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Women and smoking; a report of the Surgeon General : executive summary
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    Message from Tommy G. Thompson, Secretary of Health and Human Services -- Foreword -- Preface from the Surgeon General, U.S. Department of Health and Human Services -- 1. Major conclusions -- 2. Patterns of tobacco use among women and girls -- 3. Health consequences of tobacco use among women -- 4. Factors influencing tobacco use among women -- 5. Efforts to reduce tobacco use among women -- A vision for the future: what is needed to reduce smoking among women -- Bibliography.

    This is the second report of the U.S. Surgeon General devoted to women and smoking. The first was published in 1980, 16 years after the initial landmark report on smoking and health of the Advisory Committee to the Surgeon General appeared in 1964. The 1964 report summarized the accumulated evidence that demonstrated that smoking was a cause of human cancer and other diseases. Most of the early evidence was based on men. For example, the report concluded, "Cigarette smoking is causally related to lung cancer in men.... The data for women, though less extensive, point in the same direction". By the time of the 1980 report, the evidence clearly showed that women were also experiencing devastating health consequences from smoking and that "the first signs of an epidemic of smoking-related disease among women are now appearing". The evidence had solidified later among women than among men because smoking became commonplace among women about 25 years later than it had among men. However, it was still deemed necessary to include a section in the preface of the 1980 report titled "The Fallacy of Women's Immunity." In the two decades since, numerous studies have expanded the breadth and depth of what is known about the health consequences of smoking among women, about historical and contemporary patterns of smoking in demographic subgroups of the female population, about factors that affect initiation and maintenance of smoking among women (including advertising and marketing of tobacco products), and about interventions to assist women to quit smoking. The present report reviews the now massive body of evidence on women and smoking--evidence that taken together compels the Nation to make reducing and preventing smoking one of the highest contemporary priorities for women's health. A report focused on women is greatly needed. No longer are the first signs of an epidemic of tobacco-related diseases among women being seen, as was the case when the 1980 report was written. Since 1980, hundreds of additional studies have expanded what is known about the health effects of smoking among women, and this report summarizes that knowledge. Today the Nation is in the midst of a full-blown epidemic. Lung cancer, once rare among women, has surpassed breast cancer as the leading cause of female cancer death in the United States, now accounting for 25 percent of all cancer deaths among women. Surveys have indicated that many women do not know this fact. And lung cancer is only one of myriad serious disease risks faced by women who smoke. Although women and men who smoke share excess risks for diseases such as cancer, heart disease, and emphysema, women also experience unique smoking-related disease risks related to pregnancy, oral contraceptive use, menstrual function, and cervical cancer. These risks deserve to be highlighted and broadly recognized. Moreover, much of what is known about the health effects of exposure to environmental tobacco smoke among nonsmokers comes from studies of women, because historically men were more likely than women to smoke and because many women who did not smoke were married to smokers.

    Includes bibliographical references (p. 12-13).

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