Duke Center for Nicotine and Smoking Cessation Research


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	CNSCR All of Duke

Facts About Smoking

Evidence suggests that humans have been using tobacco in various forms for more than 1000 years. Native Americans smoked, chewed, and snorted it. These habits were introduced to Europeans by explorers returning from the Americas in the late 15th and early 16th centuries. (more)

Many physicians and politicians in Europe, including the French ambassador to Portugal, Jean Nicot (for whom nicotine is named), touted its medicinal properties. Tobacco quickly became the primary export from the American colonies back to Europe during the early 17th century. An estimated 40,000 pounds of tobacco were sent from Virginia to England in 1620. Trade between European countries and others led to the spread of tobacco use around the globe. (more)

Despite its long history, the true dangers of smoking were not fully recognized until quite recently. In fact, until just a few years ago, the tobacco industry had vehemently denied that using their products could lead to addiction or cause disease. (more)

Today, smoking is considered the leading preventable cause of death in the United States, claiming more than 440,000 lives each year. This figure includes at least 3,000 deaths per year due to lung cancer caused by second hand smoke. The direct medical costs of treating smoking-related illnesses exceed $75 billion per year. (more)

On a positive note, levels of tobacco use among both adolescents and adults have decreased in recent years. Less than 25% of Americans aged 18 or older are current smokers, down from more than 40% in the mid-1960s. Levels of smoking among adolescents increased sharply during the early 1990s but the trend reversed itself during the second half of that decade. Estimates suggest that roughly 16% of high school seniors smoked cigarettes on a daily basis in 2003. While this proportion is still alarmingly high, it represents a decrease from nearly 30% in the mid-1970s. (more)

Reasons for the decline in smoking, just like the reasons why some people choose to smoke, are complex. Restrictions on tobacco advertising, stricter enforcement of purchasing laws, greater awareness of health risks, counter advertising (view CDC poster campaign), and higher taxes on tobacco products probably all contribute. (more)

Levels of smoking, laws related to tobacco use, and the public's perception of cigarettes and cigarette manufacturers have all changed drastically in the past few decades. Below is a tobacco timeline covering the past 40 years that lists some of these changes.

Important Smoking-Related Events in the Past 40 Years
[Primarily from The Surgeon General's Report on Reducing Tobacco Use, 2000]

Year	Event
1963	Highest level of smoking per capita in the US during the 20th century – 4,345 cigarettes per person over the age of 18, for a grand total of 523,900,000,000 cigarettes during a single year. (more information)
1964	• First major report on the health risks of smoking is released by the Surgeon General (read the report) • American Medical Association (AMA) officially calls smoking "a serious health hazard" • State Mutual Life becomes first company to offer discounted rates on life insurance to nonsmokers
1965	Federal Cigarette Labeling and Advertising Act requires health warning to be printed on all cigarette packs.
1967	Surgeon General concludes that smoking is the main cause of lung cancer
1970	Public Health Cigarette Smoking Act bans cigarette ads on TV and radio
1972	Report by the Surgeon General identifies second hand smoke as hazardous
1973	Civil Aeronautics Board requires no-smoking sections on all commercial airline flights
1975	• U.S. Government stops providing cigarettes to soldiers and sailors in rations • Minnesota becomes first state to restrict smoking in most public buildings
1981	Surgeon General concludes that so-called "light" cigarettes might reduce risk of lung cancer but are still quite hazardous (read the report)
1988	Congressionally mandated smoking ban takes effect on domestic airline flights less than 2 hours in long
1990	Smoking banned on all domestic flights 6 hours or less
1991	The FDA approves a nicotine patch as a prescription drug
1992	Hospitals required to be smoke free by January 1994 to maintain accreditation Federal legislation requires states to adopt and enforce restrictions on tobacco sales to minors or risk losing substance abuse funding
1994	Mississippi becomes the first state to sue the tobacco industry to recover Medicaid costs for tobacco-related illnesses The six major domestic cigarette manufacturers testify before the U.S. House Subcommittee on Health and the Environment that nicotine is not addicting and that they do not manipulate nicotine in cigarettes
1995	The Journal of the American Medical Association (JAMA) publishes articles on documents indicating that the tobacco industry knew early on that smoking was dangerous and nicotine was addictive
1996	FDA approved nicotine gum and two nicotine patches for over-the-counter sale
1997	The Liggett Group reaches historic settlement with 22 state Attorneys General that have filed suits to recoup Medicaid costs to treat smoking-related illnesses
1998	California bans smoking in bars
1999	• Tobacco executives testify before Congress that nicotine is addictive and smoking may cause cancer • Attorneys General of 46 states and 5 territories sign a $206 billion agreement with tobacco companies to settle Medicaid lawsuits (now known as "The Master Settlement")
2002	Levels of smoking dropped to roughly 2000 cigarettes per person over 18 per year, less than half the level 40 years earlier (more information)
2004	Despite decreases in levels of tobacco use, it remains the leading preventable cause of death in the U.S.

TOBACCO FACTS

Each year, due smoking by others, an estimated 3,000 nonsmoking Americans die of lung cancer and 300,000 children suffer from lower respiratory tract infections. (Source: CDC)

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