报刊选读 List finds smoking worse than thought

The list of diseases linked to smoking grew longer Thursday. Add acute myeloid leukemia, cancers of the cervix, kidney, pancreas and stomach, abdominal aortic aneurysms, cataracts, periodontitis and pneumonia.

"We've known for decades that smoking is bad for your health, but this report shows that it's even worse," said Surgeon General Richard Carmona, announcing his first official assessment of the effects of tobacco.

The report said current evidence is not conclusive enough to say smoking causes colorectal cancer, liver cancer, prostate cancer or erectile disfunction. Some research has associated those diseases with smoking, but Carmona said more proof is needed.

The evidence suggests smoking may not cause breast cancer in women but that some women, depending on genetics, may increase their risk of getting it by smoking, the report said.

Diseases previously linked to smoking include cancer of the bladder, esophagus, larynx, lung and mouth. Also tied to smoking was chronic lung disease, chronic heart and cardiovascular disease, osteoporosis, peptic ulcers and reproductive problems.

About 440,000 Americans die of smoking-related diseases each year. The report said more than 12 million people have died from smoking-related diseases in the 40 years since the first surgeon general's report on smoking and health was released in 1964.

That report linked smoking to lung and larynx cancer and chronic bronchitis. Subsequent reports, such as the one released Thursday, have expanded the list of diseases linked to smoking.

Carmona's report said treating smoking-related diseases costs the nation US$75 billion annually. The loss of productivity from smoking is estimated to be US$82 billion annually.

On average, the surgeon general said, smokers die 13 years to 14 years before nonsmokers.

The number of adults who smoke has dropped from about 42 percent in 1965 to about 22 percent in 2002, the last year for which such data is available, according to the surgeon general.

The government has set a goal of 12 percent by 2010, but is having trouble getting the rate to come down as quickly as sought. The smoking rate is declining by less than one-half of a percentage point annually.

Cheryl Healton, president of the anti-smoking American Legacy Foundation, said officials have failed to act on recommendations made by a government-appointed scientific panel last year. Among its proposals was raising the federal tax on cigarettes from 39 cents per pack to US$2.39.

The Bush administration did agree with the proposal to establish a national hot line to counsel smokers. That should be set up next year.

Matthew Myers, president of the Campaign for Tobacco-free Kids, said the surgeon general's report demonstrates the need for the Food and Drug Administration to regulate cigarettes. That has been proposed in Congress.

Carmona said he was briefed on the legislation, which would set strict rules for marketing and manufacturing cigarettes. While he stopped short of endorsing the bill, he said it was "wonderful" that lawmakers were considering it.

Health and Human Services Secretary Tommy Thompson has said he thinks tobacco ought to be regulated.

When U.S. President Bush asked recently if he thinks more regulation of the industry is needed, he reaffirmed his position that the emphasis ought to be on preventing teenagers from smoking.

The administration recently signed a treaty that would put new restrictions on cigarette manufactures worldwide. Public health officials complain that the administration has not yet submitted the treaty to the Senate for ratification.