Fifty years after first surgeon general’s report on tobacco and cancer, new evidence points to the overall effects of smoking on the body.

In January 1964, Luther Terry, the ninth Surgeon General of the United States, released a report citing scientific evidence that smoking causes cancer.

While that information is now common knowledge, at the time of the report smoking was allowed nearly everywhere, including hospitals. Tobacco company ads contained endorsements from doctors, celebrities—including future U.S. President Ronald Reagan—and cartoon characters. About 42 percent of all adults in the U.S. smoked at the time.

But that Surgeon General’s report began the transformation of U.S. tobacco laws and changed the health of a nation. An estimated 18 percent of adults in the U.S. currently smoke, according to the latest numbers from the U.S. Centers for Disease Control and Prevention.

Now, though the U.S. is filled with a lot less tobacco smoke, acting Surgeon General Dr. Boris Lushniak says the air still needs more clearing. His office this week released a 900-page report on the dangers of tobacco.

“It is my sincere hope that 50 years from now we won’t need another Surgeon General’s report on smoking and health because tobacco-related disease and death will be a thing of the past. Working together, we can make that vision a reality,” Lushniak wrote in the report’s introduction.

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Along with releasing the latest data about the health risks of smoking, the Surgeon General also scolded tobacco companies for “fraudulent practices” and Hollywood for allowing for the reemergence of smoking in movies and television.

Earlier this week, two tobacco companies, Altria Group Inc. and Reynolds American Group, entered into an agreement with the U.S. government to publicly admit that they deceived Americans about the dangers of smoking, according to Businessweek.

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Since the first Surgeon General’s report 50 years ago, tobacco has killed more than 20 million people prematurely, according to government estimates.

The latest report includes information about all the other ills tobacco use can cause, far beyond lung cancer and heart attacks. It reinforces scientific data that shows smoking’s systemic effects on the body, from oral cancer to impotence.

The report states that smoking can increase a person’s risk of diabetes, arthritis, colorectal cancer, liver cancer, breast cancer, and other life-threatening conditions. The report also states that women’s risk of dying of lung cancer is now on par with men’s.

Repeated exposure to secondhand smoke is also linked to higher rates of stroke among nonsmokers, the report states.

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Dr. Richard Carmona, the 17th Surgeon General of the United States, also warned the U.S. about the dangers of smoking in his report 12 years ago.

“I am elated that the Office of the Surgeon continues its exceptional 50 year history of serving the public by advancing the best science to protect the public’s health,” he told Healthline. “Tobacco remains the biggest cause of death, disease, and health-related economic burden in our nation. Therefore, we must do all possible to improve the health literacy of the nation so we may eradicate all tobacco use.”

Carmona’s landmark report in 2006 showed that secondhand smoke increased a nonsmoker’s risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. He later testified before Congress that his findings and research were “watered down” to fit the Bush Administration’s political agenda.

Carmona was the first surgeon general to support the complete ban of tobacco products across the country.

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Disclosure Statement: Dr. Carmona serves on the Board of Directors for Healtline Networks.