Surgeon General's Report on Smoking Turns 40

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This week marks the fortieth anniversary of the first time the U.S. government declared smoking a serious danger to health, the Surgeon General's Report on Smoking and Health, published January 11, 1964. With evidence of over 7,000 biomedical research articles on the topic, the committee of the Surgeon General declared, "Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action."

The Surgeon General's report made clear the connection between smoking cigarettes and mortality. From the studies used it found that the death rate among smokers for all causes was significantly higher than nonsmokers: for those who smoked 10-19 cigarettes a day, the death rate was 70% higher than nonsmokers, and it increased with the number of cigarettes smoked (the picture has gotten still worse as we've learned more in the years since). The report definitively acknowledged that cigarette smoking is a significant cause of chronic bronchitis, emphysema, heart disease, low birth weight, and of course lung cancer. It was the lead story in the news across the country, and within three months of its release cigarette consumption dropped by 20%.

Following the initial report, in 1965 Congress passed the Federal Cigarette Labeling and Advertising Act, which required the Surgeon General's Cigarette Warning Label, variations of which we see on cigarette packs today. The Cigarette Act of 1969 banned all cigarette advertising from TV and radio. And in 1988, declaring it an addictive drug, Surgeon General C. Everett Koop likened nicotine to cocaine and heroin. Ten years later in 1998, in the Master Settlement Agreement with forty-six U.S. states, major tobacco companies agreed to take measures restricting advertising to kids (banning the use of cartoon characters in advertising and promotion by cigarette companies of heavily youth-oriented events) and agreed to pay $200 billion dollars over several decades to be used for anti-smoking campaigns.

Since the Surgeons General's first report on Smoking and Health, the percentage of Americans that smoke has decreased from roughly 50% in 1964 to around 20% today. Still, we have a long way to go. More than 46 million people in America smoke. Every year 8.6 million become ill and 440, 000 die from smoking-related illnesses. Of all public health topics consumers fret over, from trans fats and "toxic" chemicals to the debates over organic vs. processed foods, mad cow disease, and SARs, there is still no greater preventable cause of death and disease than smoking.

Kim Bowman is a research intern at the American Council on Science and Health. ACSH has released a guide to Cigarettes: What the Warning Label Doesn't Tell You in versions for adults and teens. With luck, rising awareness of cigarettes' dangers will mean fewer letters like the one we received from a reader of this site who claims to be a cigarette-addicted teen.


January 26, 2004

To whom it may concern:

I am forty-eight years old and I smoke. I completely agree that cigarette smoking is not good at all, but why is it that every time a person tries to look up a means of quitting, it ends up being something you have to buy? Sounds like everybody has an opinion, just not for free!

I have tried to quit several times. I only end up gaining twenty pounds. At my age, it is as hard to lose pounds as it is to quit smoking. Which do you think is worse, being 50+ pounds overweight or smoking? Neither one is healthy, but like I said, at my age it's not that easy.

When I started smoking, no one said it was bad for you. You could smoke anywhere, including the doctor's office! Sometimes even the doctor smoked! On top of everything else, if you're a woman (which I am) and a short one at that, you have more problems being overweight than you do smoking. Let's face it, the world is not ready for short, overweight women in the workforce or anywhere else! The only place I feel comfortable is at home and church. Of which neither pays cash for your work.

So what am I saying? Why don't you and everybody else that has opinions, suggestions, warnings, help, or anything else you can think of offer them completey free and without obligation?! I can tell you now, raising the price of tobacco in all forms is not going to make or help us quit. What we need is real help free of charge. After all, I do think the government and the doctors and the tobacco companies owe us that much for not telling us the truth way back when!



ACSH replies:

Your dilemma is, unfortunately, all too common, and we empathize with your problems of trying to lose weight and quit smoking. We believe, based on the scientific evidence, that smoking is actually more risky than being overweight, in general.

Many states have QuitSmoking programs at very low or no cost. Try communicating with your local or state health department to see if there is a Smoking Cessation program you can enter at affordable cost.

See our cessation publication, Kicking Butts.

Gilbert Ross, M.D.
Medical/Executive Director, ACSH