Report of the Surgeon General

Cover title.Shipping list no.: 1994-0111-P.Also available via Internet from the NIH Web site. Address as of 8/26/04: http://profiles.nlm.nih.gov/NN/B/C/F/T/%5F/nnbcft.pdf; current access available via PURL.Also available on the World Wide Web.Includes bibliographical references (p. 11)

Reducing tobacco use: a report of the Surgeon General : executive summary

Shipping list no.: 2000-0350-P.Published also as Morbidity and mortality weekly report. Recommendations and reports ; v. 49, no. RR-16.Also available via the World Wide Web.Includes bibliographical references (p. 21-22)

Preventing tobacco use among young people: a report of the Surgeon General

Health consequences of tobacco use by young people -- Health consequences of smoking among young people -- Adult health implications of smoking among young people -- Nicotine addiction in adolescence -- Smoking as a risk factor for other drug use -- Health consequences of smokeless tobacco use among young people -- Epidemiology of tobacco use among young people in the United States -- Cigarette smoking among young people in the United States -- Smokeless tobacco use among young people in the United States -- Psychosocial risk factors for initiating tobacco use -- Initiation of cigarette smoking -- Initiation of smokeless tobacco use -- Implications of research for preventing tobacco use: modifying psychosocial risk -- Tobacco advertising and promotional activities -- Role of advertising and promotion in the marketing of tobacco products -- History of cigarette advertising to the young -- Historical content analyses of cigarette advertising -- Promotional efforts of the tobacco industry -- Research on the effects of cigarette advertising and promotional activities on young people --Efforts to prevent tobacco use among young people -- Public opinion about preventing tobacco use among young people -- Educational efforts to prevent tobacco use among young people -- Public policies to prevent tobacco use among young people.Constitutes the 1994 Surgeon general's report on the health consequences of smoking. Cf. Foreword and transmittal letter from Donna E. Shalala.Also available via the World Wide Web.Includes bibliographical references and index

The Surgeon General's call to action to support breastfeeding

"For nearly all infants, breastfeeding is the best source of infant nutrition and immunologic protection, and it provides remarkable health benefits to mothers as well. Babies who are breastfed are less likely to become overweight and obese. Many mothers in the United States want to breastfeed, and most try. And yet within only three months after giving birth, more than two-thirds of breastfeeding mothers have already begun using formula. By six months postpartum, more than half of mothers have given up on breastfeeding, and mothers who breastfeed one-yearolds or toddlers are a rarity in our society. October 2010 marked the 10th anniversary of the release of the HHS Blueprint for Action on Breastfeeding, in which former Surgeon General David Satcher, M.D., Ph.D., reiterated the commitment of previous Surgeons General to support breastfeeding as a public health goal. This was the first comprehensive framework for national action on breastfeeding. It was created through collaboration among representatives from medical, business, women's health, and advocacy groups as well as academic communities. The Blueprint provided specific action steps for the health care system, researchers, employers, and communities to better protect, promote, and support breastfeeding. I have issued this Call to Action because the time has come to set forth the important roles and responsibilities of clinicians, employers, communities, researchers, and government leaders and to urge us all to take on a commitment to enable mothers to meet their personal goals for breastfeeding. Mothers are acutely aware of and devoted to their responsibilities when it comes to feeding their children, but the responsibilities of others must be identified so that all mothers can obtain the information, help, and support they deserve when they breastfeed their infants. Identifying the support systems that are needed to help mothers meet their personal breastfeeding goals will allow them to stop feeling guilty and alone when problems with breastfeeding arise. All too often, mothers who wish to breastfeed encounter daunting challenges in moving through the health care system. Furthermore, there is often an incompatibility between employment and breastfeeding, but with help this is not impossible to overcome. Even so, because the barriers can seem insurmountable at times, many mothers stop breastfeeding. In addition, families are often unable to find the support they need in their communities to make breastfeeding work for them. From a societal perspective, many research questions related to breastfeeding remain unanswered, and for too long, breastfeeding has received insufficient national attention as a public health issue. This Call to Action describes in detail how different people and organizations can contribute to the health of mothers and their children. Rarely are we given the chance to make such a profound and lasting difference in the lives of so many. I am confident that this Call to Action will spark countless imaginative, effective, and mutually supportive endeavors that improve support for breastfeeding mothers and children in our nation." - p. vThe Importance of breastfeeding -- Rates of breastfeeding -- Barriers to breastfeeding in the United States -- Breastfeeding from the public health perspective -- A Call to action -- References -- Acknowledgments -- Appendix 1. Actions to improve breastfeeding -- Appendix 2. Excess health risks associated with not breastfeeding -- Appendix 3. Development of the call to action -- Appendix 4. Abbreviations and acronyms"The Surgeon General's Call to Action to Support Breastfeeding was prepared by the Centers for Disease Control and Prevention and the Office on Women's Health under the direction of the Office of the Surgeon General. These three agencies are part of the U.S. Department of Health and Human Services, which published the Call to Action." -p. 69"CS213420"Also available via the World Wide Web.as an Acrobat .pdf file (903.73 KB, 100 p.).Includes bibliographical references (p. 59-68).U.S. Department of Health and Human Services. The Surgeon General's Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2011

