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Originally published: 2014-01-20 12:45:49
Last modified: 2014-01-20 12:46:34

Tobacco use remains leading cause of preventable disease, disability and death in US

by Sherrie Norris

Tobacco use remains the leading preventable cause of disease, disability and death in the U.S., but in the last 50 years since the first surgeon general's report on the ill effects of smoking cigarettes was released, significant progress has been made in tobacco prevention. 

That's the word from David C. Willard, northwest tobacco prevention coordinator with the Appalachian District Health Department in Boone, whose research confirms that smoking prevalence among adults in the United States has been reduced by half since 1964.

 Still, an estimated 440,000 people die each year from illnesses associated with smoking, Willard said, which is more than the number of people who die from AIDS, alcohol, car accidents, illegal drugs, murders and suicides combined.  

Undoubtedly, that report half a century ago cited cigarettes as the principle cause of lung cancer and heart disease, Willard said.

"We know now that cigarette use can lead to many other illnesses," he said. 

Willard is anticipating the 50th anniversary issue of the surgeon general's report on smoking and health to be released this month. "We expect it to highlight 50 years of progress in tobacco control and prevention, as well as new data on the health consequences of tobacco use; it will also detail initiatives that can end the tobacco use epidemic in the U.S.," he said.

North Carolina has made progress in reducing the exposure to cigarette smoke through comprehensive tobacco prevention programs resulting in well-informed citizens, policy change and lower youth smoking rates, Willard said, adding that the state's greatest accomplishment is the reduced number of young people who are smoking cigarettes. 

The 2002 funds received by the state through the tobacco Master Settlement Agreement, Willard said, were placed in the N.C. Health and Wellness Trust Fund and invested in programs aimed to curb tobacco use among young people. During the time, middle school smoking rates dropped from 9.3 percent to 4.2 percent, and the high school smoking rate dropped from 27.3 percent to 15.5 percent, which is below the national average.

With funding removed from the N.C. Health and Wellness Trust Fund, the numbers are not expected to decrease as dramatically, and are likely to level out and begin to increase again over time, he said. 

"It is estimated that after cuts were made to tobacco prevention funding, youth rates could increase by as much as 2.3 percent, meaning more than 12,000 youths would start smoking annually," he said.

On Jan. 2, 2010, restaurants and bars in North Carolina became smoke free indoors, and North Carolina became one of the first tobacco states to pass a law requiring all restaurant and bars to be smoke free.

Not only did this give some smokers the push they needed to quit smoking, Willard said, it also allowed for less exposure to secondhand smoke, which leads to many serious illnesses, including asthma, respiratory infections and cardiovascular disease. 

Willard's research indicated that cardiac disease, alone, leads to about 47,000 deaths a year. 

Within the first year of the smoke-free law for restaurants and bars, weekly heart attack emergency room visits were reduced by 21 percent. 

The support from the public also remains high, with 83 percent approving of the law.  

Although tremendous headway has been made in tobacco prevention, there remain issues that need to be solved, Willard said. 

"Adult smoking rates in our state remain above the national average and currently ranks 50th in tobacco prevention funding," he said. 

Smoking-related health costs are estimated at $2.46 billion annually in North Carolina. The national Healthy People 2020 objective is to reduce the national smoking rate to 12 percent; the current average is 19.0 percent. 

Source: David Willard, northwest tobacco prevention coordinator, Appalachian District Health Department, 126 Poplar Grove Connector Boone, N.C. 28607 Phone: (828) 264-4995, Fax (828) 264-4997;,  N.C. Department of Health and Human Services, N.C. Public Health