WASHINGTON - Think the occasional cigarette won't hurt? Even social smoking - or inhaling someone else's secondhand smoke - could be enough to block your arteries and trigger a heart attack, says the newest surgeon general's report on the killer the nation just can't kick.

Lung cancer is what people usually fear from smoking, and yes, that can take years to strike. But Thursday's report says that tobacco smoke begins poisoning immediately - as more than 7,000 chemicals in each puff rapidly spread through the body to cause cellular damage in nearly every organ.

"That one puff . . . could be the one that causes your heart attack," said Surgeon General Regina Benjamin.

Or the one that triggers someone else's: "I advise people to try to avoid being around smoking any way that you can," she said.

About 443,000 Americans die from tobacco-caused illnesses every year. While the smoking rate has dropped dramatically since 1964, when the first surgeon general's report declared tobacco deadly, progress has stalled in the past decade. About 46 million adults - one in five - still smoke, and tens of millions more are regularly exposed to secondhand smoke. The government had hoped to drop the smoking rate to 12 percent by this year, a goal not only missed but that's now been put off to 2020.

Thursday's report is the 30th issued by the nation's surgeons general to warn the public about tobacco's risks.

"How many reports more does Congress need to have to say that cigarettes as a class of products ought to be banned?" asked well-known nicotine expert K. Michael Cummings of the Roswell Park Cancer Institute, who helped to review the report. "One-third of the patients who are in our hospital are here today because of cigarettes."

This newest report devotes more than 700 pages to detail the biology of how cigarette smoke accomplishes its dirty deeds.