Washington: Smoking - known to cause lung cancer and heart disease - can even trigger diabetes, erectile dysfunction, arthritis, blindness and liver cancer, according to a new US report released today which also found that modern cigarettes are more dangerous than ever.
The report by the acting US surgeon general, Dr Boris D Lushniak, significantly expands the list of smoking-caused diseases.
According to the report, smoking causes diabetes mellitus, rheumatoid arthritis and immune system weakness, increased risk for tuberculosis disease and death, impaired fertility, cleft lip and cleft palates in babies of women who smoke during early pregnancy, erectile dysfunction, and age-related macular degeneration.
Secondhand smoke exposure is now known to cause strokes in nonsmokers, it added.
Lushniak said that even though today's smokers smoke fewer cigarettes than those 50 years ago, they are at higher risk of developing lung cancer.
Changes in the design and composition of cigarettes since the 1950s have increased the risk of adenocarcinoma of the lung, the most common type of lung cancer.
"Evidence suggests that ventilated filters may have contributed to higher risks of lung cancer by enabling smokers to inhale more vigorously, thereby drawing carcinogens contained in cigarette smoke more deeply into lung tissue," he said.
"At least 70 of the chemicals in cigarette smoke are known carcinogens. Levels of some of these chemicals have increased as manufacturing processes have changed," he added.
Women's disease risks from smoking have risen sharply over the last 50 years and are now equal to men's for lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular diseases. The number of women dying from COPD now exceeds the number of men, according to the report.
Since the first US Surgeon General's report on smoking and health was published 50 years ago, more than 20 million Americans have died because of smoking.
Most of the 20 million smoking-related deaths in US have been adults with a history of smoking; however, 2.5 million of those deaths have been among nonsmokers who died from diseases caused by exposure to secondhand smoke.
If current rates continue, 5.6 million Americans younger than 18 years of age who are alive today are projected to die prematurely from smoking-related disease, the report said.
Despite significant progress since the first US Surgeon General's report, smoking remains the single largest cause of preventable disease and death in the US - killing half a million Americans a year.
The estimated economic costs attributable to smoking and exposure to tobacco smoke continue to increase and now approach USD 300 billion annually, with direct medical costs of at least USD 130 billion, the report said.
The report blamed the tobacco epidemic on the tobacco industry, which "deliberately misled the public about the risks of smoking cigarettes."
Evidence-based tobacco control interventions that are effective continue to be underutilised and implemented at far below funding levels recommended by the Centers for Disease Control and Prevention, the report said.
New "end game" strategies have been proposed with the goal of eliminating tobacco smoking. Some of these strategies may prove useful for the US, particularly reduction of the nicotine content of tobacco products and greater restrictions on sales (including bans on entire categories of tobacco products), the report concluded.