Tobacco Facts
CIGARETTE SMOKING-RELATED MORTALITY
More than 400,000 Americans die from smoking each year. One in five deaths in the United States is smoking related. (1)
Smoking kills more than 176,000 men and 142,000 women annually. (1)
On average, individuals who smoke die nearly seven years earlier than nonsmokers. (2)
Annually in the U.S., smoking is responsible for more than 5 million years of potential life lost due to premature death. (1)
Reflecting female cigarette smoking patterns, over the last 30 years, lung cancer deaths among women have increased over 400 percent--exceeding breast cancer deaths in the mid-1980s. (3) The American Cancer Society estimates that in 1994, 59,000 women died of lung cancer, compared to 46,000 breast cancer deaths. (4)
Approximately ten million people in the U.S. have died from causes attributed to smoking since the first surgeon general's report on smoking and health in 1964--two million of these deaths were the result of lung cancer alone. (2)
Exposure to secondhand tobacco smoke (or environmental tobacco smoke) causes an estimated 3,000 lung cancer deaths in American adults annually. (5) Scientific studies exist which also link second hand smoke with heart disease.
Among men, cigarette smoking increases the risk of lung cancer death by more than 22 times and the risk of bronchitis and emphysema deaths by nearly 10 times. Among women, smoking increases the risk of dying from lung cancer about 12 times and the risk of dying from bronchitis and emphysema by more than 10 times. Smoking triples the risk of dying from ischemic heart disease among middle-aged men and women. (1)
References
1. Centers for Disease Control and
Prevention (1993). Smoking related mortality and years of potential life
lost--United States, 1990. Morbidity and Mortality Weekly report, 42,
645-648.
2. Office on
Smoking and Health, Unpublished Data, 1994.
3. Centers for Disease
Control and Prevention (1993). Mortality trends for selected smoking
related and breast cancer, U.S. 1950-1990. Morbidity and Mortality Weekly
Report, 42, 857,863-866.
4. American Cancer Society (1994). Cancer
Facts and Figures--1994. Atlanta, GA; American Cancer Society.
5. U.S.
Environmental Protection Agency (1992). Respiratory Health Effects of
Passive Smoking; Lung Cancer and other disorders. U.S. Environmental
Protection Agency, Office of Health and Environmental Assessment, Office
of Research and Development, Washington, D.C.,
EPA/600/6-90/006F.
The Surgeon General concluded in 1989 that tobacco advertising and promotion do appear to stimulate cigarette consumption. (1)
Tobacco companies spent nearly 4 billion dollars in 1990 or about 11 million dollars a day to advertise and promote cigarettes. Increasingly, these marketing dollars are going toward promotional activities that may have special appeal to youth such as sponsorship of public entertainment, distribution of specialty items bearing product names, and the issuing of coupons and premiums. (2)
Cigarette advertisements tend to emphasize youthful vigor, sexual attraction, and independence themes that are likely to appeal to teenagers and young adults struggling with these issues. (3)
About 85 percent of adolescent smokers prefer Marlboro, Newport, or Camel, the three most heavily advertised brands. (4)
Cigarette promotions of televised sporting events heavily expose large numbers of youth to implicit prosmoking messages. During the 1989 Marlboro Grand Prix Telecast, the Marlboro logo was seen or mentioned more than 6,000 times and was visible for 46 of the 94 minutes the race was broadcast. (5)
Tobacco company spending for specialty gift items (such as T-shirts, sunglasses, key chains, calendars, and sporting goods) bearing a cigarette brand logo increased 17 percent from 262 million dollars to 307 million dollars, between 1989 and 1990. (6)
"Old Joe", the cartoon camel used to advertise Camel cigarettes, is as familiar to children as Mickey Mouse's silhouette. A study found that 91% of six-year-olds recognized Old Joe and linked him with his product. This was the same recognition level for the Disney icon. (6)
Since the Old Joe cartoon character was introduced in 1988, Camels share of the adolescent market has increased dramatically from less than 1 percent before 1988 to 8 percent in 1989. Some studies suggest a market share after 1989 as high as 30 percent. (7,8)
