Tobacco use continues to be the leading cause of preventable death in the United States, accounting for about 30% of all cancer deaths. While fewer people are smoking cigarettes and smoking rates have drastically dropped during the past several decades, there are still an estimated 34.2 million people in the U.S. who smoke.
For more than 40 years, the American Cancer Society has hosted the Great American Smokeout on the third Thursday of November. The Great American Smokeout is an opportunity for people who smoke to commit to healthy, smoke -free lives – not just for a day, but for a lifetime.
The idea is to provide an opportunity for individuals, community groups, businesses, health care providers, and others to encourage people to use the date to make a plan to quit, or plan in advance and initiate a smoking cessation plan on the day of the event. We are joing in that effort.
The event challenges people to stop smoking and helps everyone learn about the many tools they can use to help quit and stay healthy. For this year’s 45th Great American Smokeout on Thursday, November 19, 2020, the American Cancer Society (ACS) is reminding people who smoke to use this as a day to make a plan to commit to a tobacco- and smoke-free life, especially people who are at increased risk for severe illness from COVID-19.
Smoking and COVID
While the harms of tobacco use are well-established – causing 8 million deaths every year from cardiovascular diseases, lung disorders, cancers, diabetes, and hypertension – the pandemic highlights even more the fact tobacco use is also known to increase the risk for severe disease and death in many respiratory infections. At the time of writing, the WHO, CDC and other prominent population health organizations have concluded the available evidence suggests smoking is associated with increased severity of disease and death in hospitalized COVID-19 patients, yet studies still need to be completed.
In their recent press release, the ACS put it this way: “Based on what is known at this time, people who smoke might be at increased risk for complications from COVID-19, and we are concerned about worsening disparities of smoking-related illness and COVID-19 in high-risk populations,” said Laura Makaroff, senior vice president, prevention and early detection, American Cancer Society. “There’s never been a better time to quit smoking, and the sooner someone quits, the more they can reduce their chances of developing tobacco-related diseases.
How many people smoke?
Each minute, smokers burn through nearly 11 million cigarettes and 10 perish from the habit – yes, one approximately every six seconds.
There are around one billion smokers in the world – one-seventh of the global population – according to WHO and other estimates.
China has the highest number: within its population of 1.3 billion, about 315 million are smokers; and they consume more than a third of the world’s cigarettes, also according to WHO.
Indonesia has the highest proportion of smokers – 76% of the country’s men over 15 are stuck in the habit.
About 80% of the world’s smokers live in low to middle-income countries, and 226 million of them are considered poor.
About 32.4 million American adults still smoke cigarettes, and smoking remains the single largest preventable cause of death and illness in the world. Smoking causes an estimated 480,000 deaths every year, or about 1 in 5 deaths. And more than 16 million Americans live with a smoking-related disease.
On the decline?
While the rates of cigarette smoking have declined over the past several decades, from 42% in 1965 to 13.7% in 2018, the gains have been inconsistent and the advent of vaping have hindered the efforts. Some groups smoke more heavily or at higher rates and suffer disproportionately from smoking-related cancer and other diseases. These populations tend to be those who experience inequities in multiple areas of their lives, including those at lower socioeconomic levels, those without college degrees, American Indians/Alaska natives, African American/Black communities, LGBTQ communities, those in the military, those with behavioral health conditions, and others.
A study published in The Lancet medical journal, April 2017, found the percentage of people using tobacco every day has dropped in 25 years.
One in four men and one in 20 women smoked daily in 2015, down from one in three men and one in 12 women in 1990. Newest estimates are now showing 1 in 5 people smoke across the general population, or about the same as at the turn of the century.
Reductions in smoking rates in some nations “are almost entirely offset by the increasing consumption in many countries with weaker tobacco control regulations,” says The Tobacco Atlas anti-smoking lobby. These include poorer parts of the world – in particular, sub-Saharan Africa. In addition, Electronic cigarettes have also entered most markets.
Tobacco use has decreased in places such as Australia, Brazil and Britain, where anti-smoking measures include higher taxes, bans and health warnings. France reports a million fewer daily smokers in 2017 over 2016. Ireland and Uruguay are the two countries which have achieved the highest levels of tobacco control.
Since 2007, the number of people around the world to have benefited from stronger regulations has more than quadrupled – up from one billion to five billion.
Tobacco sales have even declined in China, down by 10% from a peak in 2012, according to the Euromonitor International market research group.
