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A new report by the U.S. surgeon general greatly broadens the list of disease evils linked to cigarettes and concludes that urgent, aggressive action is needed to further reduce smoking rates and save lives. The report, released Friday, recommends prevention efforts that especially target groups most vulnerable to smoking, including low-income Americans and ethnic minorities and youth.

If smoking rates persist unchanged, 5.6 million American children alive today will die prematurely because of smoking, the report finds. It pegs the economic costs of smoking at $289 billion a year or more in medical care and productivity losses.

“We need an all-hands-on-deck approach,”said Health and Human Services Secretary Kathleen Sebelius Friday at a White House event to mark the report’s publication. She urged local elected officials, the medical community, faith leaders and society as a whole to intensify efforts to end the “tobacco epidemic.”

“It’s time to take these efforts to the next level,” she said. That includes the Obama administration’s proposed $0.94 increase in the federal excise tax of $1.01 per pack of cigarettes, which Sebelius highlighted Friday.

The 980-page, research-based document aims to capture public attention — and change public behavior — in the same way as the landmark 1964 surgeon general’s report that officially linked tobacco with lung cancer and heart disease for the first time. It blames cigarette smoking for a host of ills, saying smoking can cause liver and colorectal cancer, diabetes, rheumatoid arthritis, impaired immune function, ectopic pregnancy and erectile dysfunction.

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