Under a voluntary code of advertising adopted in 1964, cigarette companies agreed not to advertise in publications directed mainly to an audience under 21 years of age. In February 1990, a marketing firm under contract for R.J. Reynolds Tobacco Company developed plans to promote "Dakota" brand cigarettes to 18 through 20-year-old women. (9)
Cigarette advertisements appear in publications with large teenage readerships. In Glamour, 25 percent of whose readers are females 18-years-old and under, cigarette advertising expenditures were 6.3 million dollars in 1985. (3)
Although it is illegal in all states to sell tobacco to persons under age 18, children and adolescents have easy access to tobacco products. One author estimated that underage persons can purchase cigarettes 70-80 percent of the time over the counter and 90-100 percent of the time through vending machines. (1)
Each year merchants illegally sell to minors 947 million packs of cigarettes and 26 million containers of spitting tobacco. These products are worth 1.26 billion dollars and they generate 221 million dollars in tobacco industry profits. (2)
Among the estimated 2.6 million U.S. smokers age 12-17 years in 1989, about 1.5 million (58%) usually buy their own cigarettes. (3)
Of the estimated 13.9 million youth aged 12-17 who had not smoked a cigarette in 1989, about 62 percent of them believed it would be easy for them to get cigarettes including 53 percent aged 12-15 and 88 percent aged 16-17. (3)
Among youths aged 12-17 who usually bought their own cigarettes in 1989, about 85 percent often or sometimes bought them from a small store, 50 percent from a large store, and 15 percent from vending machine. (3)
Children can purchase cigarettes from vending machines placed in "adult only" areas, such as bars, 77 percent of the time. (4)
Only 54 percent of the executives of the 148 largest U.S. companies that sell tobacco products could correctly identify the minimum age of purchase in the state where they live. (5)
The recently enacted Synar Amendment, Public Law 102-31, requires that all states enact and enforce a law prohibiting the sale or distribution of tobacco products to minors (persons <18 years old) as a condition of receiving full funding of block grants from the Substance Abuse and Mental Health Services Administration. (6)
References
1. Altman et al
(1989). Reducing the illegal sale of cigarettes to minors. Journal of the
American Medical Association, 261, 80-83.
2. DiFranza, J. R. &
Tye, J. B. (1990). Who profits from tobacco sales to children? Journal of
the American Medical Association, 263, 2784-2787.
3. Centers for
Disease Control (1992). Accessibility of cigarettes to youth aged 12-17
years - United States. Morbidity and Mortality Weekly Report, 41, 485-488.
4. Forster, J.L., Hourigan, M. & McGovern, P. (1992). Availability
of cigarettes to underage youth in three communities. Preventive Medicine,
21, 320-328.
5. Altman et al (1992). Policy alternatives for reducing
tobacco sales to minors: Results from national survey of retail chain and
franchise stores. Journal of Public Health Policy, 13, 318-331.
6.
Centers for Disease Control and Prevention. (1993). Minors access to
tobacco- Missouri, 1992 and Texas, 1993. Morbidity and Mortality Weekly
Report, 42, 125-128.
About 23 million women 18 years and older and at least 1.5 million adolescent girls in the United States are smokers. Twenty-five percent of 17 and 18-year-old girls smoke. (1, 2)
Among ethnic populations, smoking rates among U.S. women 18 years and older are: White: 27.2%, African American: 27.8%, Hispanic/Latino: 20.7%, American Indian: 39.4%, Asian: 15.2%. (1)
Women are beginning to smoke at younger ages, increasing their risks of developing smoking-related diseases. (2)
The gap in smoking prevalence between men and women has narrowed dramatically in recent years. While the percentage of male smokers dropped 24 percentage points between 1964 and 1991, the percentage of female smokers has dropped only 10 percentage points in the same period. (3)
Between 1960 and 1990, the lung cancer rate in women increased more than 500 percent, and the rate is continuing to increase. Lung cancer surpassed breast cancer in 1987 as the number one cause of death in women. The American Cancer Society estimated that in 1994, lung cancer will kill 59,000 and breast cancer will kill 46,000 women. (5)
References
1. Centers for
Disease Control and Prevention (1994). Cigarette smoking among
adults--United States, 1992, and changes in the definition of cigarette
smoking. Morbidity and Mortality Weekly Report, 43, 342-346.
