Anti-smoking fight labeled hardly won

Fifty years ago, when U.S. Surgeon General Luther Terry released his office’s first report definitively linking smoking and lung cancer, the dark cloud over American smokers wasn’t a fear of death. It was smoke.

In 1963, Americans puffed a then-record 523 billion cigarettes, more or less everywhere. They smoked at home and in the office, in cars, bars and businesses.

The report, released Jan. 11, 1964, was not a death knell for the habit as Americans had come to know it. The number of Americans who smoke continued to rise, not peaking until 1981.

But the 387-page document identified smoking as a cause of lung cancer in men, a likely cause of lung cancer in women, and a likely cause of emphysema and chronic bronchitis. It represented the first true salvo in a public health campaign against tobacco use and the deadly, preventable diseases it causes.

“Before the report, smoking was accepted and encouraged and thought to be cool,” said Jenifer Marks, a general thoracic surgeon at Memorial Hospital in Colorado Springs, Colo.

While the number of American smokers has dropped significantly since 1981, annual consumption is 640 billion cigarettes, and lung cancer remains the leading cancer killer for men and women. Cigarette smoking is to blame for one-in-five deaths in the United States, according to the American Lung Association.

“We have made tremendous progress over the last 50 years, helping the public understand the risks from smoking and working to reduce smoking rates across America,” said Paul G. Billings, senior vice president of advocacy and education for the lung association. “However, the job is far from complete, and every year more than 443,000 Americans lose their lives to tobacco-related illness.”

Can’t say we haven’t been warned. The 1964 report set the stage for label requirements on cigarette packs and a ban on broadcast media ads in 1971. Today, quit-smoking hot lines and cessation programs abound. Anti-smoking commercials are grim, focusing on the likelihood of disease, disfigurement and death.

“I don’t think anyone is in denial about the health risks of smoking. Obviously the risks of it are much more well known publicly now,” Marks said, “but it’s a habit. We get people in the office with a cancer diagnosis that are still smoking. There’s a lot of information out there, but quitting has to be an individual decision.”

After climbing steadily until the early 2000s, the incidence of lung cancer in men and women is on the decline. Still, the Arkansas Department of Health estimates that, every year, 2,389 Arkansans are diagnosed with lung cancer and 2,034 Arkansans die from it.

The overall five-year survival rate for all stages of lung cancer is 16 percent, Marks said, but with early detection and treatment those odds do increase.

Since a large study found screening and early detection could reduce the risk of dying from lung cancer by 20 percent, the national Community Preventive Services Task Force has recommended screenings be a health-care standard for smokers and other high-risk candidates.

“The screening piece is so important. That’s a really big step. We’ve never thought that screening for lung cancer helped people live longer,” Marks said. “A lot of people think the diagnosis is a death sentence, but if diagnosed with Stage 1 or 2, that’s potentially treatable with chemo or surgery. You can still live a long time.” Celia Storey added information to this report.

ActiveStyle, Pages 25 on 02/17/2014

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