Health consequences of involuntary exposure to tobacco smoke, a report of the Surgeon General

Prepared by the U.S. Department of Health and Human Services under the direction of the Office of the Surgeon General.Mode of access: Internet from the Surgeon General's web site. Address as of 6/29/06: http://www.surgeongeneral.gov/library/secondhandsmoke/secondhandsmoke.pdf; current access is available via PURL

The Health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General : executive summary

This Surgeon General\u2019s report returns to the topic of the health effects of involuntary exposure to tobacco smoke. The last comprehensive review of this evidence by the Department of Health and Human Services (DHHS) was in the 1986 Surgeon General\u2019s report, The Health Consequences of Involuntary Smoking, published 20 years ago this year. This new report updates the evidence of the harmful effects of involuntary exposure to tobacco smoke. This large body of research findings is captured in an accompanying dynamic database that profiles key epidemiologic findings, and allows the evidence on health effects of exposure to tobacco smoke to be synthesized and updated (following the format of the 2004 report, The Health Consequences of Smoking). The database enables users to explore the data and studies supporting the conclusions in the report. The database is available on the Web site of the Centers for Disease Control and Prevention (CDC) at http://www.cdc.gov/tobacco. I am grateful to the leadership of the Surgeon General, CDC\u2019s Office on Smoking and Health, and all of the contributors for preparing this important report and bringing this topic to the forefront once again.Secondhand smoke, also known as environmental tobacco smoke, is a mixture of the smoke given off by the burning end of tobacco products (sidestream smoke) and the mainstream smoke exhaled by smokers. People are exposed to secondhand smoke at home, in the workplace, and in other public places such as bars, restaurants, and recreation venues. It is harmful and hazardous to the health of the general public and particularly dangerous to children. It increases the risk of serious respiratory problems in children, such as a greater number and severity of asthma attacks and lower respiratory tract infections, and increases the risk for middle ear infections. It is also a known human carcinogen (cancer-causing agent). Inhaling secondhand smoke causes lung cancer and coronary heart disease in nonsmoking adults.We have made great progress since the late 1980s in reducing the involuntary exposure of nonsmokers in this country to secondhand smoke. The proportion of nonsmokers aged 4 and older with a blood cotinine level (a metabolite of nicotine) indicating exposure has declined from 88 percent in 1988\u20131991 down to 43 percent in 2001\u20132002, a decline that exceeds the Healthy People 2010 objective for this measure. Despite the great progress that has been made, involuntary exposure to secondhand smoke remains a serious public health hazard that can be prevented by making homes, workplaces, and public places completely smoke-free. As of the year 2000, more than 126 million residents of the United States aged 3 or older still are estimated to be exposed to secondhand smoke. Smoke-free environments are the most effective method for reducing exposures. Healthy People 2010 objectives address this issue and seek optimal protection of nonsmokers through policies, regulations, and laws requiring smoke-free environments in all schools, workplaces, and public places.Suggested citation: U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General\u2014Executive Summary. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.CDC-INFO Pub ID 998586998586Includes bibliographical references

