers over non-smokers. The report estimated that average smokers had a nine- to ten-fold risk of developing lung cancer compared to non-smokers: heavy smokers had at least a twenty-fold risk. The risk rose with the duration of smoking and diminished with the cessation of smoking.

“The report also named smoking as the most important cause of chronic bronchitis and pointed to a correlation between smoking and emphysema, and smoking and coronary heart disease. It noted that smoking during pregnancy reduced the average weight of newborns.

“On one issue the committee hedged: nicotine addiction. It insisted that the “tobacco habit should be characterized as an habituation rather than an addiction,” in part because the addictive properties of nicotine were not yet fully understood, in part because of differences over the meaning of addiction.”

Of course, the Surgeon General’s Reports have been updated many times.

According to “Tobacco Free Florida:” 

“Cigarette smoking is the leading cause of preventable death in the United States. It causes more than 480,000 deaths each year. That is nearly 1 in 5 deaths, or 1,300 deaths every day. In Florida alone, cigarette smoking is responsible for 32,300 deaths every year. ^1,2,3

“For every person who dies because of smoking, at least 30 people live with a serious smoking-related illness. That means more than 16 million Americans are living with a disease caused by smoking. ^1,2,3

“The risks are increased for cancer of stomach, esophagus, mouth, colon, rectum and cervix.  Also increased risk for stroke, diabetes, heart, and damaged immune systems.”

Now it is rare to see people walking down the street smoking cigarettes.  Pipes and cigars were, for a while, thought to be OK, but later we learned that all forms of smoking were risky, and part of that was the inhalation of second hand smoke.

And now the Surgeon General tells us that our society still has a way to go to reduce to zero the health risks of smoking.  And there is the added challenge of vaping.

In Ocean Grove, smoking is banned on the beaches and in most of our parks, and you will never see someone light up a cigar or cigarette in a restaurant.

Yet for some young people, it still seems cool to smoke a cigarette, especially for young women, and kids tend to be fearless about their health.

And remember that tobacco smoking has a powerful allure.    After all, smoking is relaxing, pleasurable, and powerfully addictive. So stopping is a real challenge, and  smokers need to be reminded about second hand smoke that places others and themselves at risk.

This is from the NHS (UK) about  smoking and brain chemicals:

“Nicotine alters the balance of 2 chemicals called dopamine and noradrenaline in your brain. When nicotine changes the levels of these chemicals, your mood and concentration levels change. Many smokers find this enjoyable.

“The changes happen very quickly. When you inhale the nicotine, it immediately rushes to your brain, where it produces feelings of pleasure and reduces stress and anxiety. This is why many smokers enjoy the nicotine rush and become dependent on it.

“The more you smoke, the more your brain becomes used to the nicotine.  This means you have to smoke more to get the same effect.”

You can see how far we have come if you see the movie The Irishman   (set in the 1950’s) where everybody smokes all the time.

Smoking a cigar it still is on my bucket list, especially if it is a Cuban being lit outdoors, on a starlit evening, in the Cotswolds, as an RAF fighter flies low overhead.  Otherwise I could resist it.