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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

U.S. Makes Progress in Curbing Smoking, but Disparities Persist

January 23, 2014 | Tobacco and Smoking | Comments
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Although the U.S. has made strides in reducing smoking rates over the last five decades, tobacco use remains a major health risk, according to a new report by the Surgeon General. Smoking rates have dropped by half in the last 50 years since the 1964 landmark report that linked smoking with cancer. Yet, every year, nearly half a million American adults still die prematurely from diseases associated with tobacco use.

Smoking has been the cause of more than 20 million premature deaths since 1964, as a result of smoking-related cancers, heart disease, residential fires, and more. The economic costs of tobacco use are now estimated at over $289 billion. Despite a drop in the overall rate of smoking, there has been a concerning rise in the use of other tobacco products. For example, the percentage of U.S. middle and high school students who use electronic, or e-cigarettes, more than doubled between 2011 and 2012.

The Surgeon General’s report notes that tobacco control efforts must target not only the general population, but also populations with a higher prevalence of tobacco use and lower rates of quitting, such as individuals with mental illness or addictions. Currently, people with a substance use disorder or mental illness smoke at 2-4 times the rate of the general population. These disparities are alarming given the health consequences of tobacco use, like heart disease, stroke, and cancer.

The report also addresses the role of tobacco industry-sponsored studies in spreading myths that tobacco use is beneficial for individuals with schizophrenia and should be permitted in psychiatric facilities. In fact, individuals with serious mental illness are particularly vulnerable to tobacco addiction and tobacco use may have detrimental long-term cognitive effects.

Acting Surgeon General Dr. Boris Lushniak said that when it comes to tobacco, “enough is enough.”

“It is my sincere hope that 50 years from now we won’t need another Surgeon General’s report on smoking and health, because tobacco-related disease and death will be a thing of the past,” he said.

“Evidence in this new report shows tobacco’s continued, immense burden to our nation,” said Health and Human Services Secretary Kathleen Sebelius. “In order to free the next generation from these burdens, we must redouble our tobacco control efforts and enlist nongovernmental partners—and society as a whole—to share in this responsibility. Ending the devastation of tobacco-related illness and death is not in the jurisdiction of any one entity. We must all share in this most worthwhile effort to end the tobacco epidemic.”

The Centers for Disease Control and Prevention recently funded the National Council to establish the National Behavioral Health Network for Tobacco and Cancer Control. The goal of the National Network is to engage a wide range of stakeholders – including public health, behavioral health, primary care, education, housing, and other social services professionals – in evidence-based approaches to prevent and reduce tobacco use and cancer among adults with mental health and substance use disorders. For questions about the National Behavioral Health Network, please contact Shelina Foderingham at

Read more about “The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General, 2014.”