“Enough is enough,” said acting Surgeon General, Dr. Boris Lushniak, at a press conference in Washington, as he repeatedly emphasized the need to push for a tobacco-free future. Lushniak along with a few notable members of the White House released the 32nd Surgeon General's Report on smoking and health, "The Health Consequences of Smoking — 50 Years of Progress," in honor of the 50th anniversary of the Surgeon General's first warning that linked smoking to poor health. The new report lists new health risks, such as rheumatoid arthritis and type 2 diabetes, as tobacco use-related health risks.

"The real emphasis needs to be put on the fact that we still have a major and tragic catastrophe going on," Lushniak said.

In fact, more than 20 million Americans have died because of smoking since 1964. And now, new information in the 980-page booklet has evidence proving that "active smoking" is a root of other illnesses including: age-related macular degeneration, diabetes, colorectal cancer, liver cancer, adverse health outcomes in cancer patients and survivors, tuberculosis, erectile dysfunction, orofacial clefts in infants, ectopic pregnancy, rheumatoid arthritis, inflammation, and impaired immune function. The report also states that exposure to secondhand smoke "has now been causally associated with an increased risk for stroke." This is not the first time that the list of smoking-related illnesses was amended. In 1990, bladder cancer was added, and in 2004 cervical cancer also made the list.

While many of the deadly findings might be the same, the number of sickness and fatalities as a result of tobacco use has not dropped. Each year, tobacco use leads to approximately 500,000 deaths in the United States and 5 million deaths worldwide, according to the report. The first Surgeon General’s warning was issued on Jan. 11, 1964 by General Luther L. Terry, and since then, the amount of evidence and findings against smoking has snowballed.

In 2014, tobacco remains the leading preventable cause of disease and death in this country, the Food and Drug Administration noted in a press release. For the last five decades, many efforts have been made to educate people, especially the youth of America in order to prevent a rise in this epidemic.

Moreover, smoking also can burns holes in medical costs. The report estimates that it can add up to $130 billion per year in medical spending and $150 billion in productivity losses from premature deaths.

The alleged culprit? The tobacco industry advertisements, according to Cecilia Muñoz, assistant to President Obama and director of the Domestic Policy Council. There is an 18:1 ratio of advertising funds that tobacco industry spends on as compared to anti-smoking state initiatives, she said in the press conference.

The report also found that developing lung cancer is higher today than it was in the past even though smokers in 1965 made up 43 percent of the population, and today they make up 18 percent. Changes in the cigarette filter might be to blame.

Over the past few years, taxes have increased on cigarettes. This year Oregon saw a 13 cent increase, raising the total tax per box to $1.31. Other states, including New York, have taxes upward of $4 per box. The aim of these increases is to dissuade people from buying cigarettes, but oftentime, even with the hike, many folks continue to light up.

If things continue to go as they have been, 5.6 million teens and young adults will be victims to premature deaths during their adulthood. Anti-smoking advocates are still positive and hopeful for their campaigns. “We know so much more about how tobacco is killing people,” Lushniak said. And the hope of many White House officials is to educate the masses, especially the youth of our country. Graphic television advertisements and posters have a made a splash around the country, and budget allowances for anti-smoking campaigns have been made.

“It’s a winnable fight,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids. “We actually have the policies and programs to end the tobacco epidemic, and they don’t cost so much [that] they can’t be implemented quickly.”