A high cost
Still, tobacco is the leading cause of preventable death. Active smoking or passive contact kills more than seven million people every year, according to the WHO. Cancers, heart attacks, strokes and lung diseases are the main health concerns associated with tobacco. Over the 20th century, tobacco claimed 100 million lives – more than the 60-80 million deaths during World War II and the 18 million in World War I combined.
At current rates, tobacco could account for up to a billion deaths in the 21st century, the WHO says. Smoking uses up almost 6% of world spending on healthcare as well as nearly 2% of global GDP, according to a January 2017 study in the scientific journal Tobacco Control. This amounted to $1.436 billion globally in 2012, 40% of which is borne by developing countries.
The benefits of quitting
No matter your age or how long you’ve been smoking, quitting improves health both immediately and over the long term. Giving up smoking is a journey, and it can be hard, but you can increase your chances of success with a good plan and support. Getting help through counseling and medications doubles or even triples your chances of quitting successfully.
This year, Great American SmokeOut Day focuses on the multiple ways that exposure to tobacco affects the health of people’s lungs worldwide. These include:
Lung cancer. Tobacco smoking is the primary cause for lung cancer, responsible for over two thirds of lung cancer deaths globally. Second-hand smoke exposure at home or in the workplace also increases risk of lung cancer. Quitting smoking can reduce the risk of lung cancer: after 10 years of quitting smoking, risk of lung cancer falls to about half that of a smoker.
Chronic respiratory disease. Tobacco smoking is the leading cause of chronic obstructive pulmonary disease (COPD), a condition where the build-up of pus-filled mucus in the lungs results in a painful cough and agonizing breathing difficulties. The risk of developing COPD is particularly high among individuals who start smoking at a young age, as tobacco smoke significantly slows lung development. Tobacco also exacerbates asthma, which restricts activity and contributes to disability. Early smoking cessation is the most effective treatment for slowing the progression of COPD and improving asthma symptoms.
Across the life-course. Infants exposed in-utero to tobacco smoke toxins, through maternal smoking or maternal exposure to second-hand smoke, frequently experience reduced lung growth and function. Young children exposed to second-hand smoke are at risk of the onset and exacerbation of asthma, pneumonia and bronchitis, and frequent lower respiratory infections.
Globally, an estimated 60 000 children die before the age of 5 of lower respiratory infections caused by second-hand smoke. Those who live on into adulthood continue to suffer the health consequences of second-hand smoke exposure, as frequent lower respiratory infections in early childhood significantly increase risk of developing COPD in adulthood.
Tuberculosis. Tuberculosis (TB) damages the lungs and reduces lung function, which is further exacerbated by tobacco smoking. About one quarter of the world’s population has latent TB, placing them at risk of developing the active disease. People who smoke are twice as likely to fall ill with TB. Active TB, compounded by the damaging lung health effects of tobacco smoking, substantially increases risk of disability and death from respiratory failure.
Air pollution. Tobacco smoke is a very dangerous form of indoor air pollution: it contains over 7 000 chemicals, 69 of which are known to cause cancer. Though smoke may be invisible and odorless, it can linger in the air for up to five hours, putting those exposed at risk of lung cancer, chronic respiratory diseases, and reduced lung function.
Goals of the Great American SmokeOut Day 2020 campaign
The most effective measure to improve lung health is to reduce tobacco use and second-hand smoke exposure. But knowledge among large sections of the general public, and particularly among smokers, on the implications for the health of people’s lungs from tobacco smoking and second-hand smoke exposure is low in some countries. Despite convincing evidence of the harms of tobacco on lung health, the potential of tobacco control for improving lung health remains underestimated.
The Great American SmokeOut Day 2020 campaign will raise awareness on the:
- risks posed by tobacco smoking and second-hand smoke exposure;
- awareness on the particular dangers of tobacco smoking to lung health;
- magnitude of death and illness from lung diseases caused by tobacco, including chronic respiratory diseases and lung cancer;
- implications of second-hand exposure for lung health of people across age groups;
- importance of lung health to achieving overall health and well-being;
- feasible actions and measures that key audiences, including the public and governments, can take to reduce the risks to lung health posed by tobacco.
It’s hard to quit tobacco
And yet, you can do it. Addiction to nicotine in cigarettes is one of the strongest and most deadly addictions one can have. Quitting is hard for many people who smoke. It takes commitment and starts with a plan, often takes more than one quit attempt, and requires a lot of support. Often, the younger one was when he or she started to smoke, the more intense the addiction.
People who smoke are strongly advised to use proven cessation methods, such as prescription medications and counseling, to quit smoking. It’s a good idea to talk to your doctor or pharmacist to get their advice.
