among health-care providers as to whether it truly
lowers the risk for bacterial endocarditis. However,
the American Heart Association, the American
Dental Association, the Infectious Diseases Society
of America, the American Academy of Pediatrics,
and the American Society for Gastrointestinal
Endoscopy jointly recommend antibiotic prophy-
laxis in specific circumstances.
See also IMMUNODEFICIENCY; VALVULAR HEART DIS-
EASE.
antismoking efforts The US health community
has targeted cigarette smoking since the landmark
1964 surgeon general’s report, Smoking and Health:
Report of the Advisory Committee to the Surgeon Gen-
eral of the Public Health Service, formally identified
the connections between smoking and health con-
ditions such as LUNG CANCER, laryngeal CANCER, and
chronic BRONCHITIS. A single sentence from the
387-page document summarized what was to
become a major preventive health emphasis in the
United States for the ensuing decades: “Cigarette
smoking is a health hazard of sufficient impor-
tance in the United States to warrant appropriate
remedial action.”
At the time of the 1964 surgeon general’s
report, 70 million Americans were smokers. The
US Centers for Disease Control and Prevention
(CDC) reports the number of current smokers
remains fairly stable at about 46.2 million, 8.6
million of them becoming ill as a result each year.
Health experts project that more than half of peo-
ple who continue to smoke, about 25 million, will
die of smoking-related diseases. Antismoking
efforts have a two-prong focus:
- Encourage people never to start smoking.
- Encourage people who do smoke to stop, no
matter how long they have been smoking.
These efforts emphasize coordinated educa-
tional approaches among schools, youth organiza-
tions, community organizations, sports and
athletic organizations, and health-care providers.
As well, a number of class-action lawsuits against
TOBACCOcompanies have forced payments from
them to fund health care for smoking-related
chronic illnesses and antismoking efforts. General
practice guidelines for physicians include screen-
ing for tobacco use and recommendation of SMOK-
ING CESSATIONmethods for people who do smoke.KEY ANTISMOKING EFFORTS- intensive education of youth through the schools, advertis-
ing, community programs, celebrity advocates, and other
targeted approaches - effective and accessible SMOKING CESSATIONmethods
- strong warning labels on cigarette packages
- stringent enforcement of age-restricted access to TOBACCO
products - prohibition of smoking in the workplace, public buildings
and venues, and other indoor locations
The 1964 report that first linked cigarettes and
cancer and subsequent surgeon general’s reports
on smoking and health are available on the CDC’s
Web site (www.cdc.gov/tobacco/sgr/index.htm).
See also CANCER PREVENTION; LIFESTYLE AND
HEALTH; SMOKING AND CANCER; SMOKING AND CARDIO-
VASCULAR DISEASE; SMOKING AND HEALTH; TOBACCO USE
OTHER THAN SMOKING.8 Preventive Medicine