History of the Great American Smokeout
What is the Great American Smokeout?
Every year, on the third Thursday of November, smokers across the nation take part in the American Cancer Society Great American Smokeout. They may use the date to make a plan to quit, or plan in advance and then quit smoking that day. The Great American Smokeout challenges people to stop using tobacco and helps people know about the many tools they can use to quit and stay quit.
In many towns and communities, local volunteers use this day to publicize the need to quit, and press for laws that control tobacco use and discourage teens from starting, and support people who want to quit.
It's hard to quit tobacco
Research shows that smokers are most successful in kicking the habit when they have support, such as:
■Telephone smoking-cessation hotlines
■Online quit groups
■Nicotine replacement products
■Prescription medicine to lessen cravings
■Encouragement and support from friends and family members
Using 2 or more of these measures to quit smoking works better than using any one of them alone. For example, some people use a prescription medicine along with nicotine replacement. Other people may use as many as 3 or 4 of the methods listed above.
Telephone stop-smoking hotlines are an easy-to-use resource, and they are available in all 50 states.
Call us at 1-800-227-2345 to get more information on quitting tobacco and to find telephone counseling or other support in your area. You can also learn more in the "Stay Away from Tobacco" section.
How the Great American Smokeout began
The Great American Smokeout has helped dramatically change Americans’ attitudes about smoking. These changes have led to community programs and smoke-free laws that are now saving lives in many states. Annual Great American Smokeout events began in the 1970s, when smoking and secondhand smoke were commonplace.
The idea for the Great American Smokeout grew from a 1970 event in Randolph, Massachusetts, at which Arthur P. Mullaney asked people to give up cigarettes for a day and donate the money they would have spent on cigarettes to a high school scholarship fund. Then in 1974, Lynn R. Smith, editor of the Monticello Times in Minnesota, spearheaded the state’s first D-Day, or Don’t Smoke Day.
The idea caught on, and on November 18, 1976, the California Division of the American Cancer Society got nearly 1 million smokers to quit for the day. That California event marked the first Great American Smokeout, and the Society took the program nationwide in 1977. Since then, there have been dramatic changes in the way society views tobacco advertising and tobacco use. Many public places and work areas are now smoke-free – this protects non-smokers and supports smokers who want to quit.
The Great American Smokeout helps fuel new laws and save lives.
Each year, the Great American Smokeout also draws attention to the deaths and chronic diseases caused by smoking. Throughout the late 1980s and 1990s, many state and local governments responded by banning smoking in workplaces and restaurants, raising taxes on cigarettes, limiting cigarette promotions, discouraging teen cigarette use, and taking further action to counter smoking. These efforts continue today.
Because of the efforts of individuals and groups that have led anti-tobacco efforts, there have been significant landmarks in the areas of research, policy, and the environment:
■In 1977, Berkeley, California, became the first community to limit smoking in restaurants and other public places.
■In 1983, San Francisco passed the first strong workplace smoking restrictions, including bans on smoking in private workplaces.
■In 1990, the federal smoking ban on all interstate buses and domestic flights of 6 hours or less took effect.
■In 1994, Mississippi filed the first of 24 state lawsuits seeking to recuperate millions of dollars from tobacco companies for smoking-related illnesses paid for by Medicaid.
■In 1999, the Department of Justice filed suit against cigarette manufacturers, charging the industry with defrauding the public by lying about the risks of smoking.
■In 1999, the Master Settlement Agreement (MSA) was passed, requiring tobacco companies to pay $206 billion to 45 states by the year 2025 to cover Medicaid costs of treating smokers. The MSA agreement also closed the Tobacco Institute and ended cartoon advertising and tobacco billboards.
■In 2009, The Family Smoking Prevention and Tobacco Control Act was signed into law. It gives the FDA the authority to regulate the sale, manufacturing, and marketing of tobacco products and protects children from the tobacco industry’s marketing practices.
Those states with strong tobacco control laws are now reaping the fruits of their labor. From 1965 to today, cigarette smoking among adults in the United States decreased from more than 42% to around 18%. Strong smoke-free policies, media campaigns, and increases in the prices of tobacco products are at least partly credited for these decreases.
