Surgeon General’s Tobacco Report Highlights Progress, Remaining Gaps in Prevention

January 14th, 2025

Sixty-one years ago, the U.S. Surgeon General released the first report on smoking and health, a landmark document that tied smoking to lung cancer and respiratory disease.

It marked the beginning of a massive shift in attitudes and behavior. 

At the time, nearly half of U.S. adults smoked cigarettes. Today, only about one in nine adults smoke. Smoking in enclosed spaces, once common in airlines, buses and offices, has become relatively rare. 

The report also led to the now-familiar warning labels on cigarette packages. 

Yet even with this progress, tobacco’s ongoing toll serves as a grim reminder of its deadly consequences. Cigarette smoking still causes nearly a half a million U.S. deaths per year. 

And this terrible burden falls disproportionately on some Americans. 

Late last year, the current Surgeon General released the latest in the ongoing series of reports on tobacco and health. 

Vivek H. Murthy, M.D., M.B.A. writes: “Today, as we show in this report, cigarette smoking among men and women living in poverty is more than twice as common compared to those not living in poverty. American Indian and Alaska Native adults and youth have the highest prevalence of cigarette smoking by race and ethnicity in the United States, and among people who do not smoke, exposure to secondhand tobacco smoke remains disproportionately higher among Black people than among people in other racial and ethnic groups. 

Youth who identify as lesbian, gay, or bisexual have a prevalence of cigarette smoking that is nearly double that of their heterosexual peers. The gap in tobacco use between youth living in rural areas and those living in urban areas has widened since 1998. Across the country, income, race and ethnicity, level of education, sexual orientation and gender identity, geography, and mental health play a significant role in determining who uses tobacco and who suffers from its harmful health consequences.”

He adds: “Industry-designed tobacco products such as menthol cigarettes and flavored cigars also contribute to tobacco-related health disparities. Today, the tobacco industry continues to outspend tobacco control efforts by a factor of at least 12 to 1 annually with more than $8.5 billion spent in tobacco-related advertising and promotion.”

The report offers a vision for a tobacco-free future, focused on supporting those who bear the greatest burden, and a call to action to make this vision a reality.

The Surgeon General concludes: “As a father of two young children, few things are more important to me than ensuring they have the best possible chance of good health and a bright future. I want this for all our kids. I believe the vast majority of Americans feel the same about our sacred responsibility to protect our kids. 

“Nine in 10 adults who smoke began smoking as youth. Children should not have to worry about a multibillion-dollar commercial tobacco industry that profits at the expense of their health. The time is now to accelerate a whole-of-society effort to reach the tobacco endgame: a world in which zero lives are harmed by or lost to tobacco use. 

“By driving down the appeal, availability, and addictiveness of tobacco products, we can make this more than just a possibility. We can make it a reality. Can we summon the moral courage as a nation to do so, for one another, for our children, and for generations to come?”