Performance Improvement 2005. The Health Consequences of Smoking: a Report of the Surgeon General


This report of the Surgeon General on the health effects of smoking returns to the topic of active smoking and disease, the focus of the first Surgeon General’s report published in 1964. The first report established a model of comprehensive evidence evaluation for the 27 reports that have followed: for those on the adverse health effects of smoking, the evidence has been evaluated using guidelines for assessing causality of smoking with disease. Using this model, every report on health had found that smoking causes many diseases and adverse effects. Repeatedly, the reports have concluded that smoking is the single greatest cause of avoidable morbidity and mortality in the United States. Because there has not been a recent systematic review of the full sweep of the evidence, the topic of active smoking and health was considered appropriate for this latest report. This report also updates the methodology for evaluating evidence that the 1964 report initiated. This report establishes a uniformity of language concerning causality of associations so as to bring greater specificity to the report’s findings. Beginning with this report, conclusions concerning causality of association will be placed into one of four categories with regard to strength of the evidence: (1) sufficient to infer a causal relationship; (2) suggestive but not sufficient to infer a causal relationship; (3) inadequate to infer the presence or absence of a causal relationship; or (4) suggestive of no causal relationship. Also, this report only covers active smoking. Passive smoking was the focus of the 1986 Surgeon General’s report. The literature review for this report was selective. There was more focus on reviewing conclusions drawn from previous Surgeon General’s reports and new studies for that topic. In addition, conclusions from prior reports have been updated and are presented in this new format based on the evidence evaluated in this report. Remarkably, this report identifies a substantial number of diseases found to be caused by smoking that weren’t previously causally associated with smoking.

PIC ID: 8053; Agency Sponsor: CDC-NCCDPHP, National Center for Chronic Disease Prevention and Health Promotion; Federal Contact: Norman, Leslie, 770-488-5469; Performer: Cygnus Corporation, Inc., Washington, DC

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