Americans have 14 million smoking-related ailments: study

A woman smokes a cigarette in this illustration picture taken in Paris, October 8, 2014. REUTERS/Christian Hartmann

By Kathryn Doyle NEW YORK (Reuters Health) - About 14 million major medical conditions in the U.S. can be blamed on smoking, according to a study by health officials. Using surveys, the researchers found that in 2009 roughly seven million Americans reported almost 11 million major medical conditions caused by smoking. Including ailments people don’t know they have or didn't report, that number climbs to 14 million medical conditions. “That’s obviously an immense number,” Brian Rostron told Reuters Health by phone. “It’s continuing to be a problem. Even if people are former smokers, they have lasting lung damage.” Rostron, the study’s lead author, is from the Center for Tobacco Products at the U.S. Food and Drug Administration in Silver Spring, Maryland. These numbers are up from the 12.7 million medical conditions estimated 10 years ago by the U.S. Centers for Disease Control and Prevention (CDC). The increase over the past decade may be due to improved survey methods or to people with smoking-related ailments living longer), Rostron and coauthors write in JAMA Internal Medicine. For the new analysis, they combined 2009 U.S. Census Bureau data with national survey data on smoking and disease prevalence from 2006 to 2012. They found that almost seven million individuals reported a total of 10.9 million major smoking-related conditions that year. Between 40 and 50 percent of current smokers age 65 or older reported at least one smoking-related condition, and 17 percent of the men and 14 percent of the women reported multiple conditions. Chronic obstructive pulmonary disease, or COPD, was the most commonly reported condition with 4.3 million cases. That was followed by 2.3 million heart attacks, 1.8 million cases of diabetes, 1.1 million strokes and over a million cases of smoking-related cancers. In addition to lung cancer, other cancers that can be linked to smoking can occur in the bladder, cervix, colon, esophagus, kidney, larynx, windpipe, mouth, tongue, lip and throat. After consulting data from actual tests of lung function, the researchers found people in the surveys were underreporting cases of COPD. Including the missing cases, about 7.5 million Americans are living with COPD. Overall, the number of illness related to smoking rises to about 14 million. Lung function naturally declines with age, but COPD makes that worse, said senior author Terry Pechacek, deputy director for research translation at the Office of Smoking and Health at the CDC in Atlanta. “It’s a creeping disease, and people accept the fact that they can’t walk up two flights of stairs just because of ageing, but that does becomes a clinical condition,” he said by phone. Dr. Steven Schroeder, who wrote an editorial about the new study, said by phone that smoking may be worse for the body than people think. “People are walking around with about 14 million chronic diseases that won’t get better,” said Schroeder, an expert on the effects of smoking from the University of California, San Francisco. “It looks like women smokers are particularly vulnerable.” While men made up more cases of diabetes and heart attack related to smoking, women were more likely to have COPD, lung cancers and other cancers. Fewer women in the U.S. are smokers, Schroeder said. It could be that women are more susceptible to the negative effects of smoking. The disease numbers will probably start going down in the next few years following the nation’s declining smoking rates, he said. Almost half of all smokers try to quit each year, but less than one in 10 succeed, the CDC’s Pechacek said. “One of the unfortunate things is even if everyone quit right now, we are going to face the morbidity and mortality epidemic for decades,” Pechacek said. “It’s not a statistic. It really is really compromising people’s lives.” A large part of the financial burden of these diseases falls on Medicare and Medicaid, the government-run insurance programs for the elderly, disabled and poor, Pechacek said. “But the reality is we’re all paying for it,” he said, adding that there are losses to productivity, physical activity and time with family. SOURCE: and JAMA Internal Medicine, October 13, 2014.