2. U.S.
Department of Health and Human Services (1994). Preventing tobacco use
among young people: A report of the Surgeon General. Atlanta, GA: Public
Health Service, Centers for Disease Control and Prevention, National
Center for Chronic Disease Prevention and Health Promotion, Office on
Smoking and Health.
3. Centers for Disease Control. Trends and recent
patterns in selected tobacco-use behaviors--United States 1900-1993. (IN
PRESS)
5. Centers for Disease control and Prevention (1993). Mortality
trends for selected smoking related cancers and breast cancer--United
States, 1950-1990. Morbidity and Mortality Weekly Report, 42, 863-866.
Nearly 600 ingredients added in the manufacture of cigarettes. (1)
The manufacturers of cigarettes and smokeless tobacco are required to provide the secretary of the U.S. Department of Health and Human Services with lists of the ingredients used in the production of cigarettes and smokeless tobacco. (2,3)
The tobacco industry is not required to report the sources of their additives, nor to report the quantities and proportions of these additives. (2,3) Without this information it is difficult to determine the health risks associated with tobacco additives. (4)
Research has documented that numerous chemical treatments and additives are applied to cigarettes during the manufacturing process. The chemicals include pesticides, flavorings, plasticizers, adhesives, humectants (for moisture), and other agents. The details of these products remain a secret. (4)
The U.S. Department of Health and Human services is required by law to maintain the confidentiality of the ingredient lists submitted directly by the tobacco industry. The release of any information from the department of Health and Human services would constitute a felony. (2,3)
Over the past 30 years research has proven that smoking and the use of other tobacco products cause premature death and disability. While the addition of hundreds of chemicals in tobacco products is a concern, an additive-free cigarette would still be deadly. Processed, unadulterated tobacco contains at least 2,550 known compounds. It is estimated that tobacco smoke contains more than 4,000 compounds including more than 40 known to cause cancer. (4)
Chewing tobacco and snuff, tobacco products that are not smoked, contain high concentrations of cancer causing chemicals. (4)
References
1. American
Tobacco Company, Brown and Williamson, Liggett Group, Inc., Lorilard,
Inc., Philip Morris, Inc, & R.J. Reynolds Tobacco Company (1994).
Ingredients added to Tobacco in the Manufacturing of Cigarettes.
2.
Comprehensive Smoking Education Act, Public Law 98-474 (1984).
3.
Comprehensive Smokeless Tobacco Health Education Act of 1986. (1986).
4. U. S. Department of Health and Human Services (1989). Reducing the
Health consequences of smoking: 25 years of progress. A report of the
Surgeon General. U. S. Department of Health and Human Services, Public
Health Service, Centers for Disease Control and Prevention, Center for
Chronic Disease Prevention and Health Promotion, Office on Smoking and
Health. DHHS Pub. No. 89-8411.
In 1988, the Surgeon General concluded that
- Tobacco use is addicting.
- Nicotine is the drug in tobacco that causes addiction.
- Addiction to tobacco is akin to addiction to drugs such as cocaine and heroin. (1)
Tobacco use meets the primary criteria for defining drug addiction defined by the World Health Organization, National Institute on Drug Abuse, and The American Psychiatric Association. These criteria are:
- The drug seeking or taking behavior is driven by strong, persistent, and often irresistible urges.
- The substance is mood altering and enters the brain through the blood stream; the drug is reinforcing, that is, the is rewarding that the user continues to use it.
