EXPERT VOICES

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Tobacco/Smoking (14 posts)  RSS

Can we predict who will become addicted to cigarettes?

July 24, 2014

By Victoria Stevens, PhD

Every day in the United States, nearly 4,000 young people under the age of 18 smoke their first cigarette, according to the Centers for Disease Control's Youth and Tobacco Use Fact Sheet. About 1,000 of these kids will go on to become daily smokers, which is the next step on the pathway to becoming addicted to nicotine. Over the course of a year, that is 365,000 new daily smokers. About 60%, or almost 220,000, will still be regular smokers 7 to 9 years later. 

When they tried that first cigarette, did they expect to become dependent on nicotine and unable to quit smoking whenever they want to? Of course not, because they feel young and invincible. In fact, only 3% of the regular smokers expected to be still smoking 5 years later. 

Is nicotine addiction in our genes?

A paper published in JAMA Psychiatry may give some clues to why so many young people continue smoking after that first try. Please note: the research is preliminary, and much more needs to be done before any conclusions are reached and recommendations made. But it's also intriguing. More...

E-Cigarettes – It’s Complicated

June 24, 2014

By Thomas J. Glynn, PhD

Editor's note: This blog is the last one frequent contributor Dr. Glynn will write before his upcoming retirement. We wanted to thank him for his expertise and ability to break down a topic and offer insight, as well as his excellent writing. We offer him best wishes for a long, happy retirement.


In May 2011, I had the opportunity to write the first Expert Voices blog on what was then a new, but growing, public health concern - the emergence of e-cigarettes.

At that time, I wrote that "e-cigarettes have been described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health;" that they "are a source of controversy;" and that we need "to put science to work (and) obtain, solid, independent data" regarding e-cigarettes.

Now, 3 years later, more than 1,000 research papers, commentaries, and opinion pieces have been published about e-cigarettes. There's been continuous public debate about and media attention paid to e-cigarettes, and there's a proposed FDA rule regarding e-cigarette regulation.

Now, it is finally possible, at long last, to say that... e-cigarettes continue to be described both as a miracle answer to the devastating effects of cigarette smoking and as a grave danger to the public health; that they remain a source of controversy; and that more independent, objective data are needed.

Consensus remains elusive

Yes, the old French adage - plus ca change, plus c'est  la meme chose  (the more things change, the more they remain the same)-- is an apt description for the state of affairs regarding e-cigarettes in June 2014. Despite the considerable research, debate, media attention, Congressional hearings, and, yes, blogs, over the past 3 years, the public health, advocacy, scientific, and medical communities are little closer to a consensus regarding e-cigarettes than they were in May 2011. More...

The Landmark Surgeon General Report on Smoking and Health, 50 Years Later

January 15, 2014

By Richard C. Wender, MD

 

Fifty years ago, on January 11, 1964, Luther Terry held a press conference to announce the results of the first Surgeon General's report on smoking and health, the most impactful public health document in history. The report laid to rest over a decade of debate about the health risks of smoking by definitively stating that smoking causes lung and laryngeal cancer in men, chronic bronchitis, and other diseases.

Research conducted by the American Cancer Society and other groups had already demonstrated the adverse health effects of smoking, but, until the Surgeon General's report, the tobacco industry had been successful in hiding the truth. The extraordinary methods used by the Surgeon General to ensure that the report was completely unbiased -- including allowing the tobacco industry to veto nominees to serve on the panel -- the thoroughness of the research, and the clarity of the conclusions, all led to one outcome: the end of the debate about the health risks of smoking and the launch of the true fight to end the use of tobacco products. The progress in the tobacco fight over the past 50 years represents one of the most successful, life-saving public health campaigns in our nation's history.

