Key tools against smoking in last 50 years have been taxes, laws, regulations, medicine, education and cessation programs

Eight million lives have been saved as a result of the U.S. surgeon general's efforts for tobacco control says an article in the Journal of the American Medical Association.

Surgeon General Luther Terry jump-started America's efforts to battle diseases caused by smoking in 1964 with the release of a report that led to health warnings on tobacco products and the 1971 ban of smoking ads on TV and radio. It changed people's attitudes and brought attention to the issue.

Adult smoking rates have decreased by more than half since 1965, with a steady decline among children and adolescent smokers. Still, 43 million Americans smoke, and Kentucky has the highest smoking rate in the nation, 29 percent, according to the federal Centers for Disease Control and Prevention.

Since the initial report, there have been many advances in smoking-cessation methods, said Ellen R. Gritz, behavioral-science professor at the University of Texas' M. D. Anderson Cancer Center. The university has identified five critical developments that have advanced efforts to stop people from smoking and decrease lung cancer:

• Taxation: The report says that taxing tobacco products has made them less affordable and accessible to youth and lower-income people.  “Taxation is the single most important factor in reducing smoking rates,” said Gritz.

• Regulation and legislation: Laws and rules include the required warnings on tobacco products, prohibition of advertising, insurance coverage of smoking-cessation treatment and, most recently, smoking bans in public places.

• Medications to help smokers quit: The Food and Drug Administration's approval of these medications have all shown a "strong positive effect" on smoking cessation efforts, the report says.

• Educational programs for children and adults: “Campaigns have changed the social norms in our society making tobacco use less socially acceptable, particularly among youth,” said Alexander Prokhorov, professor of behavioral science at M. D. Anderson.

• Cessation programs for smokers: People who want to quit smoking benefit from combined strategies, such as counseling and medication, which are often offered together in a formal program, according to the report. One of the main methods, Cooper-Clayton, was developed at the University of Kentucky.

Other efforts that may help people quit smoking, the report says, are continued studies of how the brain triggers the desire to smoke and the genetic predispositions of smokers, development of other counseling programs, increasing health-care providers' role in encouraging smokers to quit, targeting programs toward groups that are most susceptible to smoke, and lung cancer screening with low-dose CT scans. (Read more)