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This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.
The world is living dangerously - either because it has little choice or because it is making the wrong choices -- Dr Gro Harlem Brundtland WHO Director-General
This booklet for schools, medical personnel, and parents contains highlights from the 2012 Surgeon General's report on tobacco use among youth and teens (ages 12 through 17) and young adults (ages 18 through 25). The report details the causes and the consequences of tobacco use among youth and young adults by focusing on the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. This is the first time tobacco data on young adults as a discrete population have been explored in detail. The report also highlights successful strategies to prevent young people from using tobacco.
This volume presents results from three large, more contemporary prospective mortality studies and provides longer followup for two of the older studies dating from the 1950's. When observations from the more contemporary studies are compared with those from the 1950's, one important but disturbing conclusion is apparent - mortality risks among continuing smokers, both males and females, have increased. In fact, relative risks for smokers compared to never-smokers have increased for all major smoking-related diseases - coronary heart disease (CHD), lung cancer, other smoking-related cancers, stroke, and chronic obstructive pulmonary disease (COPD). This increase over time in the relative risks for smokers compared to never-smokers has occured despite a dramatic decline in cardiovascular disease (CVD) death rates in the U.S. population, suggesting that the decline in CVD death rates has been proportionately greater among never-smokers than among continuing smokers. The clearest message that is drawn from the enormous quantity of data presented in this monograph is that smoking prevention and cessation efforts are complementary, not alternative, solutions to the current epidemic of diseases caused by smoking.
Identifies upward trend in cigar use as potential serious public health problem.
Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine. At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.
This book comprehensively covers the science and policy issues relevant to one of the major public health disasters of modern times. It pulls together the aetiology and burden of the myriad of tobacco related diseases with the successes and failures of tobacco control policies. The book looks at lessons learnt to help set health policy for reducing the burden of tobacco related diseases. The book also deals with the international public health policy issues which bear on control of the problem of tobacco use and which vary between continents. The editors are an international group distinguished in the field of tobacco related diseases, epidemiology, and tobacco control. The contributors are world experts drawn from the various clinical fields. This major reference text gives a unique overview of one of the major public health problems in both the developed and developing world. The book is directed at an international public health and epidemiology audience includng health economists and those interested in tobacco control.
The National Institutes of Health Publication 07-6242, The Role of the Media in Promoting and Reducing Tobacco Use, NCI Tobacco Control Monograph 19, (the 19th of the Tobacco Control Monograph series of the National Cancer Institute (NCI) provides a critical, scientific review and synthesis of current evidence regarding the power of the media both to encourage and discourage tobacco use. The work presented is the most current and comprehensive distillation of the scientific literature on media communications in tobacco promotion and tobacco control. The six main parts of this monograph deal with aspects of media communications relevant to tobacco promotion and tobacco control. Part 1, an overview, frames the rationale for the monograph's organization and presents the key issues and conclusions of the research as a whole and of the individual chapters. This section describes media research theories that guided this assessment of the relationship between media and tobacco use, which can be viewed as a multilevel issue ranging from consumer-level advertising and promotion to stakeholder-level marketing aimed toward retailers, policymakers, and others. Part 2 further explores tobacco marketing—the range of media interventions used by the tobacco industry to promote its products, such as brand advertising and promotion, as well as corporate sponsorship and advertising. This section also evaluates the evidence for the influence of tobacco marketing on smoking behavior and discusses regulatory and constitutional issues related to marketing restrictions. Part 3 explores how both the tobacco control community and the tobacco industry have used news and entertainment media to advocate their positions and how such coverage relates to tobacco use and tobacco policy change. The section also appraises evidence of the influence of tobacco use in movies on youth smoking initiation. Part 4 focuses on tobacco control media interventions and the strategies, themes, and communication designs intended to prevent tobacco use or encourage cessation, including opportunities for new media interventions. This section also synthesizes evidence on the effectiveness of mass media campaigns in reducing smoking. Part 5 discusses tobacco industry efforts to diminish media interventions by the tobacco control community and to use the media to oppose state tobacco control ballot initiatives and referenda. Finally, Part 6 examines possible future directions in the use of media to promote or to control tobacco use and summarizes research needs and opportunities. Key lessons from this volume can inform policymakers as well as scientists and practitioners. Most critical from a policy standpoint is the conclusion, supported by strong evidence, that both exposure to tobacco marketing and depictions of tobacco in movies promote smoking initiation. In the United States in 2005—the same year in which 2.7 million American adolescents aged 12 to 17 used cigarettes in the past month1 and 438,000 Americans died prematurely from diseases caused by tobacco use or secondhand smoke exposure2—the tobacco industry spent $13.5 billion (in 2006 dollars) on cigarette advertising and promotion,3 an average of $37 million per day. The tobacco industry continues to succeed in overcoming partial restrictions on tobacco marketing in the United States, and tobacco marketing remains pervasive and effective in promoting tobacco use. Efforts to curb the depiction of tobacco use in movies have increased in recent years, and the evidence reviewed here indicates that progress in this area could be expected to translate into lower rates of youth smoking initiation in the future. Strong evidence indicates that media campaigns can reduce tobacco use. This volume highlights the complexities of assessing the media's influence on tobacco-related attitudes and behavior. A vast range of research is reviewed.~