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Experts increasingly contemplate end of smoking

ATLANTA (AP) - Health officials have begun to predict the end of cigarette smoking in America.

They have long wished for a cigarette-free America, but shied away from calling for smoking rates to fall to zero or near zero by any particular year. The power of tobacco companies and popularity of their products made such a goal seem like a pipe dream.

But a confluence of changes has recently prompted public health leaders to start throwing around phrases like "endgame" and "tobacco-free generation." Now, they talk about the slowly-declining adult smoking rate dropping to 10 percent in the next decade and to 5 percent or lower by 2050.

Acting U.S. Surgeon General Boris Lushniak last month released a 980-page report on smoking that pushed for stepped-up tobacco-control measures. His news conference was an unusually animated showing of anti-smoking bravado, with Lushniak nearly yelling, repeatedly, "Enough is enough!"

"I can't accept that we're just allowing these numbers to trickle down," he said, in a recent interview with the AP. "We believe we have the public health tools to get us to the zero level."

This is not the first time a federal health official has spoken so boldly. In 1984, Surgeon General C. Everett Koop called for a "smoke-free society" by the year 2000. However, Koop - a bold talker on many issues - didn't offer specifics on how to achieve such a goal.

"What's different today is that we have policies and programs that have been proven to drive down tobacco use," said Matthew Myers, president of the Campaign for Tobacco-Free Kids. "We couldn't say that in 1984."

Among the things that have changed:

-Cigarette taxes have increased around the country, making smokes more expensive. Though prices vary from state to state, on average a pack of cigarettes that would have sold for about $1.75 20 years ago would cost more than triple that now.

-Laws banning smoking in restaurants, bars and workplaces have popped up all over the country. Airline flights have long been off-limits for smoking.

-Polls show that cigarette smoking is no longer considered normal behavior, and is now less popular among teens than marijuana.

-Federal officials are increasingly aggressive about anti-smoking advertising. The Food and Drug Administration launched a new youth tobacco prevention campaign last week. At about the same time, the Centers for Disease Control and Prevention debuted a third, $60-million round of its successful anti-tobacco ad campaign - this one featuring poignant, deathbed images of a woman featured in earlier ads.

-Tobacco companies, once considered impervious to legal attack, have suffered some huge defeats in court. Perhaps the biggest was the 1998 settlement of a case brought by more than 40 states demanding compensation for the costs of treating smoking-related illnesses. Big Tobacco agreed to pay about $200 billion and curtail marketing of cigarettes to youths.

-Retailing of cigarettes is changing, too. CVS Caremark, the nation's second-largest pharmacy chain, announced last week it will stop selling tobacco products at its more than 7,600 drugstores. The company said it made the decision in a bid to focus more on providing health care, but medical and public health leaders predicted pressure will increase on companies like Walgreen Co. and Wal-Mart Stores Inc. to follow suit.

"I do think, in another few years, that pharmacies selling cigarettes will look as anachronistic" as old cigarette ads featuring physician endorsements look today, said CDC Director Dr. Tom Frieden.

These developments have made many in public health dream bigger. It's caused Myers' organization and others to recently tout the goal of bringing the adult smoking rate down to 10 percent by 2024, from the current 18 percent. That would mean dropping it at twice the speed it declined over the last 10 years.

The bigger goal is to reduce U.S. smoking-related deaths to fewer than 10,000, from the current level of 480,000. But even if smoking rates dropped to zero immediately, it would take decades to see that benefit, since smoking-triggered cancers can take decades to develop.

But while some experts and advocates are swinging for the fences, others are more pessimistic. They say the key to reaching such goals is not simply more taxes and more local smoking bans, but action by the U.S. Food and Drug Administration to regulate smoking.

A 2009 federal law gave the FDA the authority to regulate tobacco products. The law barred FDA from outright blocking the sale of cigarettes, but the agency was free to take such pivotal steps as prohibiting the use of appealing menthol flavoring in cigarettes and requiring cigarette makers to ratchet down the amount of addictive nicotine in each smoke.

But nearly five years after gaining power over cigarettes, FDA has yet to even propose such regulations. Agency officials say they're working on it.

Many believe FDA's delay is driven by defense preparations for an anticipated battery of legal and political challenges.

A spokesman for Altria Group Inc., the maker of Marlboro, said the company supports FDA exercising its regulatory authority over tobacco products. But as a whole, the industry has tended to fight regulation. Some of the nation's largest tobacco companies - though not Altria - sued to stop FDA-proposed graphic warning labels on cigarette packs. A federal court blocked the ads.

