In the first Surgeon General's report since 1990 to focus solely on smoking cessation, U.S. Surgeon General Vice Admiral Jerome M. Adams, MD, MPH, underscores the strides made in smoking cessation over the last three decades, while also updating findings on the biology of addiction and smoking cessation; examining clinical treatments and tools proven to increase smoking cessation; and the importance of population-based strategies to increase smoking cessation, especially given "continued diversification of the tobacco product landscape."

The new report – "Smoking Cessation: A Report of the Surgeon General" – released on Jan. 23 highlights a sharp decline in the prevalence of current smoking from 1990 to 2017 in both men and women (52.0 percent to 15.8 percent and 34.1 percent to 12.2 percent, respectively). It also emphasizes that more than three of five U.S. adults who ever smoked cigarettes have quit.

Key takeaways from the report include the health and quality of life benefits of smoking cessation at any age. The report underscores that smoking cessation can add as much as a decade to life expectancy and specifically calls out the role quitting smoking can play in the health of those diagnosed with heart disease and chronic obstructive pulmonary disease. Additionally, the report highlights the "substantial financial burden" of smoking on health care systems, society and smokers themselves, as well as the considerable disparities that exist across the U.S. population when it comes to smoking prevalence.

The report recommends use of smoking cessation medications approved by the U.S. Food and Drug Administration and behavioral counseling as the most cost-effective cessation strategies – both of which are not being used as frequently as they should. It also suggests "using combinations of nicotine replacement therapies can further increase the likelihood of quitting" and emphasizes the benefits of insurance coverage for smoking cessation treatment "that is comprehensive, barrier-free, and widely promoted."

The report also calls out the role that policies like smoke-free laws have played in broadening the prevalence of smoking cessation, while acknowledging that the growth in vaping and e-cigarettes "could have several different potential impacts, ranging from accelerating the rates of complete cessation among adult smokers to erasing progress in reducing all forms of use of tobacco products, especially among youth and young adults."

"Everyone has a role in helping to continue to reduce the burden of tobacco use on our society. It is critical that clinical interventions be adopted alongside broader efforts at the health system and population levels to promote and cultivate successful cessation and tobacco-free norms," said Adams. "Even today, with all the gains that have been made over the past few decades, smoking remains the single largest cause of preventable disease and death in the United States. As a nation, we can and must spare no effort to reduce the completely preventable health and financial costs that tobacco smoking has on society."

Learn more about ACC's efforts around tobacco policies at ACC.org/Advocacy. Check out CardioSmart.org/StopSmoking for patient education tools.

Clinical Topics: Prevention, Smoking

Keywords: ACC Advocacy, Tobacco, Tobacco Use, Tobacco Products, United States Food and Drug Administration, Electronic Nicotine Delivery Systems, Smoking Cessation

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