March 14, 2012
NIDA Director, Dr. Nora D. Volkow

In 1964, the Surgeon General’s report Smoking and Health revealed to the public the harms of tobacco and began nearly a half century of smoking reduction campaigns and tobacco control programs. The results of a major study funded by the National Cancer Institute (NCI) and published this month in the Journal of the National Cancer Institute provide the clearest picture yet of how beneficial those programs have been in saving lives, but they also show how much more we can do.

Indeed, 440,000 Americans die each year from preventable smoking-related diseases, including lung cancer, which kills more U.S. men and women than any other type of cancer. Cigarette smoking is responsible for the vast majority (90 percent) of these deaths. However, the good news is that deaths from lung cancer have declined since the late 1980s.

Several research teams that make up the NCI’s Cancer Intervention and Surveillance Modeling Network (CISNET) used sophisticated mathematical models to estimate the effect of reductions in smoking on lung cancer mortality during the last quarter of the 20th century. To do this, they modeled actual smoking trends and lung cancer deaths and compared this with a “what-if” scenario in which the Surgeon General’s report had never been issued and no tobacco control programs had ever been initiated—and thus American smoking behaviors had continued unchanged since 1965. The analysis showed that programs to reduce smoking prevented over 795,000 deaths from lung cancer between 1975 and 2000, more than previously thought. The CISNET study did not estimate how many deaths from other smoking-related diseases (e.g., cardiovascular disease and stroke) were also prevented.

The 795,000 number is encouraging, but we can do better. The CISNET teams also estimated lung cancer rates in a perfect world where the Surgeon General’s report got all Americans to quit smoking within a year. If America had become a completely nonsmoking country after 1965, 1.7 million more lung cancer deaths—2.5 million total—would have been averted between 1975 and 2000. Moreover, declines in smoking have slowed in recent years.  And both adults and young people, who are more vulnerable to developing nicotine addiction, are still taking up smoking in high numbers. In 2010, there were 6,500 new cigarette smokers every day. Over half of those were younger than 18.

The bottom line is that while proven smoking reduction programs are available and are helping people quit, we cannot afford to be complacent.  This week, the Surgeon General released a new report—Preventing Tobacco Use among Youth and Youth Adults— ( emphasizing the work still left to do to.   We must strengthen our education and prevention efforts to impress upon people, especially adolescents, the dangers of cigarettes and other tobacco products. We must also continue to develop better and more effective treatments through research. Every smoker who quits and every would-be smoker who is deterred is potentially a life saved.