Smoking and the Lost Legacy of the First Surgeon General’s Report on Smoking and Health

On January 11, 1964 Surgeon General Luther L. Terry, MD, the ninth Surgeon General of the United States, made a bold announcement to a roomful of reporters: “Cigarette smoking causes lung cancer and probably heart disease, and the government should do something about it.”

At the press conference in 1964, Terry, himself a longtime smoker, unveiled the first report on Smoking and Health: Report of the Advisory Committee of the Surgeon General of the Public Health Service.

In the years since the first unveiling, 31 other reports have presented facts about the hazards of smoking and tobacco use. It is said that these reports and the tobacco control initiatives that were conceived as a result of it, have saved more than 8 million lives in the past 50 years. [1][2][3][4]

More symbol than substance
But as the nation is prepares to commemorate the 50th anniversary of the release of the Surgeon General’s report, a veteran anti-smoking strategist argues in a provocative new documentary released?earlier this month that efforts to reduce smoking have become more symbol than substance.

In this documentary — called Blowing Smoke: The Lost Legacy of the Surgeon General?s Report – Alan Blum, MD, director of The University of Alabama Center for the Study of Tobacco and Society, chronicles the fear, foot-dragging, and squandering of funds on the part of public health agencies, universities, and organized medicine alike in ending the smoking pandemic.?

In the original report, Surgeon General Luther L. Terry declared that Cigarette smoking is causally related to lung cancer in men and is a health hazard of sufficient importance to warrant appropriate remedial action.

While ‘appropriate remedial action in the form of tobacco control initiatives have helped, Blum, noted that such action have been far too little and late because of the failure for decades to confront and outsmart the tobacco industry. Surgeon General Terry’s indictment of cigarettes in 1964 should have marked the beginning of the end of the Marlboro Man, Blum said. Yet far from riding off into the sunset, the tobacco industry is riding high in the saddle.[5]

Record profits
Remarkably, Blum points to the record profits of companies?like Altria Group Inc, the publicly-held holding company of Philip Morris, Inc, the nation?s leading cigarette maker and manufacturer of Marlboro. Blum also refers to Altria’s efforts in recruiting students as the?the new (“young”) sales force of Marlboro on more that 30 university campuses around the United States (“We’re looking for people who can handle the responsibility of marketing a product that can cause harm?”) and the significant investment in Altria by TIAA-CREF and other major pension funds. Furthermore, Blum?shows that although the percentage of American adults who smoke has declined to 20%, the actual number of people who continue smoking cigarettes ?estimated at 45 million?is nearly the same as in 1964.[5][6][7]

Missed opportunities
Commenting on the 50th anniversary of the first Surgeon General’s report, Blum said: “It’s hardly a time for celebration, rather, it should be a sobering reminder of the missed opportunities to reduce demand for cigarettes, which remain the nation?s number one avoidable cause of cancer, heart disease, emphysema, and high health costs. That nearly all government funding allocated to fight smoking is spent on research that adds very little to what we have known since 1964 is disgraceful. It suggests that the most addictive thing about tobacco today is money.

The real lost legacy is that each year more that 400,000 people die of the serious adverse effects of smoking.

For more information:
[1] Smoking and Health: Report of the Advisory Committee of the Surgeon General of the Public Health Service.
[2] Tobacco Control in the United States Has Saved 8 Million Lives In Last 50 Years – Onco’Zine – The International Oncology Network, January 10, 2014
[3] Holford TR, Meza R, Warner KE, Meernik C, Jeon J, Moolgavkar SH, Levy DT.Tobacco control and the reduction in smoking-related premature deaths in the United States, 1964-2012. JAMA. 2014 Jan 8;311(2):164-71. doi: 10.1001/jama.2013.285112.[Article][PubMed]
[4] Smoking: A health hazard of sufficient importance – The First Surgeon General Report
[5] Cole HM, Fiore MC. The war against tobacco: 50 years and counting. JAMA. 2014 Jan 8;311(2):131-2. doi: 10.1001/jama.2013.280767.[Article][PubMed]
[6] Tobacco Companies are Finally Moving Closer to Revealing the Truth about Smoking – 50 Years After First Surgeon General Report.
[7] The Harmful Effects of Smoking Public: The Public Denial in the Early-mid 1960s.

Blowing Smoke: The Lost Legacy of the Surgeon General’s Report,?was produced by Alan Blum, MD, Professor, and Gerald Leon Wallace, MD, Endowed Chair in Family Medicine and Director, The University of Alabama Center for the Study of Tobacco and Society College of Community Health Sciences, in Tuscaloosa, Alabama, USA.