Articles, Blog

Tobacco Use Epidemic in the U.S.: Is 50 Years of Progress Enough?

December 8, 2019

RADM Lushniak: Hi, I am Rear Admiral Boris
Lushniak, Acting United States Surgeon General. One of the duties of the Office of the Surgeon
General is to take the best information available and to share it with the American public,
and that’s what we’re doing today. I have a story to tell you; it’s a story that’s been
progressing over the last half century. Fifty years ago, the Surgeon General at that time,
Luther Terry, put out a report. It was the first ever report on smoking and health. And
it’s conclusion was quite simple. It said that cigarette smoking is a health hazard
of significant importance in the United States to warrant appropriate remedial action. What
does that mean? That means that cigarette smoking was deemed bad, and that we have to
do something about it. In fact we have fifty years of incredible work and achievements
that we’ve gone through. We have to look back in terms of how we’ve done. One of the things
that we’ve really done is change our social norms. It wasn’t that long ago, when in fact
physicians were part of the problem. They were in cigarette advertisements saying that
Brand X is better than Brand Y. Or this brand is less irritating than that brand. It’s almost
unimaginable right now in the twenty-first century for us to think that physicians played
a role in this. Even in the world of athletics, a little over a half-century ago, Americans
planted the flag of our nation up on Mount Everest, incredible achievement. But look
at the fact that somehow tobacco companies felt as if they were part of that achievement,
as if a mountain couldn’t be climbed without nicotine or tobacco aboard. Once again our
social norms looking at cigarettes have completely changed. Over these last fifty years, what
has been done? Well, out of the office of the Surgeon General, we have put out thirty-two
reports on smoking and health. Some of these have been very, very specific: looking at
smoking in women, smoking in youth, looking at the problems of second-hand smoke. So there
has been progress in terms of us getting the information out. This past year, we’ve issued
the 50th anniversary report. And it’s called Fifty Years of Progress. It’s pretty neat,
to think that we’ve had fifty years of progress, and there has been progress. We’ve gone from
a smoking rate of forty-three percent in this country to eighteen percent right now. That’s
great, that’s progress. And yet I have to emphasize that the problem isn’t over. We
really have to get together and work to try to solve this tobacco problem in our nation.
Because right now we still have bad statistics. Right? We look at this, and one out of every
three cancer deaths could be prevented. Back in 1964, we had one cancer that was identified
and was associated with smoking; that was lung cancer in men. Now we’re up to thirteen
different cancers. We keep finding brand new diseases: diabetes, arthritis, erectile dysfunction,
macular degeneration that causes blindness, all directly associated with smoking. Each
and every year, 480,000 people in the United States die prematurely because of tobacco-related
diseases. Beyond that, there’s incredible economic effects as well. Do you realize each
and every year, 289 billion, that’s billion with a B, billion dollars are spent on tobacco-related
diseases in this country? Sometimes people say, Well after fifty years, isn’t eighteen
percent of our population, isn’t that good enough, isn’t that an achievement? I gotta
tell you that if I accepted the current trends, if the Surgeon General said, Okay that’s good
enough, we would in essence say that five-point-six million kids who are now alive, it’s okay
if they die prematurely from smoking-related diseases. Do you realize that’s one out of
every thirteen children out there? Is that acceptable? In reality we can’t accept that.
We realize that even after fifty years, although we’ve had achievements, the struggle remains.
We have to still push forward and our mission is a bold and noble mission. Our mission is
really to have a tobacco-free generation within a generation. That is achievable: we have
tobacco-control measures that do work. We have to get more aggressive in utilizing and
implementing them in our society. So what’s my vision? My vision is that twenty-five years
from now when we issue the 75th anniversary report, that in fact we’ll have a lot of zero’s,
when we look at smoking rates in this country. And certainly, fifty years from now, when
the 100th anniversary report is out, what are we going to see? We hope we see that we
look at smoking strictly as a historical disease, a disease that used to occur in our society,
and somehow that society accepted a deadly product as a given. Fifty years from now we
hope that the problem is solved. That step by step we approach this, and say, twenty-five
years from now we have to have achievement in terms of a tobacco-free generation. We
have to take the passion, we have to take yes, I daresay a little bit of anger into
this, and in essence say we can solve the tobacco problem. We have to boldly work under
a flag, and a new mission. And, with a certain amount of anger, say when it comes to tobacco
use in this country that enough is enough!

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