"The industry makes money as long as they can delay regulation," said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.

Warner and Michigan colleague David Mendez estimate that, barring any major new tobacco control victories, the adult smoking rate will drop from its current 18 percent only to about 12 percent by 2050. If health officials do make huge strides, the rate could drop as low as 6 percent, they think.

But Lushniak said zero. Will that ever happen?

Some experts doubt it. As long as cigarettes and other combustible tobacco products are legal, it's likely some people will smoke them. Efforts to prohibit them are likely to fail, they say. (Remember Prohibition?)

"It's hard to do a ban on cigarettes because you're taking something away from people they have and are using. Once you have something, you hold tight," said Richard Daynard, a Northeastern University law professor who focuses on tobacco issues.

Better, he said, to bar people from having a product in the first place. He is intrigued by legal efforts in Singapore and a handful of other countries to ban sales of tobacco to anyone born after a certain year - 2000, say. That would be constitutional, he said. The question is: Would our culture accept it?

Probably not, said Ruth Malone, editor-in-chief of the scientific journal Tobacco Control.

"In our culture, we tend to think we have a right to things even if they're terrible for us," she said.

A growing number of experts believe the most promising option is to get people to switch voluntarily to something else, like electronic cigarettes.

Electronic cigarettes are battery-powered devices that provide users with aerosol puffs that typically contain nicotine, and sometimes flavorings like fruit, mint or chocolate. They've often been described as a less dangerous alternative to regular cigarettes. But there are few studies exploring exactly what chemicals are in them, and in what concentrations, and whether those levels are harmful.

They're controversial: Some experts believe that at a time when cigarette smoking has finally become passe in popular culture, e-cigarettes may re-glamorize puffing away in public places. Cigarette sales could surge.

"It could go in either direction," said John Seffrin, the American Cancer Society's chief executive officer.

But if the FDA can ratchet down nicotine in conventional cigarettes to levels below what's in e-cigarettes, perhaps everyone who clings to smoking will switch to the higher-nicotine new products. That could achieve the end of smoking, at least of combustible, carcinogen-filled cigarettes - or so the thinking goes.

In the past, "the country really wasn't ready" to walk away from cigarettes," Daynard said. "I think the country's ready now."

Join the discussion

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hccbillandpat February 10 2014 at 10:26 AM


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jktkw February 10 2014 at 4:46 AM

straight to the street "black market"

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john&jan February 10 2014 at 5:18 AM

been on both sides, smoked many years,have not smoked for 2 yrs. now. still a choice this is the usa and for now we are still a free country. some of it may be true and alot of it is a lie. cannot blame cancer on just smoking,those little kids who die each day with cancer,they do not smoke. let our country stay free as many who gave their life for it to be free and these failed leaders we have today are taking our freedom away.

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vlfjr123 February 10 2014 at 5:21 AM

what will they tell you you cant do next. your freedom of choice is being stripped away one shaving at a time. wake up america !

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2 replies
uptonkaren vlfjr123 February 10 2014 at 6:34 AM

AMEN!!!!!!!!!!!!! Next will be alcohol, increase our drugs from CVS and making mariguana LEGAL ( a mind altering drug), VERY scary!!!!!!!!!!!!

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jostories vlfjr123 February 10 2014 at 6:45 AM

your choice is costing ME money. When you get cancer, I am the one not only to pay through my taxes but the one that takes care of you as an advanced practice nurse. What if YOUR choice hit you in your pocketbook? would that change your tune?

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3 replies
FRED February 10 2014 at 5:36 AM

What would the feds do if everyone stopped smoking? The billions in tax dollars, which they have stolen in larger amounts lately, would be out of their pockets and the addiction to our money is tremendous. They would be like a junkies without anymore fixes. Their eyes would be on us to extract more and more in devious ways. So who believes they want a tobacco free society?

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b2ran February 10 2014 at 5:55 AM

I didn't even read the whole article, simply because it is filled with BS. The bottom line is all about choices in an individual's life. I for one, have been a nicotine addict off and on for about 42 years. It has been my choice, no ads like the Marlboro man or TV ads back in the day, influenced me. Plain and simple I started and no one held a gun to my head.

Having said that, it is still my choice and of course more bad information has come out against smoking since the 60s of course. Of course bad thing have come out against other health issues, but this one is number one and maybe it should be. However, many have quite in the past few years with “vaping” they call it, with the electronic cigarettes. I’ve tried it and it didn’t work for me, but it works for millions maybe.