Still, today about 1 in 5 US adults smoke cigarettes (that’s more than 43 million people). And nearly 16 million people smoke tobacco in cigars or pipes. Lung cancer is the leading cause of cancer death for men and women. About 87% of lung cancer deaths are thought to result from smoking. Smoking also causes cancers of the larynx (voice box), mouth, pharynx (throat), esophagus (swallowing tube), and bladder. It also has been linked to the development of cancers of the pancreas, cervix, ovary (mucinous), colon/rectum, kidney, stomach, and some types of leukemia. Cigars and pipes cause cancers, too.
Smoking is responsible for nearly 1 in 3 cancer deaths, and 1 in 5 deaths from all causes. Another 8.6 million people live with serious illnesses caused by smoking.
Fortunately, the past few decades have seen great strides in changing attitudes about smoking, understanding the addiction, and learning how to help people quit. Today, the American Cancer Society Great American Smokeout is celebrated with rallies, parades, stunts, quitting information, and even “cold turkey” menu items in schools, workplaces, Main Streets, and legislative halls throughout the US.
Visit www.cancer.org to learn more about quitting smoking, improving your health, or getting involved with the Great American Smokeout in your community. Or just call your American Cancer Society anytime at 1-800-227-2345.
American Cancer Society. Cancer Facts & Figures 2013. Atlanta, Ga: American Cancer Society; 2013.
Centers for Disease Control and Prevention (CDC). Early Release of Selected Estimates Based on Data From the 2012 National Health Interview Survey. Released 6/2013. Accessed at www.cdc.gov/nchs/data/nhis/earlyrelease/earlyrelease201306_08.pdf on November 15, 2013.
Centers for Disease Control and Prevention (CDC). Quitting Smoking Among Adults --- United States, 2001--2010. MMWR. November 11, 2011 / 60(44);1513-1519. Accessed at www.cdc.gov/mmwr/preview/mmwrhtml/mm6044a2.htm?s_cid= mm6044a2.htm_w on November 15, 2013.
Pike KJ, Rabius V, McAlister A, Geiger A. American Cancer Society’s QuitLink: randomized trial of Internet assistance. Nicotine Tob Res. 2007;9(3):415-420.
Rouse, K. Personal Communication, October 20, 2004.
Smokefree.gov. Frequently Asked Questions about 1-800-QUIT-NOW. Accessed at http://smokefree.gov/talk-to-an-expert on November 13, 2013.
US Department of Commerce. United States Census Bureau. State & County QuickFacts, USA. Last revised June 17, 2013. Accessed at http://quickfacts.census.gov/qfd/states/00000.html on November 15, 2013.
Editor's note: Laura Esserman is director of the Carol Franc Buck Breast Care Center and a professor of surgery and radiology at the University of California at San Francisco. Beth Crawford is a genetic counselor and director of clinical services for the Cancer Risk Program at the UCSF Helen Diller Family Comprehensive Cancer Center.
(Health.com) -- Since Angelina Jolie's brave op-ed in The New York Times, many women have called my clinic asking if, like Jolie, they should get genetic testing or a bilateral mastectomy.
But the choice that she made is not for everyone.
That's why I want to share what you should know about reducing your risk of breast cancer, whether you have a family history or not.
Should you be tested for a breast cancer mutation?
Inherited gene mutations that result in a very high risk of breast and ovarian cancer, including the BRCA1 mutation that Jolie carries, are rare (1 in 400 people) and account for only about 5% of breast cancers.
If you have a history of at least one of these cancers on one side of your family -- two first-degree relatives (mom, sister or daughter) or three second-degree relatives (grandmother or aunt) -- this is a clue that your family might be at risk, especially if at least one person was diagnosed before age 50. (One hallmark of hereditary cancer is young age at diagnosis.)
A genetic counselor can help you sift through your history and help you decide if you should consider getting tested. (If you're in this high-risk group, the test is usually covered by your health insurance.)
