The latest Surgeon General’s Report on the health effects of smoking offers even more evidence of just how much harm tobacco is causing. Researchers keep finding new and insidious ways in which smoking is harming the smokers themselves and nonsmokers who breathe in toxic fumes.

The 2014 report  finds that cigarette smoking kills even more Americans than previously estimated (about 480,000 a year, up from 443,000), and is a cause, though not necessarily the major cause, of even more diseases than previously recognized, including liver and colon and rectal cancers. These add to the long list of other cancers caused by smoking, as well as rheumatoid arthritis and other ailments. The report newly identifies exposure to secondhand smoke as a cause of strokes.

Most shocking, the report finds that today’s smokers have a much higher risk for lung cancer and chronic obstructive pulmonary disease than smokers in 1964, despite smoking fewer cigarettes.

It reports that the risk of developing cancer of the lung has increased substantially over the past several decades because of changes in the design and composition of cigarettes. These include ventilated filters that lead to more puffing of noxious materials and blended tobaccos that contain carcinogenic substances.

It is sad that the tobacco industry aggressively markets and promotes lethal and addictive products and continues to recruit youth and young adults as new customers. If you know anyone who smokes, please share this article with them. Yes, it's even worse than we thought.