Smoking and Health at 50: A Public Health Milestone

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EBRC takes a special look at Smoking and Health, the 1964 report to the Surgeon General that forever changed how this country thought about cigarettes, on the eve of its 50th anniversary.


Smoking and Health at 50: A Public Health Milestone

Evidence-Based Respiratory Care Traces the Surgeon General’s Fight Against Tobacco, as New Data Show the Efforts are Saving Lives

PLAINSBORO, N.J. — Tomorrow, America will mark milestone in public health: The 50th anniversary of the release of Smoking and Health, the 1964 report to the Surgeon General that forever changed how this country thought about cigarettes.


A feature in the inaugural issue of Evidence-Based Respiratory Care, the third publication in The American Journal of Managed Care’s “Evidence-Based” series, traces the history of America’s relationship with cigarette smoking and shows how science ultimately prevailed despite enormous pressure from the tobacco industry. As EBRC reports, the announcement on January 11, 1964, from then-U.S. Surgeon General Luther E. Terry that cigarette smoking causes lung cancer in men and probably women, and is among the causes of chronic bronchitis, “resounded like a voice from the sky.”

EBRC’s story, “Smoking and Health Turns 50: From Scientific Triumph to Public Health Success Story,” features an interview with Don Shopland, who was a young federal employee barely out of high school when he was assigned to assist the Advisory Committee to the Surgeon General, which had been appointed in 1963 by President Kennedy’s Administration. Shopland’s account of the intense secrecy surrounding the report, given the role of tobacco in the culture during the 1960s, is must-reading for all interested in the role of epidemiology and public health. For the full story, click here.

As Tom Glynn of the American Cancer Society told EBRC, the place that cigarettes once held in American culture is unimaginable to today’s youth. “Most people don’t remember, but if you sat in a movie theater, people smoked next to you. People smoked on airplanes; homes were filled with smoke,” said Glynn, 66, who grew up in a smoke-filled apartment in New York City with two smoking parents and a grandfather who puffed a pipe.

EBRC also explores the complicated relationship over a 20-year period between tobacco companies and the American Medical Association, and, in particular, the Journal of the American Medical Association, which relied heavily on tobacco advertising in the lean years of the Depression and World War II.

Data released in the Annual Report to the Nation on the Status of Cancer reveal that the long road to curbing cigarette smoking is saving lives. According to the report, the death rate from lung cancer, which accounts for more than 25 percent of cancer deaths, has been rapidly declining over the years, likely due to the reduced prevalence of smoking. Men presented a 1.9 percent per year reduction in deaths from lung cancer during 1993-2005, which further declined by 2.9 percent from 2005-2010. A similar trend was observed in women; a 1.4 percent decline during 2004-2010, which was a sharp turnaround from the 0.3 percent increase in death rate observed during 1995-2004.

“We went from 42 percent of the population then (smoking) to 19 percent now,” said Glynn, of ACS. “That is a huge public health success. Probably between 8 and 12 million lives have been saved since the publication of that report, but we still have 44 million people smoking, even though 70 percent of them say they want to stop. Our work remains to get people to stop smoking, period. I know that sounds obvious, but that’s the work, still.’’

Indeed, the ACS reports that despite the encouraging decline in lung cancer deaths, the disease remains a leading cause of death among both men and women.

EBRC’s special report is accompanied by an article by Brenda Schmidt, president and CEO of Viridian Health Management, on the return-on-investment that smoking cessation programs can yield for employers. A final piece looks at “next generation” smoking regulations in public housing, which are popping up where smoking bans began — in Berkeley, Calif.

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