What’s the state of smoking in America?

January 12, 2014 at 12:00 AM EDT
It’s been 50 years since the first Surgeon General’s report on the hazards of smoking. Smoking rates in the U.S. have dropped from 43 percent of all adults to 18 percent and smoking is banned in many public places. What’s the state of smoking in America today? Acting Surgeon General Boris Lushniak provides perspective.

HARI SREENIVASAN: This weekend marks the 50th anniversary of the landmark 1964 report by then Surgeon-General Luther Terry warning about the dangers of smoking. That report is widely credited with saving millions of lives. For more about the government’s current efforts to reduce smoking, we are joined now from Washington by Rear Admiral Boris Lushniak.he is the Acting United States Surgeon General.

Thanks for being with us. I just wanted to start with, where are we on this war against tobacco, war on smoking, considering the long time we’ve had in fighting it?

BORIS LUSHNIAK: Well it’s interesting. We’ve had fifty years of progress since that landmark Surgeon General’s report back in 1964. Over these fifty years incredible things have taken place. Our society has changed. Changed in terms of tobacco use, in terms of its acceptance of smoking in public establishments; in restaurants, in bars. So things have really changed for the better. In addition, smoking rates have come down in the United States. We went from 43 percent of adult smokers in the United States to 18 percent currently. So that’s really made incredible headway, yet I have to emphasize the battle isn’t over, the war isn’t over.

Eighteen percent of American adults who are still smoking, basically 40 million people in our population. So this is really still concerning to me as acting Surgeon General. Certainly of those 40 million people who are actively smokers, the idea is that their health is really being hurt by this incredible habit, by this incredible addiction to nicotine. That being said we have to realize also that of that whole group, we’re going to have roughly a half million people every year dying from smoking related diseases. So although we’ve made progress in a half century the reality is we still have a lot of work to do.

HARI SREENIVASAN: So, you know, we increasingly see tough advertisements on the air against smoking. Really graphic descriptions whether it’s targeting teens or people that might have emphysema. Are these ads working?

BORIS LUSHNIAK: I think they’re working. In particular, the CDC- the Center for Disease Control and Prevention came up with a series of advertisements from former smokers called TIPS. And that really was quite effective in terms of reducing the number of smokers. In addition. There’s various policies that need to be implemented and further implemented in order to make us a tobacco free society. So we really have to work at the idea of using media, using those advertisements. We have to look at really concentrating on the youth of America to make it more difficult to actually get cigarettes. And in addition we have to look at the idea of pricing cigarettes appropriately so that ultimately it becomes a hardship to use those products.

HARI SREENIVASAN:  So, let’s talk a little bit about packaging those products. Other countries have much more graphic detail of the potential dangers of smoking. I know the US Court struck down one of the plans here but what’s next? Do we change packaging?

BORIS LUSHNIAK: Well, we’re currently working closely, the office of the Surgeon general is working closely with the Food and Drug Administration, specifically the Center for Tobacco Products and are reanalyzing the whole row of the idea of the warning labels and the idea of how graphic they should be and so there will probably be more information coming out on this in the near future.

HARI SREENIVASAN: Ok, does it make sense to increase taxes on cigarettes? Are the as high as they could be?

BORIS LUSHNIAK: Well in terms of one of the effective methods of us decreasing the number of smokers in America is oddly enough the pricing of cigarettes. So whether it’s the form of taxation of cigarette pricing, that is an effective measure. And although this does become, I use the term before, a hardship, in reality my role as acting Surgeon General is to make sure that we’re doing the right public health thing which is to decrease the number of smokers in America. So yes, pricing is an effective way of dealing with this problem.

HARI SREENIVASAN: Ok, one of the things that I wanted to ask and a lot of people were asking about this when we said that we were going to interview you is this to e-cigarettes- what does the Surgeon General think about e-cigarettes? Is there good data on any deleterious effects to the rest of us or even to those people who are still using them?

BORIS LUSHNIAK: Yes, and the e-cigarette movement has certainly become strong, there’s many more people using e-cigarettes and right now we’re still gathering data. I don’t feel comfortable in terms of the e-cigarettes being a substitute for cigarettes at this point. The reality is there’s still an addictive product within those e-cigarettes that are introduced into the body via the repertory tract via breathing. And so the reality of the situation is we’re still waiting on gathering more data, and again we’re working with the Food and Drug Administration, the Center for Tobacco Products that are beginning to look very much more aggressively at the e-cigarette issue.

HARI SREENIVASAN: Now is it possible that we’re going to waiting for data for so long, we don’t get ahead of stopping it in the sense that we might have this actual switch in this transition to e-cigarettes which keeps people unhealthy and then we’re fighting an uphill battle again?

BORIS LUSHNIAK: Well once again my hope is we’ll have data coming out rather soon. What we already know is the e-cigarettes certainly are becoming much more popular. We also know that in many cases the tobacco control policies that are being utilized for regular cigarettes are in fact being utilized for e-cigarettes as well.

HARI SREENIVASAN: Ok, another question we had from a mother in Colorado where marijuana has recently become much more accessible. She’s saying ‘well what about the impact of second hand marijuana smoke on kids? Is there anything that the Federal Government ‘s going to be doing to try and keep her kids safe?

BORIS LUSHNIAK: Well again, from a public health perspective, the marijuana issue has become big. Certainly with the legalization that has taken place in Colorado and in Washington State, it is of concern to me as the acting Surgeon General of the United States. That being said it’s really on several fronts here. One of which is marijuana is addictive. Secondly, once again, it’s something that breathed in and so I really am concerned about the repertory effects of marijuana. And third, it does alter one’s cognition, one’s thought process. And so of those three realms, my concern is not only the secondhand smoking issue but also the issue of the primary issue and the public health effect on that individual.

HARI SREENIVASAN: Boris Lushniak, the acting Surgeon General. Thanks so much for your time.

BORIS LUSHNIAK: Great. Thank you so much, Hari.