Ever since the Surgeon General first issued the seminal report about the negative health effects of smoking 50 years ago, the number of smokers has fallen significantly.

Nonetheless, current lung cancer rates are a testament to the pervasiveness of enduring misconceptions about tobacco, according to the experts at the University of Texas MD Anderson Cancer Center.

“Since 1964, smoking rates have dropped by more than half as a result of successful education, legislative, and smoking cessation efforts,” said Lewis Foxhall, vice president for health policy at MD Anderson. “Still, lung cancer remains the number one cancer killer and the leading preventable cause of death in the United States.”

Each year, more than 200,000 people are diagnosed with lung cancer and 150,000 people die as a result of this disease. Smoking is culpable for 90 percent of lung cancer deaths and 30 percent of all cancer deaths.

Addressing these discouraging stats on the 50th anniversary of the federal health warning, Foxhall and colleagues took it upon themselves to dispel the tobacco myths that make smoking an enduring habit.

Myth #1: A lot less people smoke now than back in the old days

Perhaps the viscerally disturbing commercials of former smokers, stricter anti-smoking laws, and hefty taxes on a pack of smokes have dissuaded many from smoking, in contrast to classic Hollywood movies that depicted the habit as charming. But 43.8 million – one in five – people in the United States still smoke.

“The current percentage of smokers is 19 percent. That’s significantly lower than the 42 percent in 1965,” Foxhall said. “However, the actual number of people smoking today is close to the same.”

That’s because of population growth, Foxall explained. Approximately 50 million people smoked in 1965, which was then a much larger portion of the population.

Myth #2: Smoking alternatives like e-Cigarettes, cigars and hookahs are less harmful

More smokers are turning to other supposedly less harmful smoking alternatives, such as e-cigarettes. Jenny McCarthy was recently tapped to be part of Blu e-cigarettes advertising campaign. In response, Freedom Laser Therapy, a company that promotes a nicotine free way to quit smoking, is offering the celebrity $1 million to drop the ads. The company argues that e-cigarrette gadgets are ultimately unhealthy because they keep people hooked to nicotine.

The five largest cigarette companies spent $9.94 billion in advertising and marketing in 2008 alone, a large portion of which is for promoting smoking alternatives.

“The tobacco industry comes up with these new products to recruit new, younger smokers,” said Alexander Prokhorov, director of the Tobacco Outreach Education Program at MD Anderson. “And, they advertise them as less harmful than conventional cigarettes. But once a young person gets acquainted with nicotine, it’s more likely he or she will try other tobacco products.”

“While e-cigarettes may contain less harmful substances than combustible tobacco, they’re presently unregulated so quality control over the nicotine content and other components is left to the manufacturer,” said Paul Cinciripini, professor and deputy chair of behavioral science and director of the Tobacco Treatment Program at MD Anderson. “At this time, it’s far too early to tell whether or not e-cigarettes can be used effectively as a smoking cessation device."

Myth #3: Social smoking every now and then isn’t a big deal

David Wetter, chair of health disparities research at MD Anderson, wants to see the numbers that support that notion — if any exist. “Science has not identified a safe level of smoking, and even a few cigarettes here and there can maintain addiction,” he said. “If you are a former smoker, data suggests that having just a single puff can send you back to smoking.”

Myth #4: Secondhand smoke isn’t an issue outdoors

Perhaps a more open space allows for smoke to dissipate more effectively, but that doesn't override the fact that secondhand smoke exposure even at lower concentrations still poses health risks. In fact, exposure to secondhand smoke generally increases a person’s risk of heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. Furthermore, secondhand smoke packs a nastier punch by having higher levels of cancer-causing chemicals.

Altogether, the doctors conclude, the 50th anniversary of the Surgeon General warning should make us contemplate why the health care costs of smoking reach $96 billion every year while spending on tobacco advertising is $8 billion, more than advertising expenditure of fast food chains, wireless phone companies, and the pharmaceutical industry, combined.