Research shows that people who smoke are most successful in their efforts to stop smoking when they have support, such as:
- Telephone quitlines
- American Cancer Society Freshstart Program
- Nicotine Anonymous meetings
- Self-help books and materials
- Smoking counselors or coaches
- Encouragement and support from friends and family members
Using 2 or more of these measures to quit smoking works better than using any one of them alone. For example, some people use a prescription medicine along with nicotine replacement. Other people may use as many as 3 or 4 of the methods listed above. Professional guidance can help you choose the approach that’s right for you.
How the Great American Smokeout began
The Great American Smokeout event has helped dramatically change Americans’ attitudes about smoking. These changes have led to community programs and smoke-free laws that are now saving lives across the country. Annual Great American Smokeout events began in the 1970s, when smoking and secondhand smoke were common.
The idea for the Great American Smokeout grew from a 1970 event in Randolph, Massachusetts, at which Arthur P. Mullaney asked people to give up cigarettes for a day and donate the money they would have spent on cigarettes to a high school scholarship fund.
Then in 1974, Lynn R. Smith, editor of the Monticello Times in Minnesota, spearheaded the state’s first D-Day, or Don’t Smoke Day.
The idea caught on, and on November 18, 1976, the California Division of the American Cancer Society got nearly 1 million people who smoke to quit for the day. That California event marked the first official Smokeout, and the American Cancer Society took it nationwide in 1977. Since then, there have been dramatic changes in the way the public views tobacco advertising and tobacco use. Many public places and work areas are now smoke-free – this protects non-smokers and supports people who smoke who want to quit.
The Great American Smokeout event helps fuel new laws and save lives
Each year, the Great American Smokeout event draws attention to preventing the deaths and chronic illnesses caused by smoking. Throughout the late 1980s and 1990s, many state and local governments responded by banning smoking in workplaces and restaurants, raising taxes on cigarettes, limiting cigarette promotions, discouraging teen cigarette use, and taking further action to counter smoking. These efforts continue today.
Because of the many individuals and groups that have led smoke-free advocacy efforts, there have been significant landmarks in the areas of research, policy, and the environment:
- 1977: Berkeley, California, became the first community to limit smoking in restaurants and other public places.
- 1983: San Francisco passed the first strong workplace smoking restrictions, eliminating smoking in private workplaces.
- 1990: The federal smoke-free law for all domestic flights of 6 hours or less took effect
- 1994: Mississippi filed the first of 24 state lawsuits seeking to recuperate millions of dollars from tobacco companies for smoking-related illnesses paid for by Medicaid.
- 1994: ABC News reported for the first time that cigarette companies manipulated the nicotine in their products to cause and sustain addiction in people who smoke.
- 1994: The U.S. Food and Drug Administration (FDA) opened an historic investigation into the tobacco industry’s manipulation of nicotine and targeting of children in advertising and promotion.
- 1999: The Department of Justice filed suit against cigarette manufacturers, charging the industry with defrauding the public by lying about the risks of smoking.
- 1999: the Master Settlement Agreement (MSA) was passed, requiring tobacco companies to pay $206 billion to 45 states by the year 2025 to cover Medicaid costs of treating people who smoke. The MSA agreement also closed the Tobacco Institute and ended cartoon advertising and tobacco billboards.
- 2009:The Family Smoking Prevention and Tobacco Control Act was signed into law. It gives the FDA the authority to regulate the sale, manufacturing, and marketing of tobacco products and protects children from the tobacco industry’s marketing practices.
- 2017: More than 11 years after a federal court first ordered them to do so, the major U.S. tobacco companies began publishing “corrective statement” advertisements telling the American people the truth about their deadly and addictive products. Tobacco companies had to publish corrective statements in the nation’s top-selling newspapers from November 2017 to April 2018, according to the court ruling. The court also required corrective statements to air on major television networks from November 2017 to November 2018. The American Cancer Society, along with other public health groups, played a major role as an intervenor in the Justice Department’s litigation against Big Tobacco.
The Great American Smokeout materials are copyrighted by the American Cancer Society, Inc. Great American Smokeout is a trademark of the American Cancer Society, Inc. Use of the Smokeout Materials does not state or imply the American Cancer Society’s endorsement of any goods or services. The Smokeout may not be used to support political parties or candidates or in connection with pornographic or otherwise offensive sexual materials, racially or ethnically prejudicial materials, or other materials which may damage the goodwill associated with the American Cancer Society.