The Surgeon General's call to action to prevent suicide, 1999

This Surgeon General's Call To Action introduces a blueprint for addressing suicide--Awareness, Intervention, and Methodology, or AIM--n approach derived from the collaborative deliberations of the conference participants. As a framework for suicide prevention, AIM includes 15 key recommendations that were refined from consensus and evidence-based findings presented at the Reno conference. Recognizing that mental and substance abuse disorders confer the greatest risk for suicidal behavior, these recommendations suggest an important approach to preventing suicide and injuries from suicidal behavior by addressing the problems of undetected and undertreated mental and substance abuse disorders in conjunction with other public health approaches. These recommendations and their supporting conceptual framework are essential steps toward a comprehensive National Strategy for Suicide Prevention. Other necessary elements will include constructive public health policy, measurable overall objectives, ways to monitor and evaluate progress toward these objectives, and provision of resources for groups and agencies identified to carry out the recommendations. The nation needs to move forward with these crucial recommendations and support continued efforts to improve the scientific bases of suicide prevention.In 1996, the World Health Organization (WHO), recognizing the growing problem of suicide worldwide, urged member nations to address suicide. Its document, Prevention of Suicide: Guidelines for the Formulation and Implementation of National Strategies, motivated the creation of an innovative public/private partnership to seek a national strategy for the United States. This public/private partnership included agencies in the U.S. Department of Health and Human Services, encompassing the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the National Institute of Mental Health (NIMH), the Office of the Surgeon General, and the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Suicide Prevention Advocacy Network (SPAN), a public grassroots advocacy organization made up of suicide survivors (persons close to someone who completed suicide), attempters of suicide, community activists, and health and mental health clinicians. An outgrowth of this collaborative effort was a jointly sponsored national conference on suicide prevention convened in Reno, Nevada, in October 1998. Conference participants included researchers, health and mental health clinicians, policy makers, suicide survivors, and community activists and leaders. They engaged in careful analysis of what is known and unknown about suicide and its potential responsiveness to a public health model emphasizing suicide prevention."Technical assistance and scientific consultation in the preparation of this document was provided by the CDC, NIMH, Office of the Surgeon General and SAMHSA. Support for its publication has been provided by the CDC, National Center for Injury Prevention and Control. Support for the National Conference on Suicide Prevention in Reno, Nevada, 1998, was provided in part by the Centers for Disease Control and Prevention (National Center for Injury Prevention and Control), the Health Resources and Services Administration, the National Institute of Mental Health, and the Substance Abuse and Mental Health Services Administration (Center for Mental Health Services)." - acknowledgeentsIncludes bibliographical references (p. 17-20).U.S. Public Health Service, The Surgeon General's Call To Action To Prevent Suicide. Washington, DC: 1999

Preventing tobacco use among young people: a report of the Surgeon General : executive summary

This Surgeon General's report on smoking and health is the twenty-third in a series that was begun in 1964 and mandated by federal law in 1969. This report is the first in this series to focus on young people. It underscores the seriousness of tobacco use, its relationship to other adolescent problem behaviors, and the responsibility of all citizens to protect the health of our children. Since 1964, substantial changes have occurred in scientific knowledge of the health consequences of smoking and smokeless tobacco use. Much more is also known about programs and policies that encourage nonsmoking behavior among adults and protect nonsmokers from exposure to environmental tobacco smoke. Although considerable gains have been made against smoking among U.S. adults, this progress has not been realized with young people. Onset rates of cigarette smoking among our youth have not declined over the past decade, and 28 percent of the nation's high school seniors are currently cigarette smokers. The onset of tobacco use occurs primarily in early adolescence, a developmental stage that is several decades removed from the death and disability that are associated with smoking and smokeless tobacco use in adulthood. Currently, very few people begin to use tobacco as adults; almost all first use has occurred by the time people graduate from high school. The earlier young people begin using tobacco, the more heavily they are likely to use it as adults, and the longer potential time they have to be users. Both the duration and the amount of tobacco use are related to eventual chronic health problems. The processes of nicotine addiction further ensure that many of today's adolescent smokers will regularly use tobacco when they are adults. Preventing smoking and smokeless tobacco use among young people is critical to ending the epidemic of tobacco use in the United States. This report examines the past few decades' extensive scientific literature on the factors that influence the onset of use among young people and on strategies to prevent this onset. To better understand adolescent tobacco use, this report draws not only on medical and epidemiologic research but also on behavioral and social investigations. The resulting examination of the advertising and promotional activities of the tobacco industry, as well as the review of research on the effects of these activities on young people, marks an important contribution to our understanding of the epidemic of tobacco use in the United States and elsewhere. In particular, this research on the social environment of young people identifies key risk factors that encourage tobacco use. The careful targeting of these risk factors--on a communitywide basis--has proven successful in preventing the onset and development of tobacco use among young people.March 11, 1994.The issue of MMWR Recommendations and Reports (Vol. 43, No. RR-4) is a reprint of the Executive Summary of the Surgeon General's report entitled Preventing Tobacco Use Among Young People, released February 1994. The report is included in the MMWR series of publications so that the material may be readily accessible to the public health community.Includes bibliographical references (p. 10)