The reassuring news is that genetic testing isn't warranted for most women, even those who have one relative who has had cancer.
I've had worried patients ask me if they should get the test anyway, and I tell them no: First of all, you could pay several thousand dollars out of pocket.
Second, the worst possible scenario is that the test comes back showing a genetic variant of unknown significance -- one that probably means nothing, but since we don't know for sure, can produce unnecessary anxiety.
What are your options if you test positive?
Jolie had a preventive mastectomy, but that's not your only avenue. Prevention is not an emergency -- cancer doesn't sprout up overnight -- so if you do learn you are a mutation carrier, you have time to weigh your options.
My patients' choices are often influenced by where they are in their lives.
If they're young and have not had children yet, they may want to opt for intensive screenings, like MRIs. For BRCA carriers, that means both mammograms and MRIs staggered at six-month intervals (before the age of 30 we only use MRI).
I just make sure patients are aware that since an MRI is so sensitive, it has a high rate of false positives (suspicious findings that turn out to be benign). This can be incredibly stressful.
Of course screening is not prevention: While catching a cancer earlier can mean less treatment, it depends on the tumor type. A stage 1 triple-negative tumor, for instance, will still require more aggressive treatment. By comparison, a stage 1 hormonally driven breast cancer may not.
The good news is that the treatment and reconstruction options are much better than what we had even 10 years ago.
Another alternative is medication: There are drugs, like tamoxifen, that can reduce the risk of breast cancer by about 50%.
Aromatase inhibitors such as exemestane have also been found to lower the risk of breast cancer in postmenopausal women by about 65%.
Then there's preventive mastectomy, which for women with a BRCA mutation lowers the risk of developing breast cancer from 60 to 80% to about 5%.
Women, like Jolie, who have had relatives die from cancer at a young age are often especially interested in this option. Women who have young children may also be highly motivated to do everything they can to lower their chances of developing cancer.
Removal of the ovaries and fallopian tubes reduces the risk of ovarian cancer (for which we don't have an effective screening test) by 80 to 90% and is recommended for women who carry a BRCA mutation, after they're done having children. (Jolie, whose mother died of ovarian cancer, has indicated that she plans to have her ovaries removed.)
The decision to have risk-reducing surgery is difficult and very personal. I've had patients with BRCA mutations who are diagnosed with DCIS (ductal carcinoma in situ, an early, noninvasive form of cancer) and say, "That's it, I want them both off." I've had women in their 50s tell me that they've gotten this far and been all right, so they don't want to do any more.
It's not the sort of thing you do without a lot of talking and thinking. If a woman wants surgery, I ask her if she'll be upset if she doesn't get a good cosmetic result from reconstructive surgery.
If she says she doesn't care, that the most important thing to her is the breast tissue being completely gone, then I know she's ready.
What if you don't have a genetic risk?
Every woman has some risk of developing breast cancer. However, breast cancer is a collection of many diseases, ranging from those that are slow growing and unlikely to ever cause harm, to those that are aggressive and life-threatening.
We do not treat them the same way. Our next challenge is to learn how to tailor screening and prevention strategies to different women depending on their family and medical history.
In the meantime, there are things you can do right now to help lower your risk of developing breast cancer, whether or not you're a mutation carrier.
Exercising, maintaining your body weight in the normal range and eating a healthy diet (low in animal fats) all improve both your breast and overall health. Be familiar with your body, too, and if you find a new mass, let your doctor know immediately.
If you have one or more risk factors -- a previous abnormal biopsy, any type of family history, early-age onset of periods, late or no child bearing, or extremely dense breast tissue -- talk to your doctor about whether you're a candidate for drugs such as tamoxifen or raloxifene, which are FDA-approved for breast cancer prevention.
Also, avoid hormone replacement therapy after menopause, keep alcohol intake low and, if you need to take medication for osteopenia or osteoporosis, consider raloxifene, which can also lower breast cancer risk.
It's easy to hear about a celebrity like Jolie and panic, but I'll share with you what I tell patients every day: While all women are at risk for breast cancer, most of us won't get it.