The Great American and Polish Smokeouts, efforts to combat growing health disparities in the tobacco epidemic, and sustaining efforts to end combustible tobacco use.

In the 50 years following the 1964 Surgeon General’s Report, public health efforts averted an estimated 8 million deaths in the United States that otherwise would have resulted from cigarette smoking. Since 1976, the American Cancer Society has hosted the Great American Smokeout, an annual public awareness event to encourage people to quit smoking. The Smokeout has inspired similar initiatives around the world. Notably, the Great Polish Smokeout, known locally as “Quit Smoking with Us” (Rzuć palenie razem z nami), underpinned the Poles’ turnaround from the world’s top smokers to one of the leaders in European tobacco control.

The Great American Smokeout now emphasizes the increasingly disparate nature of the problem, focusing attention on smoking in certain at-risk and frequently overlapping populations, including: individuals with less education; individuals living in poverty; members of certain racial/ethnic groups; individuals experiencing mental illness and/or substance abuse; individuals of certain sexual orientation; and members of the military. In Poland, smoking prevalence is now substantially higher among less educated inhabitants of smaller towns and rural areas. Smoking rates among young adult men and women have converged; among teenage girls they are in fact slightly higher than among teenage boys. The disparate nature of the tobacco epidemic in both countries underscores the need for approaches specifically geared toward at-risk populations in order to reduce health disparities.

The tobacco marketplace has also grown increasingly complex with the advent of e-cigarettes. In the U.S. and Poland, e-cigarette manufacturers have effectively marketed e-cigarettes to youth and young adults, causing rapid increases in vaping and spurring policy responses.

Health authorities should base policy action on the best available scientific evidence, recognizing the overwhelming impact of combustible cigarette smoking on public health, which too often fails to receive the level of attention that the leading cause of preventable death deserves.