War on Smoking--50th Anniversary

Fifty years ago was not just a time to wage war on poverty; it was a time to wage war on smoking with an important report from the US Surgeon-General. Poverty and smoking are both bad for your health, of course, and the irony is that the war on smoking was less successful among the poor than among the non-poor. Nonetheless, as the Economist points out, the success is evident.

The report clearly showed how smokers died younger. A year later, Congress required health warnings on every packet. Public understanding of the risks of smoking changed even faster. Ads in the 1950s had claimed that tobacco was good for you; after the report millions of Americans quit puffing. In the past 50 years cigarette consumption per adult has fallen by 72%. The report called smoking a habit, not an addiction. But apart from that, it hit the coffin nail on the head.

Smoking still takes its toll in the US, however. The December 2013 issue of Population and Development Review has a paper by Andrew Fenelon at Brown University on "Geographic Divergence in Mortality in the United States." Drawing upon his doctoral dissertation research, he shows that a very high fraction of the lower life expectancy in southern states than in the rest of the country is due to smoking.

Relatively high smoking-attributable mortality in the South explains 50–100 percent of the divergence for men between 1965 and 1985 and up to 50 percent for women between 1985 and 2004. There is also a geographic correspondence between the contribution of smoking and other factors, suggesting that smoking may be one piece of a more complex health-related puzzle.

The next geographic frontier for anti-smoking campaigns is China. The government is trying to crack down on smoking there, but there's a long way to go. The New York Times recently summarized a paper published in the Journal of the American Medical Association showing that the percentage of Chinese who smoke has leveled off at about 24 percent, but population growth over the past few decades means that there are currently about as many smokers in China as there are people of all ages in the US.