The U.S.
Surgeon General released a landmark report on smoking and health in 1964,
concluding that smoking caused lung cancer.
At that time, smoking was at its peak in the U.S. – more than half of
the men and nearly one-third of the women were reported to be smokers.
The U.S.
Surgeon General released another report [1] in June this year, titled “The
Health Consequences of Smoking - 50 Years of Progress.”
A time plot
based on the recent report [2] shows the trend of one statistic – adult per
capita cigarette consumption – for the period of 1900-2012. It reveals the rise of smoking in the U.S. in
the first half of the 20th century, coinciding with the Great
Depression and two world wars when the government supplied cigarettes as
rations to soldiers. There has been a
steady decline in the last 50 years.
When the
1964 report was released, an American adult was smoking more than 4,200
cigarettes a year on the average. Today it is less than 1,300. About 18% of Americans smoked in 2012, down
from the overall 42% in 1964. The
difference between male and female smokers is relatively small – men at 20% and
women at 16%. According to a 2013 Gallup
poll [3], 95% of the American public believed that smoking is very harmful or
somewhat harmful, compared to only 44% of Americans who believed that smoking
causes cancer in 1958.
After the
release of the 1964 report, Congress required all cigarette packages to carry a
health warning label in 1965. Cigarette
advertising on television and radio were banned effective in 1970. Taxes on cigarettes were raised; treatments
for nicotine introduced; non-smoker rights movement started. Together laws, regulations, public education,
treatment, taxation, and community efforts have all played an important role in
transforming a national habit to a recognized threat to human health and
quality of life in the last 50 years. This was beyond my wildest imagination that it
could happen in my lifetime.
Statistics
has been at the center of this enormous social change from the beginning of the
smoking and health issue.
As early as
1928, statistical data began to appear and showed a higher proportion of heavy
smokers among lung cancer patients [4]. A
10-member advisory committee prepared the 1964 report, spending over a year to
review more than 7,000 scientific articles along with 150 consultants. By design, the committee included five
non-smokers and five smokers, representing disciplines in medicine, surgery,
pharmacology, and STATISTICS. The lone statistician was William G. Cochran,
a smoker who was also a founding member of the Statistics Department at Harvard
University and author of two classic books, “Experimental Design” and “Sampling
Techniques.”
During the
past 50 years, an estimated 21 million Americans have died because of smoking,
including nearly 2.5 million non-smokers due to second-hand smoke and 100,000
babies due to parental smoking.
There are
still about 42 million adult smokers and 3.5 million middle and high school
students smoking cigarettes in the U.S. today.
Interestingly, Asian Americans have the lowest rate of smokers at 11%
among all racial groups in the U.S.
China agreed
to join the World Health Organization Framework Convention on Tobacco Control
in 2003. It reported [5] 356 million
smokers in 2010, about 28% of its total population and practically unchanged
from its 2002 level. The gender
difference was remarkable – 340 million male smokers (96%) and 16 million
female smokers (4%). About 1.2 million
people die from smoking in China each year.
Among the remaining over 900 million non-smokers in China, about 738
million, including 182 million children, are exposed to second-hand smoke. Only 20% of Chinese adults reportedly
believed that smoking causes cancer in 2010 [6].
More
detailed historical records on smoking in China are either inconsistent or fragmented. One source outside of China [7] suggested that
there were 281 million Chinese smokers in 2012 and an increase of 100 million
smokers from 1980.
China has
been stumbling in its efforts to control smoking.
According to
a 2013 survey by the Chinese Association on Tobacco Control [8], 50.2% of the
male school teachers were smokers; male doctors 47.3%; and male public servants
61%. Given these high rates for their
important roles, there is concern and skepticism on how effective tobacco
control can be implemented or enforced.
Coupled with
the institutional issues of its tobacco industry, China has been criticized for
its ineffective tobacco control ineffective. While the size of some American
Tobacco companies may be larger, they are not state-owned. China is the world's
largest tobacco producer and consumer. Its
state-owned monopoly, China National Tobacco Corporation, is the largest
company of this type in the world.
Nonetheless,
the Chinese government has enacted a number of measures to restrict smoking in
recent years. The Ministry
of Health took the lead in banning smoking in the medical and healthcare systems
in 2009. Smoking in public indoor spaces
such as restaurants, hotels, and public transportation were banned beginning in
2011.
According to
the Chinese Tobacco Control Program (2012-2015) [9,10], China will ban
cigarette advertising, marketing and sponsorship, setting a goal of reducing
the smoking rate from 28.1% in 2010 to 25%.
Smoking is a
social issue common to both the U.S. and China.
Statistics
facilitates understanding of the status and implications, as well as providing
advice, assistance, and guidance for governance. More statistics can certainly be cited about the
ill effects of smoking in both nations. At
the end, it is the collective will and wisdom of each nation that will
determine the ultimate course of actions.
REFERENCES
[10] China Women’s Federation News. Banning Tobacco
Advertising Cannot be Just Paper Planning. Retrieved from
http://acwf.people.com.cn/n/2013/0603/c99013-21712571.html.
据《国家新型城镇化规划（2014-2020）》报告，2010年中国共有658个城市。截至2015年6月，有据可查的中国城市增加到670个，分别是4个直辖市，291个地级市和375个县级市。山东是全国最多城市的省份，共48个。广东其次，共44个。
