Prevalence, economic, and medical impact of tobacco smoking.

Objective: The goal of this review is to report the epidemiology and risks associated with tobacco smoking. It also suggests reasons and measures to achieve a smoke-free society.

Data sources: References are limited to the English language and human subjects. All are publications from either the United States or the United Kingdom and extend back to the past 50 years. Sources include computerized databases and bibliographies of recent articles and books.

Study selection: Papers were selected on the basis of their timeliness, credibility of their data, explanation of important findings, extrapolation of clinical data from large patient populations, and clarification of controversial issues. Approximately 60% of the articles initially reviewed are included in the bibliography.

Results: Tobacco smoking continues to affect the lives of millions of Americans. The risks of cardiovascular diseases, cancer, and respiratory diseases are significantly increased in both the smoker and in those exposed to environmental tobacco smoke.

Conclusions: Understanding the consequences of tobacco smoking is necessary to effectively mobilize the appropriate political, social, and medical resources to combat this most important health issue.