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Success and Failure of the American Anti-Smoking Campaign

Impact of the American Anti-Smoking Campaign on Lung Cancer Mortality. Published in the International Journal of Cancer, Volume 97, pages 804 to 806, February, 2002. By Brad Rodu and Philip Cole. (UAB TRF)

Birmingham, AL. The 35-year campaign against cigarette smoking in the United States has had successes and a major shortcoming, according to two UAB scientists in the February, 2002 issue of the International Journal of Cancer.

"The campaign has moderately reduced the number of young adult smokers, but its impact on older smokers is not impressive. This is due to inveterate smokers who are irreversibly addicted to nicotine," says Dr. Brad Rodu, lead author of the study. Rodu, an oral pathologist, co-authored the paper with Dr. Philip Cole, an epidemiologist. The two experts studied lung cancer death rates among white men born in the first half of the 20th Century, a group with the highest smoking rates and consequently the highest smoking-related disease rates.

Lung cancer was used as the 'sentinel' disease of smoking because its rates directly reflect a group's smoking. The researchers defined the anti-smoking campaign as anything that might have lowered lung cancer death rates, including elements as diverse as changes in cigarette design, educational messages and warnings, advertising limits, the availability of nicotine substitution, reduced accessibility of young persons and restrictions on smoking in public, according to the report.

Rodu and Cole place the start of the American anti-smoking campaign in 1965, the first full year of publicity after the landmark 1964 report of the US Surgeon General on Smoking and Health. From 1970 to 1996, lung cancer rates among younger white men (ages 40-44) declined 55%, indicating that the campaign was effective in reducing smoking among younger adults. However, the analysis revealed that most of the 24 million smokers between ages 40-44 and 55-59 are inveterate, according to the report. Citing Centers for Disease Control and Prevention statistics that 420,000 Americans die annually from smoking-related diseases, Rodu and Cole call for the implementation of a harm reduction strategy to directly address inveterate smokers over age 40 in order to lower the appallingly high number of deaths among them.

Note: This study was supported by the Tobacco Research Fund (UAB).

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