The consumption of tobacco products and exposure to tobacco smoke lead the world’s list of preventable causes of death, responsible for about 7 million deaths a year. In the United States, cigarette smoking and exposure to tobacco smoke causes about 480,000 premature deaths each year. Of those premature deaths, about 36% are from cancer, 39% are from heart disease and stroke, and 24% are from lung disease.1 Tobacco is the major cause of chronic obstructive lung disease and one of the major risk factors for vascular disease, including ischemic heart disease. Programs to prevent initiation of smoking have an important long-term positive impact on tobacco-related illnesses, and individual efforts to stop smoking can mitigate many of the negative health effects of tobacco use within just a few years. Smoking cessation during treatment for diseases such as COPD, CVD, and cancer improves patient outcomes.
The Society believes that cardiothoracic surgeons are in a position to help create smoking cessation programs in their facilities and encourage tobacco use cessation in their patients and communities, both locally and globally. To achieve the shared goal of eliminating morbidity and mortality from smoking-related activities, The Society of Thoracic Surgeons supports the following efforts:
1. Ratification of the World Health Organization Framework Convention on Tobacco Control (https://www.who.int/fctc/text_download/en/) and implementation of its articles, as important steps toward addressing tobacco-related disease in the United States and worldwide. The U.S. signed but did not ratify the Convention;
2. Legislation/regulation that prohibits smoking in public places and places of work, including e-cigarettes and other inhaled tobacco products;
3. Education, as a valuable and essential weapon in the effort to eliminate tobacco-related death and disease, including early tobacco warning programs within school systems, and more graphic and visible warnings on tobacco packaging;
4. Legislation that raises the minimum legal sale age (MLSA) for all tobacco products from 18 to 21;
5. Legislation/regulation that requires all tobacco product manufacturers to pay user fees to the FDA;
6. Legislation/regulation that bans all flavored tobacco products, including menthol;
7. Legislation/regulation eliminating tobacco product subsidies;
8. Legislation/regulation increasing taxation on all tobacco products;
9. Referral of patients to smoking cessation programs by Society members, who also should avail themselves of such programs if necessary; and
10. STS Divestment of assets in the tobacco industry.
Adopted: January 26, 2020 (STS Board of Directors)
1“Harms of Cigarette Smoking and Health Benefits of Quitting, About Cancer, National Cancer Institute, 12/19/2017, https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco/cessation-fact-sheet