Anti-Smoking Work Cuts U.S. Deaths as Global Market Grows

Anti-smoking measures adopted over the last 50 years in the U.S. have prevented 8 million early deaths and extended lifespans by two decades, though a rise in the global population has kept the number of smokers and the tobacco market growing.

About 5.3 million men and 2.7 million women live longer thanks to tobacco control, according to one of six studies on the topic published in the Journal of the American Medical Association. What’s more, life expectancy at age 40 for U.S. men and women has increased 2.3 years and 1.6 years, respectively.

The first U.S. Surgeon General’s report on tobacco’s ill effects was made in January 1964, when at least 50 percent of men and almost 40 percent of women smoked. Today, about one-fifth of U.S. adults smoke. Since 1980, however, the number of daily smokers globally has increased 34 percent because of population growth.

“The progress on reducing smoking prevalence is slower than population growth,” said Christopher Murray, a study author and a professor of global health at the University of Washington in Seattle. “We’re making progress but we haven’t driven down the number of smokers so the market continues to grow.”

During the 50 years the group studied, about 17.7 million people in the U.S. died prematurely from smoking, the report said. The group used the numbers of actual smoking-related deaths from 1964 through 2012, and compared them with estimated mortality without tobacco control.

Life Expectancy

For the population as a whole, life expectancy in the U.S. for men at the age of 40 increased 7.8 years over that time period, with 30 percent of the gain attributable to anti-smoking measures. Women gained 5.4 years of life expectancy at 40, with tobacco control accounting for 29 percent of the increase, the study authors found.

Smoking tobacco is linked to lung, larynx, esophageal and oral cancers, heart disease and emphysema, and “no other behavior comes close to contributing so heavily to the nation’s mortality burden,” the authors wrote.

“I struggle to think if there’s another single measure that can account for such an improvement in life expectancy in the last 50 years,” Theodore Holford, a study author and professor of biostatistics at the Yale School of Public Health, said in a telephone interview. “I can’t think of anything that comes close to that.”

Anti-Smoking Rule

After the initial report from then-Surgeon General Luther L. Terry in 1964, the U.S. Congress adopted an act which required warning labels about smoking’s health consequences. In 1969, Congress prohibited cigarette advertising on television and radio. In 2002, New York City adopted a comprehensive smoke-free law that helped influence policy makers, leading a number of states to ban smoking in workplaces, restaurants and bars. The U.S. Centers for Disease Control and Prevention is seeking to have all states and the District of Columbia eliminate smoking in public places and work sites by 2020.

Researchers found that while daily smoking prevalence decreased 25 percent for men and 42 percent for women globally since 1980, an increasing population spurred a rise in number of smokers around the world to 967 million in 2012, from 721 million in 1980. The number of cigarettes smoked each day also increased 26 percent during the period.

China, Russia, and countries in the Balkan Peninsula also were among those with the highest smoking prevalence.

“It’s interesting that we’re seeing in the last few years a slowdown in progress; the annual rate of change is getting less impressive,” Murray said. “And much of that is driven by China, and a little bit Russia, where in the last few years, there’s been no progress or even slight increases in male smoking prevalence.”

More cigarettes were sold worldwide every year during the 32 years his scientists tracked, he said. Though many measures are known to help lower rates of smoking, such as bans on cigarette advertising and higher taxes, some countries haven’t adopted them, Murray said.

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