Surgeon General 's New Anti-Smoking Plan

Surgeon General David Satcher hopes to cut smoking in the United States by half within a decade.

Satcher presented a wide range of approaches that could help reduce Americans’ use of tobacco in a 450-page report called “Reducing Tobacco Use” released today at the 11th World Conference on Tobacco OR Health in Chicago.

Smoking rates could be cut by 50 percent overall if all the proven anti-smoking measures covered in the report were implemented, he said. These include anti-smoking campaigns, stronger warnings on cigarette packages, anti-smoking school programs, doctor-recommended treatment programs, and stronger governmental bans on indoor smoking.

Satcher said this is the first surgeon general’s report ever to deal with solutions to the problem, rather than the problem itself.

“Our lack of greater progress in tobacco control is more the result of failure to implement proven strategies than it is the lack of knowledge about what to do,” Satcher said in the report.

Tax Hike

Satcher joined world health organizations in calling for a 10 percent tax hike on cigarettes to encourage smokers to quit.

On Tuesday, the World Bank and the World Health Organization urged developing nations to tax tobacco, estimating that a 10 percent increase in the price of tobacco could motivate 42 million smokers to quit and prevent 10 million tobacco-related deaths.

Satcher noted that a $2 tax hike on tobacco products in the United States could reduce their use by 3 to 5 percent. Cigarette prices and taxes in the United States are currently well below those in most other industrialized nations, he said.

Brendan McCormick, a spokesman for Philip Morris International tobacco company, said the company disagrees with the tax hike. “Adult smokers shouldn’t be penalized for their choice to smoke,” he said.

But, he added, the company supports other facets of the report, including campaigns to deter youth smoking, and better ventilation and non-smoking sections in public facilities. “We are willing to work with the Surgeon General in reaching a common ground,” he said.

Although the report focuses on the United States, its findings also apply worldwide, said Dr. Jeffrey P. Koplan, director of the Centers for Disease Control, which helped develop the report. “The CDC is committed to working with other nationals to curb the global epidemic of tobacco-related disease,” Koplan said.

Modes of Attack Other points made in the report:

U.S. warning labels on cigarettes are “weaker and less prominent” than in other countries. In Canada, for example, officials have replaced traditional warning labels that have lost their impact on consumers with graphic images of tar-stained diseased lungs to shock smokers.

The medical system needs to treat nicotine addiction more aggressively and insurance companies need to provide universal coverage of up-to-date treatments. A doctor’s advice that a patient quit smoking can quadruple normal quitting rates, while smokers who combined nicotine gum or patches with behavioral counseling had dramatically higher success rates.

Smoking rates among teens could be cut 20 to 40 percent if school-based programs along with community and media campaigns were implemented.

Currently, the report says, only 5 percent of schools follow the anti-smoking guidelines set up by the CDC, which include teaching teens the health risks of tobacco and how to resist peer pressure to smoke. Schools should be completely smoke-free, the report said.

The promotion of tobacco needs to be better regulated. The industry spends $6.7 billion annually — $18 million a day — to market tobacco. Additional restrictions on directing those campaigns toward children are needed, as well as campaigns to counter those messages, Satcher said.

“During the past four decades, we have made unprecedented gains in preventing and controlling tobacco use,” Satcher said. “However, the sobering reality is that smoking remains the leading cause of preventable death and disease in our nation, and those who suffer the most are poor Americans, minority populations and young people.”

This report is the latest in a long line of Surgeon General reports on smoking beginning in 1964. Since that time, the reports have progressed from discussing the consequences of smoking to adressing second-hand smoke (1986), the benefits of quitting (1990), prevention in youth (1994), and minority use (1998).