- There are regular patterns of use, continued use despite harmful effects, relapse following an abstinence pattern, and recurrent cravings for the drug. Dependence-producing drugs often create a tolerance, physical dependence, and pleasant effects. (1)
Sixty percent of even light smokers feel at least one key indicator of addiction (e.g., they tried to cut down and could not, or they felt they were dependent on cigarettes). (2)
Nicotine dependency is the most common form of drug addiction. Continued use of a nicotine delivery system (e.g., cigarettes, smokeless tobacco, cigars) leads to more death and disease than all other addictions combined. (1)
Eighty-five percent of cigarette smokers are daily smokers, while only 10 percent of illicit drug users are daily users. (3)
Eighty-five percent of people who have ever used an illicit drug have quit using that illicit drug, while only 63 percent of the people who have ever tried a cigarette have quit smoking. (4)
Nicotine affects the body in different ways. In stressful situations it can have an effect like a tranquilizer, while during quiet times, it can act as a stimulant. Nicotine reaches the brain within 10 seconds of inhaling. (1)
When a person uses nicotine daily, the levels of nicotine accumulate in the body. Daily users experience the effects of nicotine 24 hours a day. (1)
Seventy percent of current smokers want to quit and 87 percent of current smokers say that cigarettes are addictive. (5,6)
Most adolescents who smoke are addicted to nicotine. When young people try to quit smoking, they experience withdrawal symptoms. Eighty-four percent of 12- to 17-year-olds who smoke one pack or more of cigarettes a day say they "need or are dependent on" cigarettes. (8)
Among addictive behaviors, cigarette smoking is the one most likely to be established during adolescence. Ninety percent of smokers start before the age of 21, and 50 percent before the age of 18. Those smokers who start at an early age are more likely than late starters to develop long-term nicotine addiction (8,9)
Tobacco is often the first substance used by those young people who use alcohol, marijuana, and other drugs. (8)
References
1. U. S.
Department of Health and Human Services (1988). The health consequences of
smoking: Nicotine Addiction. A report of the Surgeon General. U. S.
Department of Health and Human Services, Public Health Service, Centers
for Disease Control and Prevention, Center for Chronic Disease Prevention
and Health Promotion, Office on Smoking and Health.
2. Giovino, G. A.,
Shelton, D. M. and Schooley, M. W. (1993) Trends in cigarette smoking
cessation in the United States. Tobacco Control, 2(suppl), s3-s10.
3.
Centers for Disease Control (1994). Cigarette smoking among adults--United
States, 1992, and changes in the definition of current cigarette smoking.
Morbidity and Mortality Weekly Report, 43, 342-346.
4. U. S.
Department of Health and Human Services (1993). National Household Survey
on Drug Abuse. DHHS Publication no. (SMA) 93-2053.
5. Gallup
Organization (1991). Despite increasing hostility, one in four Americans
still smokes. Gallup mirror of America poll. Princeton, NJ: Gallup
Organization
6. Janofsky, M. (1994). New York Times, May 1, 1994, Sec.
1.
7. Fiore, M. C., Novotny, T. E., Pierce, J. P. et al. (1990).
Methods used to quit smoking in the United States: Do cessation programs
help? Journal of the American Medical Association, 263, 2760-2765.
8.
U. S. Department of Health and Human Services (1994). Preventing tobacco
use among young people. A report of the Surgeon General. U. S. Department
of Health and Human Services, Public Health Service, Centers for Disease
Control and Prevention, Center for Chronic Disease Prevention and Health
Promotion, Office on Smoking and Health.
9. U. S. Department of Health
and Human Services (1989). Reducing the health consequences of smoking: 25
years of progress. A report of the Surgeon General. U. S. Department of
Health and Human Services, Public Health Service, Centers for Disease
Control and Prevention, Center for Chronic Disease Prevention and Health
Promotion,
10. Office on Smoking and Health. DHHS publication no.
(CDC) 89-8411.