Report of the Surgeon General

"Nearly all tobacco use begins during youth and young adulthood. These young individuals progress from smoking occasionally to smoking every day. Each day across the United States over 3,800 youth under 18 years of age start smoking. Although much progress has been made to reduce the prevalence of smoking since the first Surgeon General's report in 1964, today nearly one in four high school seniors and one in three young adults under age 26 smoke. Of every three young smokers, only one will quit, and one of those remaining smokers will die from tobacco-related causes. Most of these young people never considered the long-term health consequences associated with tobacco use when they started smoking; and nicotine, a highly addictive drug, causes many to continue smoking well into adulthood, often with deadly consequences. This Surgeon General's report examines in detail the epidemiology, health effects, and causes of tobacco use among youth ages 12 through 17 and young adults ages 18 through 25. For the first time tobacco data on young adults as a discrete population has been explored. This is because nearly all tobacco use begins in youth and young adulthood, and because young adults are a prime target for tobacco advertising and marketing activities. This report also highlights the efficacy of strategies to prevent young people from using tobacco. After years of steady decrease following the Tobacco Master Settlement Agreement of 1998, declines in youth tobacco use have slowed for cigarette smoking and stalled for use of smokeless tobacco. The latest research shows that concurrent use of multiple tobacco products is common among young people, and suggest that smokeless tobacco use is increasing among White males. An important element of this Surgeon General's report is the review of the health conse-quences of tobacco use by young people. Cigarette smoking by youth and young adults is proven to cause serious and potentially deadly health effects immediately and into adulthood. One of the most significant health effects is addiction to nicotine that keeps young people smoking longer, causing increased physical damage. Early abdominal aortic atherosclerosis has been found in young smokers which affects the flow of blood to vital organs such as the lungs. This leads to reduced lung growth that can increase the risk of chronic obstructive pulmonary disease later in life, and reduced lung function. This report examines the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. Tobacco products are among the most heavily marketed consumer goods in the U.S. Much of the nearly $10 billion spent on marketing cigarettes each year goes to programs that reduce prices and make cigarettes more affordable; smokeless tobacco products are similarly promoted. Peer influences; imagery and messages that portray tobacco use as a desirable activity; and environmental cues, including those in both traditional and emerging media platforms, all encourage young people to use tobacco. These influences help attract youth to tobacco use and reinforce the perception that smoking and various forms of tobacco use are a social norm--a particularly strong message during adolescence and young adulthood. Many initiatives have been put into place to help counter the influences that encourage young people to begin tobacco use. The Tobacco Master Settlement Agreement in 1998 curtailed much of the advertising that was particularly appealing to young people. With the passage of the 2009 legislation giving the U.S. Food and Drug Administration the authority to regulate tobacco products and tobacco advertising, we now have another important means of helping decrease the appeal of tobacco use to this population. Coordinated, multi-component interventions that include mass media campaigns, comprehensive community programs, comprehensive statewide tobacco control programs, price increases, and school-based policies have also proven effective in preventing onset and use of tobacco use among youth and young adults." - p. iiiIncludes bibliographical references (p. 8-11)

How tobacco smoke causes disease

U.S. Department of Health and Human Services. A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010