Quality & Science

Editorial: Tobacco Still Leading Preventable Cause of Death

by Richard G. Soper, MD, JD, FASAM, ASAM Weekly Editor-in-Chief | July 7, 2014

“Tobacco remains, by far, the single leading preventable cause of death in the United States and the world" said Tom Frieden, MD, MPH, director of the Centers for Disease Control and Prevention.

According to the latest surgeon general's report, smoking has killed more than 20 million people since the first report was issued. Two and a half million of those people were nonsmokers who died from breathing secondhand smoke.

"We're still a country very much addicted to tobacco," said U.S. Department of Health and Human Services Secretary Kathleen Sebelius at an event announcing the release of "The Health Consequences of Smoking — 50 Years of Progress," held Jan. 17 at the White House. "It has serious ramifications for our families, our communities, our overall health and our economy. (But) there are things each of us can do in our own communities that make a significant contribution to ending this epidemic… Most of the people who die from smoking began smoking when they were kids," she said, adding that about 3,000 kids try cigarettes every day, and of those, about 1,000 become smokers. "If we fail to reverse this trend, 5.6 million American children who are alive today will die prematurely," she said.

Smoking has been found to be a cause of a myriad of adverse health events, including diabetes, multiple types of cancer, erectile dysfunction and poor responses to medical treatment. Tobacco wins the dubious distinction of the worst effect on human health than any other such habit.

To make matters worse, tobacco companies have changed cigarettes to make them even more addictive and attractive to children. According to a report by the Campaign for Tobacco-Free Kids, changes in design and more chemical additions are luring more young people into tobacco addiction.

What is the responsibility of the addiction professional regarding tobacco? Sound off in the comments below.


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  1. Jack Rosenbaum Jul 18, 2014 - 04:20 PM
    Nicotine, as defined by Webter, is "  highly poisonous derived from tobacco "  and is now recognized by many in SUD treatment as the strongest addictive substance known to mankind. . . Big Tobacco through the incorporation of additives has increased the RISKS and HAZARDS connected with cigarette smoking and the new way of introducing the poisin of nictotine use into socety through the e- cigarette known as vaping
  2. Dave Felt Jul 09, 2014 - 06:44 PM

    Its time that the Substance Use Disorder Treatment community started addressing tobacco/nicotine as the addiction that it is.  Far too many SUD professionals view it as less harmful than the "real drugs" and see no problem with taking a smoke break with clients.   

  3. Sue Rusche Jul 09, 2014 - 01:38 PM
    One responsibility is to recognize that the tobacco industry may well take over the marijuana industry if the federal/state conflict over legalization is resolved. The last thing the nation's children need is for Big Tobacco to subsume the emerging marijuana industry to create Big Marijuana and use its considerable marketing prowess to come after kids.
  4. Emily Jul 07, 2014 - 04:41 PM

    The new ASAM Criteria includes a section on Tobacco Use Disorder. This is an important inclusion because "Patients are rarely treated for this addiction during their health care visits and hospitalizations, despite the fact that the chance that a lifelong smoker will die prematurely from a complication of smoking is approximately 50%." 

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