A new front in the anti-smoking effort

Pennsylvania's smoking ban went into effect today. Smokers will now have to leave restaurants and other public places to light up. (Sharon Gekoski-Kimmel / Inquirer).

Yet another study confirms the obvious: public health works. Specifically, tobacco control-programs and policies are effective in reducing lung cancer-associated deaths. But there is a caveat: After years of steady declines in U.S. smoking rates, the numbers haven’t moved much in nearly a decade. Now federal health officials are attempting to change that with a new, potentially disturbing campaign that will kick off in a few days.

Evidence showing the effectiveness of government-initiated policies and programs was published this week in the Journal of the National Cancer Institute. It cites factors such as “restrictions on smoking in public places, large increases in cigarette excise taxes, reduced access to cigarettes, and increased public awareness of the hazards of smoking” in preventing nearly 800,000 lung cancer deaths from 1975 to 2000.

According to the lead author, Suresh Moolgavkar of the Fred Hutchinson Cancer Research Center in Seattle, this study was “the first attempt to quantify the impact of changes in smoking behaviors on lung cancer mortality based on detailed reconstruction of cigarette smoking histories.” The paper estimates that without the tobacco control programs and policies described above, 552,000 men and 342,000 women would have died from lung cancer during those 25 years.

If  “everyone who smoked quit in 1965 and no one started smoking,” the paper concludes, “an additional 1.7 million lung cancer deaths would have been averted.” The study does not attempt to estimate the number of deaths from the numerous other causes that  are related to smoking, so the real burden is far higher.

Given this blog’s recent endosement of a soda tax, the role that cigarette taxes played in reducing smoking is particularly interesting to us, and shows just how successful such levies can be. A 2000 Centers for Disease Control and Prevention (CDC) report, Reducing Tobacco Use: A Report of the Surgeon General, confirmed that “increases in cigarette prices lead to substantial reductions in cigarette smoking by deterring smoking initiation among youth, prompting smoking cessation among adults, and reducing the average cigarette consumption among continuing smokers.” A reduction in smoking rates in the U.S. population from 23.2% in 2000 to 20.6% in 2003, for example, has been attributed to tax driven cigarette price increases starting in 1998-9.

This coming Monday, a new advertising campaign from the CDC hits the airwaves and other media depicting “the harsh reality of illness and damage suffered as a result of smoking and exposure to secondhand smoke.” The Tips from Former Smokers campaign “features compelling stories of former smokers living with smoking-related diseases and disabilities, and the toll smoking-related illnesses take on smokers and their loved ones.”

One image from the campaign shows a man shaving around his stoma, a hole in his tracheotomy from smoking-related head and neck cancer. Another image shows a legless, 31-year-old former smoker named Brandon, who lost his limbs to Buerger’s disease, “a disorder linked to tobacco use that causes blood vessels in the hands and feet to become blocked and can result in infection or gangrene.”

According to CDC Director Thomas Frieden, “there is sound evidence that supports the use of these types of hard-hitting images and messages to encourage smokers to quit, to keep children from ever beginning to smoke, and to drastically reduce the harm caused by tobacco.” The shocking images of the Tips from Former Smokers campaign do just that and will hopefully help save lives.

Significant progress has been made in tobacco control. But there is still much that can be done, including continued attention to cigarette taxation, anti-smoking regulations, media campaigns and education, and smoking cessation programs.

And, yes, some people - even some children - will be upset by the graphic images of the new campaign. (Guess what? They'll live longer.)

Read more about The Public's Health.