Tobacco. Its impact on vascular disease.

Tobacco smoking is the leading preventable cause of death in the United States. 51,71 The adverse sequelae of smoking and associated mortality are estimated to be 500,000 deaths per year, or about 40% of all preventable deaths in the United States. 48 The cost of caring for patients with smoking-related illnesses was reported to be $22 billion in 1993. The report of the Surgeon General in 1964 identified three areas of concern: atherosclerotic vascular change, chronic obstructive pulmonary disease, and cancer. 73 Cigarette smoking in the United States has been on the increase since the early 1950s, when cigarettes were essentially provided free of charge to the military. In 1950, it was estimated that an individual adult consumed 3500 cigarettes per year; 50% of the population smoked by that date. 14 In 1964, the Surgeon General's advisory committee published its work on smoking and health; smoking was said to pose a definite health hazard. 67