Author Affiliations: Departments of Surgery
and Community and Family Medicine (Dr Dacey) and Department of Surgery (Dr
Johnstone), Dartmouth-Hitchcock Medical Center, Lebanon, NH.
The costs of tobacco in both health and economic terms are enormous.
Cigarette smoking causes approximately 5 million premature deaths each year
around the world secondary to cardiovascular disease, chronic obstructive
pulmonary disease, and lung cancer.1 In the
United States, lung cancer is the leading cause of cancer-related deaths for
both men and women. More than 170 000 new cases of lung cancer (13% of
all cancer diagnoses) will be diagnosed this year, and more than 160 000
deaths from lung cancer will occur (28% of all cancer deaths).2 The
5-year survival for all patients who receive a diagnosis of lung cancer is
an abysmal 14%, and even those who are diagnosed and definitively treated
at the earliest stage (IA) have only a 67% 5-year survival.3 In
the United States, direct medical costs for the treatment of lung cancer alone
are approximately $5 billion annually.4 Years
of research and innovative treatment for lung cancer have yielded improved
amelioration of symptoms but little increase in overall survival. Clearly,
the best treatment for lung cancer is prevention. Since smoking is responsible
for 87% of deaths from lung cancer,2 tobacco
avoidance or cessation is absolutely crucial for making any real progress
in fighting this disease.
Dacey LJ, Johnstone DW. Reducing the Risk of Lung Cancer. JAMA. 2005;294(12):1550-1551. doi:10.1001/jama.294.12.1550