Learn more about the 50th anniversary of the Surgeon General's Report on Smoking and Health:

The Hammond/Horn study

The effects of tobacco control

Rates Drop for New Lung Cancer Cases in the US

Tobacco and Cancer

Guide to Quitting Smoking

 

The public health victories, and the challenges



Forty-three percent of Americans smoked prior to the Surgeon General's report; 18% smoke today. Smoking in airplanes, restaurants, and places of employment has largely disappeared.  We're now fully aware of the addictive nature of the nicotine in tobacco products, and the importance of preventing and treating that addiction. Tobacco executives were eventually forced to admit, before Congress and the country, that they were long aware of the addictive nature of their products as well as the harmful health effects. 

We've learned that raising the cost of a pack of cigarettes is the single most effective way to reduce the number of people who start using tobacco products and the most effective way to promote quitting. Tobacco tax increases have been implemented in many states.  As of 2009, the FDA was granted the authority to regulate tobacco products, although the tobacco industry has placed substantial roadblocks in the path of effective FDA action. The United States is not alone. Smoking rates in most high-resource ("Western") nations like England, Canada, and Australia have substantially declined, comparable to the progress that we've seen.  We've witnessed 50 years of amazing progress; we truly do have much to celebrate.  

And much to lament. More...

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Tobacco/Smoking

What really works to help you quit and avoid tobacco?

November 17, 2013

By Thomas J. Glynn, PhD


The American Cancer Society's first Great American Smokeout was celebrated November 18, 1976. Gerald R. Ford was President of the United States, the "War on Cancer" had begun just a few years before, Barack Obama was 15 years old and, according to a Gallup Poll taken that year, 37% of American adults smoked cigarettes.

This year, the 37th anniversary of that first Great American Smokeout, the percentage of Americans who smoke has nearly been cut in half, to 19%. And, those who do smoke use far fewer cigarettes than in 1976, from about 4,000 cigarettes per year for every U.S. adult then, to about 1,200 now.

Certainly, we know that any cigarette smoking is dangerous to the smoker and non-smokers who inhale cigarette smoke. We also know that far too many Americans continue to smoke - 44 million, at last count. Still, astounding progress has been made in combatting what is the nation's largest cause of preventable death and disability.

How do we know what works?

How was such progress made? What actions were taken to achieve such significant changes in the face of the tobacco industry's relentless, illegal, and well-funded efforts to addict men, women, and children to their deadly products? There is no easy answer to that question. But we do know that, over the past 37 years, a wide range of interventions - in communications, education, policy change, and medicine - have been undertaken. Interventions in all of these areas have been effective, but some have been more effective than others. More...

Menthol cigarettes - what's the big deal ?

August 28, 2013

By Thomas J. Glynn, PhD


The discussion around whether the U.S. Food and Drug Administration (FDA) should keep or ban menthol-flavored cigarettes has produced a number of news headlines in recent weeks, because in July the agency released a report reviewing current science around these cigarettes. This science will inform many of the decisions the agency may make about menthol cigarettes, and the millions of current and potential smokers who will be affected by those decisions. But the menthol story goes back much further than just the past few weeks.

Menthol and cigarettes: a brief history


Menthol is an organic compound which can be made in a laboratory or derived from mint oils, and has a distinctive and, for most people, pleasant odor and taste. It is used to enhance the flavor, popularity, and ease-of-use of many food products, candies, and medications.

As a medication, it can be used as a mild local anesthetic, counter-irritant, and, more specifically, for the relief of minor throat irritation. That is why menthol was first introduced in cigarettes in the 1920's and gained broader popularity with the introduction of a filtered menthol brand, Salem, in the mid-1950's.

Over the years, largely because they mask the harsh taste and/or throat-irritating properties of inhaled tobacco smoke, mentholated cigarettes have gained a wide audience, such that about 30% of all 44 million smokers in the U.S. now identify menthols as their preferred cigarette. This is especially true among African American smokers, about 80% of whom are menthol users. More...

Light smoking as risky as a pack a day?

January 02, 2013

By J. Lee Westmaas, PhD


Do you occasionally have a cigarette, maybe not even every day? Although people resolve to quit smoking in the new year, you might think only heavy smokers need to quit. But that isn't the case.

