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Office of the Surgeon General (US); Office on Smoking and Health (US). The Health Consequences of Smoking: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2004.

Cover of The Health Consequences of Smoking

The Health Consequences of Smoking: A Report of the Surgeon General.

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This new report of the Surgeon General on the health effects of smoking provides a startling picture of the damage to health caused by tobacco use. Smoking injures almost all bodily organs, and tragically this injury often leads to incurable disease and death. The comprehensive review process that is the foundation of this series of reports has found new causal associations of smoking with disease, reemphasizing the need for continued monitoring of scientific evidence on the health effects of smoking. This report also addresses changes in the cigarette and whether these changes present increased risks to smokers.

With this latest report, the format has been updated. The core of previous reports has always been the evaluation of the evidence, with general summaries of the evidence relevant to a particular disease or an adverse effect presented in various tables. These tables have been the basis for assessing the scope and consistency of the evidence and for assessing the presence of critical indicators of causality, including the findings of a dose-response relationship and a decline in risk following cessation. The printed format of these tables is supplemented with a new and dynamic database that includes the results of key studies in a format accessible through the World Wide Web, enabling readers to access additional tables and figures. The Office on Smoking and Health at the Centers for Disease Control and Prevention will maintain the database, selectively adding new critical studies as they are published. The scope of the literature is so broad that not all studies can be entered, but this new format offers a useful complement to the Smoking and Health Database that is already maintained by the Office on Smoking and Health and is readily available at

I am grateful to the leadership from the Office on Smoking and Health in preparing this report and to the Surgeon General for his guidance. These reports would not be possible without the contributions of many scientists from throughout the world who wrote and reviewed this volume. These reports remain a cornerstone of our nation’s strategy to combat the ongoing epidemic of tobacco-related disease and death.

Julie Louise Gerberding, M.D., M.P.H.


Centers for Disease Control and Prevention



Agency for Toxic Substances and Disease Registry

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