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Invited Commentary
December 2014

Even More Illness Caused by Smoking Than Previously Estimated

Author Affiliations
  • 1Division of General Internal Medicine, Department of Medicine, University of California, San Francisco
JAMA Intern Med. 2014;174(12):1928-1929. doi:10.1001/jamainternmed.2014.4297

The most striking statistic on the harms of smoking is the number of estimated deaths from tobacco exposure. There are an estimated 480 000 annual deaths caused by tobacco use in the United States,1 and approximately 5.7 million deaths each year globally, making smoking the most common cause of preventable death in the United States and worldwide.

Another way to enumerate the damage caused by smoking is to calculate how many persons are afflicted with serious smoking-attributable morbidities. The previous Centers for Disease Control and Prevention estimate—from the year 2000—put that number at 8.6 million Americans, about 60% of whom had chronic obstructive pulmonary disease (COPD); the 2014 Report of the Surgeon General1 estimated that it now might be twice as large. In this issue, Rostron et al2 present new morbidity estimates derived from 2 existing national data sets—the National Health Interview Survey (for a general estimate of all smoking-related diseases) and the National Health and Nutritional Examination Survey (NHANES) (to account for underreporting of COPD).

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