SEATTLE ― An estimated 8 million lives have been saved in the United States as a result of anti-smoking measures launched 50 years ago this month, according to a study involving researchers from Fred Hutchinson Cancer Research Center.
The study, led by the Yale School of Public Health and published Tuesday in the Journal of the American Medical Association, used mathematical models to gauge the impact of tobacco control, which started with a seminal 1964 report from the U.S. surgeon general, outlining the effects of tobacco use, as well as subsequent anti-smoking measures implemented over the past half-century. It found that those efforts have significantly shifted public attitudes and behaviors around smoking.
“While tobacco control represents one of the greatest successes in the history of public health, smoking remains as the principal cause of preventable morbidity and mortality in the U.S.,” said Dr. Rafael Meza, a former postdoc in the Public Health Sciences Division, now assistant professor at the University of Michigan School of Public Health and the paper’s second author.
“We should continue our efforts to help smokers quit and discourage non-smokers from starting the habit.”
Meza played a critical role in the estimation of mortality rates by smoking status, age, gender and cohort that were critical for the study. Drs. Suresh Moolgavkar and Jihyoun Jeon of the Public Health Sciences Division helped develop models for the study and contributed to interpreting the results. The Hutch researchers also helped write the paper and contributed to the study design.
Since the surgeon general’s groundbreaking report on Jan. 11, 1964, some 17.6 million Americans have died of smoking-related causes, but 8 million lives ― some 5.3 million men and 2.7 million women ― have been saved due to increasingly stringent tobacco-control measures, the study found.
“Today, a 40-year-old man can expect on average to live 7.8 years longer than he would have in 1964, and 30 percent of that improvement can be attributed to tobacco control,” said Theodore R. Holford, a professor in Yale’s Department of Biostatistics.
“The gains for women have been slightly less, 5.4 years, but tobacco control accounts for 29 percent of that benefit.”
Using data collected by the National Center for Health Statistics from 1965 to 2009, researchers recreated smoking life history summaries for groups born each year starting in 1864. These were used along with national mortality statistics and studies that followed large populations to calculate mortality rates by smoking status. This allowed the researchers to estimate the impact of alternative scenarios for what might have occurred had the era of tobacco control never happened.
The 1964 tobacco report was released by then-U.S. Surgeon General Luther L. Terry. It is widely seen as a pivotal factor in American public health and the first major step in ongoing efforts to convince people to stop smoking.
Terry convened a committee of specialists who reviewed some 7,000 scientific articles and worked with more than 150 consultants to formulate the report’s findings. It was released on a Saturday to generate maximum media coverage in Sunday’s newspapers.
The report spawned numerous other efforts at various levels of government to curb smoking, including the now-familiar surgeon general’s warning on the side of cigarette packages, increased taxation, restrictions on advertising and limiting public areas where people can smoke, along with programs and products to help people kick the habit.
While the percentage of smokers in the United States has decreased significantly over the past several decades, there are still an estimated 44 million Americans, or about 20 percent of the U.S. population, who smoke. Smoking is the single largest cause of preventable death in the United States.
Researchers from the Hutch, the University of Michigan School of Public Health and Georgetown University co-authored the study. Holford and co-authors are members of the National Cancer Institute’s Cancer Intervention and Surveillance Modeling Network (CISNET).