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The latest surgeon general’s reporton the health effects of smoking — issued at the 50th anniversary of the pathbreaking 1964 report — offers astonishing new evidence of just how much harm tobacco is causing. Despite the many gains in reducing risks over the past half-century, researchers keep finding new and insidious ways in which smoking is harming the smokers themselves and nonsmokers who breathe in toxic fumes.The report, issued last Friday, finds that cigarette smoking kills even more Americans than previously estimated (about 480,000 a year, up from 443,000), and is a cause, though not necessarily the major cause, of even more diseases than previously recognized, including liver and colorectal cancers. These add to the long list of other cancers caused by smoking, as well as rheumatoid arthritis and other ailments. The report newly identifies exposure to secondhand smoke as a cause of strokes.The report estimates that smoking costs the United States between $289 billion and $333 billion a year for medical care and lost productivity, well above the previous estimate of $193 billion.Most shocking, the report finds that today’s smokers have a much higher risk for lung cancer and chronic obstructive pulmonary disease than smokers in 1964, despite smoking fewer cigarettes.It reports that the risk of developing adenocarcinoma of the lung, the most common type of lung cancer, has increased substantially over the past several decades because of changes in the design and composition of cigarettes. These include ventilated filters that lead to more puffing of noxious materials and blended tobaccos that contain carcinogenic nitrosamines.There is no doubt who is to blame for this mess, the report says. It is the tobacco industry, which “aggressively markets and promotes lethal and addictive products,” continues to recruit youth and young adults as new customers, and has “deliberately misled the public on the risks of smoking cigarettes.”

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