The jury is out, so to speak, on vaping. I did the research and because the government can’t get tax money off this yet, they are trying to kill it too and in some jurisdictions they are treating it the same as smoking and New York City is number one. Of course the tobacco companies are against it because it’s cutting into their business. This year one big tobacco company is jumping off into the business due to the loss of revenue from people quitting.

The article mentioned the tax revenue. People, this is still big business and a large part of the Federal and State revenues. This has been one of the Golden Eggs the Goose laid over the years. Let’s say we totally eradicate smoking today. What’s going to take up the slack for the loss of revenue for all governments? You and I are, plain and simple.

Then this will put many people out of work from the tobacco farms, to the tobacco companies and maybe a few more I haven’t mentioned. More burden on the tax payers. So, what do you want, let it ride and take car of itself or do you want the government stepping in and pulling more communist type BS on individual freedoms.

What’s the answer, I don’t know, but this is not the only health issue that needs to be addressed, but it comes up over and over again. The law of the land these days is to legislate morals and individual choices.

That’s my story and I’m sticking too it.

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jaluty February 10 2014 at 5:59 AM

I won't be quitting and frankly I'm surprised that Americans are so damned stupid that rather than hold the government who poisoned the tobacco accountable, they are willing to destroy more jobs. Dumb asses. Do remember these are the same people who lied their asses off about marijuanna to you for years. I buy native tobacco cigarettes and last check up dr's had no idea I smoked for over 30 years. Enough with the lies and the bs.

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1 reply
nyriza jaluty February 10 2014 at 7:00 AM

I'd be more worried that my doctor didn't know that I smoked for 30 years than be proud that they didn't know. That sounds like a terrible doctor.

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Nice To See You! February 10 2014 at 9:19 AM

The latest resurrection of the smoking habit comes in the form of e-cigs. They have become the adult pacifier to a generation who 'thinks' they can eliminate smoking from their life. We see it differently as it constitutes a fake cigarette. It is still a crutch tied to nicotine. For people who truly want to consider quitting smoking, take a look at www.KickYourSmokingHabit.com for ways that are practical and workable.

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Daniel February 10 2014 at 6:10 AM

the only reason for the decline is the price of cigarettes that's it

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uh34d February 10 2014 at 9:42 AM

The latest smoke and mirror show...

We pollute our air, our potable water, our soil, chemical and genetic bastardization of our food and food chain supply, keep pumping out millions of gallons of alcohol, we stick our noses where it doesn't belong and Americans are killed and maimed, we let Americans go hungry, we ignore people with mental health issues and the focus is on cigarettes! What a joke!

Here's the deal...living life is bad for ya, then you die. Sure, we nearly all have interludes of happiness and fun but, in the end, the grim reaper comes to collect. Somebody wants to smoke, fine with me. They want to consume alcohol, drugs, fine with me. But, in order to make things more fair why don't we:

1. Have scales in grocery stores and restaurants of any kind, you're weighed and if you're overweight, you pay an additional tax on your purchase. Have a skinny friend buy your food for ya, no problem, scales in every house the government monitors, you weigh in everyday, don't and you're fined.

2. Random breathalyzer testing. Special members of law enforcement wearing distinctive uniforms go around telling you to 'blow.' Special 'breathalyzer' distinctive law enforcement vehicles pull vehicles over for occupant testing. A positive hit, driver or not, you get fined/taxed.

3. See #2 for drug testing.

4. Special 'pee patrols' that randomly walk among the populace, stop, collect and test on the spot for drugs in your system. A positive hit, you're fined/taxed.

5. Random stops to test for gun powder residue. Ya better have a good reason for having fired a gun...none, fined/taxed.

6. Special attention paid to ski and snowboard bums...get tested, test positive for alcohol/drugs, fine/taxed. I know I'm certainly tired of paying for all of those broken legs and ankles.

7. Test all members of government...test positive for alcohol/drugs, not only do you get fined/taxed, you forfeit your paycheck for say 1 month first offense, 3 months second, third you're out, unemployed (bet this would work wonders to cull the Congressional herd!) If you're an obese government worker, you receive special attention, fines/taxes are doubled.

8. Get caught drinking soda, you guessed it, fined/tax.

We're becoming a country of the absurd. We'll allow poisoning of Americans in one area, then make a stink about poisoning it another area. We allow people to own and carry guns but, legally or illegally, we do little to nothing to stop people from using them on other people. It's like suffering a national bi-polar disorder. Bottom line, smokers are an easy target now, like those welchers collecting unemployment and food stamps...we always gotta have a bogeyman.

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