This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

In response to rapidly accumulating evidence that environmental tobacco smoke (ETS) exposure causes disease beyond lung cancer & respiratory effects in children, the Calif. Environmental Protection Agency undertook a comprehensive assessment of the total range of health effects correlated with exposure to ETS. Chapters: impact of ETS on the health of Californians; exposure measurement & prevalence; developmental toxicity I: perinatal manifestations; developmental toxicity II: postnatal manifestations; reproductive effects; respiratory health effects; carcinogenic effects; & cardiovascular effects. Dozens of tables & figures.

The second report from the U.S. Surgeon General devoted to women and smoking. Includes executive summary, chapter conclusions, full text chapters, and references.

The World Health Organization has identified chronic alcohol consumption as one of the top ten risk factors for worldwide burden of disease. The International Agency for Research on Cancer has identified alcohol as carcinogenic to humans, including cancers of the upper aerodigestive tract, colon, liver and breast. Alcohol’s actions may be direct e.g. effects on retinoic acid and one-carbon metabolism, or indirect, through metabolites such as acetaldehyde and reactive oxygen species or through various signaling pathways that influence cell cycle and apoptosis that may contribute to carcinogenesis. This report reviews the state of the art in alcohol-related cancer research in ten chapters.

Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine. At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.