In 1988, then American Surgeon General C. Everett Koop called for a Smoke-Free class of 2000. An ambitious project began with grade 1 classes and the hope that by the time the students graduated in the year 2000, they would graduate as non-smokers. Since by 1988 the dangers of smoking were well known, this project was supported by the American Cancer Society, the American Heart Association, and the American Lung Association. Sadly, even in 2010 young people continue to start smoking. Recent genomic studies reveal extremely strong evidence why this is a very bad decision.

In a paper published in the Journal of the National Cancer Institute, A.W. Bergen and N. Caporaso state that “Cigarette smoking is the largest preventable risk factor for morbidity and mortality in developed countries”.

There is some indication based on twin studies that there may be genetic factors explaining vulnerability to the smoking habit. M.D. Li in a review of the genetics of smoking reported that there could be up to 15 genes related to susceptibility to smoking and substance abuse. However, an extensive genome-wide association study (GWAS) did not identify specific candidate regions that achieved the genome-wide threshold of statistical significance. The investigators headed by Neil Caporaso did, however, indicate that there were some candidate genes for follow-up studies. Besides genetic factors, there are strong indications of socio-economic links to smoking, including lower income, reduced educational achievement, and disadvantaged neighbourhood environment.

Recent news comes through the Southwest Foundation for Biomedical Research (SFBR) that Smoking has significant influence on our genes and how they function. This study reveals that smoking leads to wide-ranging negative influence on the immune system, and a strong involvement in processes related to cancer, cell death and metabolism. In a paper published in BRC Medical Genomics, the researchers led by Jac C. Charlesworth, reveal that as many as 323 unique genes showed significant changes in expression correlated to smoking. Many of these genes correspond with known smoking-related pathologies, including immune response, cell death, cancer, natural killer cell signalling and xenobiotic metabolism (metabolism of substances not considered part of the normal biochemistry of the cell such as poisons or drugs). The study concludes that smoking not only leads to a change in individual gene behaviour, but also to entire networks of gene interaction.

We are now 10 years past the year 2000, and 22 years beyond the initial date when the American Surgeon General called for a smoke-free graduating class. The scientific evidence supporting a smoke-free lifestyle seems overwhelming. It is time for very strong action by parents, educators and legislators to succeed in creating a smoke-free society.