Tobacco is even more dangerous than doctors have known. A new report says smoking causes disease in almost every organ in the body. The report is from the top government doctor in the United States, Surgeon General Richard Carmona.

The Office of the Surgeon General released its first report about smoking and health forty years ago. In nineteen-sixty-four, the surgeon general announced research establishing that smoking caused several diseases. These included cancer of the lungs and voice box.

Later studies found that smoking causes other kinds of cancer and disease. Research also showed that cigarettes harm the babies of women who smoke.

The newest report expands the list of conditions caused by smoking. New ones added include leukemia（白血病）, cataracts（白內障）and pneumonia. Smoking is now also known to cause cancers of the cervix（頸部）, kidneys, pancreas（胰腺）and stomach.

Health officials say smoking is the leading preventable cause of death and disease. An estimated four-hundred-forty-thousand Americans per year die of smoking-related diseases. The report says more than twelve-million have died since the first report forty years ago. Research has shown that the poorest and least educated are the ones most likely to smoke.

The new report says that on average, smokers die thirteen to fourteen years before non-smokers. Smoking also harms others who have to breathe around a smoker, such as children at home. And it causes economic harm, including high medical costs and lost productivity.

Some gains have been made. In nineteen-sixty-five, about forty-two percent of adults in the United States smoked. Now the estimate is about twenty-two percent. The government wants to reduce that to twelve percent by two-thousand-ten. But the report says rates of reduction among adults and young people have slowed.

Public health groups say federal and state officials need to take stronger action. Congress is considering legislation to give the Food and Drug Administration control over cigarettes.

Some are called "light" or "low tar." But Doctor Carmona says these are no healthier. He says there is no safe cigarette. The only good news for smokers in the surgeon general's report is that their health begins to improve immediately after they stop.

This VOA Special English Health Report was written by Cynthia Kirk.