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Message from Tommy G. Thompson
  Secretary of Health and Human Services

Ever since the first Surgeon General's report on smoking in 1964, Americans have learned about the dangerous effects of smoking and how tragically this habit can end life. It is an irrefutable fact that smoking cigarettes and using other tobacco products causes cancer and often results in other debilitating illnesses and death. Our Nation, rightfully, remains on an important quest to raise public awareness of the dangers of smoking and to deter people from choosing this costly habit, particularly our young people.

Too often and for too long, however, smoking has been largely viewed in the context of men's health. But smoking wreaks a great and unique toll on the health of our women and teenage girls as well. The impact smoking is having on our Nation's women is alarming. Therefore, the work of Surgeon General David Satcher and the Centers for Disease Control and Prevention (CDC) in producing this report of the Surgeon General on women and smoking could not come at a better time. Frankly, this update and expansion of the 1980 Surgeon General's report, The Health Consequences of Smoking for Women, is long due. And we are all grateful for the time and hard work put into this report by the Surgeon General, his office, the Office of Women's Health, the CDC, the National Institutes of Health, and researchers and scientists from around the world.

This report shines a bright light on the devastating impact of smoking on women and the need for the Nation to come together and address this problem. Just look at a sample of the statistics summarized in this report.

  • An estimated 27,000 more women died of lung cancer than of breast cancer in 2000.
  • Three million women have died prematurely because of smoking since 1980, and on average, these women died 14 years prematurely.
  • Twenty-two percent of women smoked cigarettes in 1998.
  • And 30 percent of high school senior girls reported smoking in the past month, according to recent information.

The report goes well beyond just the statistical impacts of smoking to lay out specific health problems incurred by women who smoke. This report found that women who smoke have a lower bone density and experience a premature decline of lung function. These women also are at increased risk of conception delay and both primary and secondary infertility. For pregnant women who smoke, the risk is increased for low birth weight, perinatal mortality---both stillbirth and neonatal deaths---and sudden infant death syndrome after the child is born. Of course, there are the health dangers of smoking that most of us are familiar with but remain just as real and just as deadly for women: cancer, emphysema, heart disease, and stroke. Now, studies suggest that even exposure to environmental tobacco smoke has a causal link to cancer and heart disease.

If we are going to succeed in reducing the number of women who smoke in this country, we must first succeed in preventing our teenagers and young women from picking up the habit. Our antismoking efforts at the U.S. Department of Health and Human Services will focus intensively on keeping tobacco out of the hands of teenage girls and college-age women. These young women are greatly influenced by their peers and the glamor of smoking portrayed through magazines, television, and movies; we must be aggressive in educating them that smoking is very addictive, harmful, and lethal. These young women must know that once they start, it will be difficult to stop---and that the health risks are very real and costly.

All of society must engage in this endeavor, as well as the overall challenge of reducing smoking in this Nation, if we are to succeed. We must re-energize our efforts and commit time and resources---private and public---to the prevention of smoking initiation. We need to provide parents, teachers, and community leaders with tools and information that effectively convey the destructive message of cigarette use. And we need all aspects of the media to join the effort in addressing this societal problem. Our best defense against the dangers of smoking is a comprehensive approach to tobacco use prevention, which includes education that is accessible to all.

We must also strengthen the enforcement activities aimed at preventing youth smoking, including no marketing geared toward teenagers and absolutely no tobacco sales to minors. We must fully support law enforcement sting operations and other improved methods of ensuring that persons who purchase tobacco products are adults.

The cost of smoking is simply too high in this country. The impacts are a financial drain on our Nation's health care system, costing up to $73 billion annually. But more important, we are losing too many of our mothers and daughters prematurely as a result of smoking. We simply can't afford to lose any women to this harmful habit.

This Surgeon General's report provides an opportunity for America to focus on how damaging smoking is to the well-being of our women and girls. We must seize this opportunity to prevent smoking by women, and help those who do smoke to quit, which will improve the overall health of women in this country. And we must do this by working together as a Nation, for that is the only way we can truly succeed in addressing this devastating problem.

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