Light or intermittent smoking has become a very common pattern for people of any age.  Many of these people do not feel addicted to tobacco and do not even call themselves "smokers." There are, however, some real risks associated with any level of smoking. Non-daily smoking, or smoking 1-5 cigarettes a day, was first noticed as far back as 1989 because it was a stark contrast to the more common pattern at that time -- 20 to 30 cigarettes a day. At that time, very light smokers were labeled "chippers" (a term that also referred to occasional users of opiates who appeared to not be addicted). Chippers didn't appear to smoke to relieve withdrawal, and sometimes didn't smoke for a day or more. More...

Mind the (Smoking) Gap: Those Who Want to Quit and Those Who Actually Do

November 14, 2012

By Thomas J. Glynn, PhD


For those who have traveled London's Underground, or Tube, the term "Mind the Gap" will be familiar. It's the warning for riders to be aware that there is a gap of several inches between the station platform and the train cars. In the public health community, we also have a gap: the gap between the number of smokers who want to quit and those who actually succeed. The American Cancer Society Great American Smokeout, held this year on November 15, is an opportunity to remind us that we also need to "mind the gap."

In the United States, this gap is very wide. Nearly 70% of the country's 43.8 million smokers say they would like to quit smoking; 52% report making at least one serious attempt to quit each year; but a disappointingly low 4% are actually successful in doing so. More...

The FDA and Tobacco Regulation Three Years Later

October 29, 2012

By Thomas J. Glynn, PhD

 

As the official sponsor of birthdays, the American Cancer Society has every reason to be proud of a "toddler" celebrating its third birthday this year. The Family Smoking Prevention and Tobacco Control Act - aka the Tobacco Control Act - was strongly supported by ACS and ACS CAN and signed into law by President Barack Obama on June 22, 2009.


For the first time and after nearly 2 decades of debate, this historic legislation gave the U.S. Food and Drug Administration (FDA) the authority to regulate tobacco products. In doing so, Congress enabled the FDA to establish the Center for Tobacco Products (CTP), which is charged with regulating the manufacture, marketing, and distribution of tobacco products in order to reduce tobacco use by children under 18 and protect public health.


More specifically, the Tobacco Control Act authorizes the FDA to act in a number of ways, including:

  • Restricting tobacco sales, distribution, and marketing
  • Requiring stronger health warnings on packaging and in advertisements
  • Requiring disclosure of tobacco product ingredients
  • Reducing (but not eliminating) the amount of nicotine in tobacco products
  • Creating standards for tobacco products
  • Regulating "modified risk" (i.e. potentially harm reducing) tobacco products, such as e-cigarettes, snus, dissolvables, etc.


So, with the authority to take these types of action, how is the Tobacco Control Act doing 3 years later? Is it having its intended effects? Are Americans - tobacco users and non-users alike - beginning to see its hoped-for health benefits? To best address these questions, it will help to take a small step back and consider the history of the Tobacco Control Act, take a brief look at the Act's accomplishments to date, and then look a bit into the future. More...

Hookahs are trendy, but are they safe?

May 29, 2012

By Tom Glynn, PhD

 

 

Hookah smoking is no safer than cigarette smoking. If you read no further, that is the take-home message for this blog -- no matter what you may have heard or read, the scientific evidence is clear that hookah smoking is not a safe alternative to smoking cigarettes.

 

Countering the widely-held, although mistaken, belief that hookah smoking is safer than cigarette smoking is important, so let's take a step back and consider what hookah is, learn about its history and current popularity, and then look at the facts about the scientific evidence regarding its effects on health. More...

Here Come the Dissolvables

November 16, 2011

By Thomas J. Glynn, PhD

 

No, "The Dissolvables" are not a Saturday morning TV cartoon show - they are the tobacco industry's latest attempt to maintain, and even expand, the number of tobacco users in the U.S., at a time when fewer people are smoking cigarettes.


"Dissolvables," as they have become collectively known, are products made of compressed tobacco and are available in a variety of forms, including sticks, pellets, and strips (think the Listerine breath strip). They dissolve in the user's mouth, delivering nicotine, as well as thousands of other chemicals and substances. Examples of these products are below.  More...

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