January 11, 2014 was the fiftieth anniversary of the Surgeon General’s landmark report titled Smoking and Health: Report of the Advisory Committee to the Surgeon General. Many studies conducted through the 1940’s and 1950’s found that smoking was a major factor in causing lung cancer, coronary disease, bronchitis, and emphysema. Despite the evidence, there was debate and doubt about the health consequences from smoking; doubt that was strategically flamed by the tobacco industry.
In 1962, President John Kennedy asked his Surgeon General, Luther Terry, to convene a group of experts to review the evidence and provide a definitive answer on the relationship between smoking and health. Ten experts in the fields of medicine, epidemiology, statistics, and pharmacology were brought together. All were vetted for having done no prior research on tobacco and health. Five smoked and five didn’t.
The result of their exhaustive study was released on a Saturday for fear that the findings would set off a stock market collapse. The expert panel determined that cigarette smoking certainly causes illness and death. They determined that people who smoke had a ten to twenty fold increased risk for lung cancer, and that cigarette smoking was correlated with emphysema and heart disease. The Surgeon General in that report called for remediation. The US Congress decided a year later that a small warning label would suffice.
The 1964 report was one milestone in an ongoing struggle against an unprecedented public health scourge. While smoking rates have dropped by more than half since 1964, the health warning was clearly not enough. Almost one in five people in the United States continue to smoke. While the tobacco companies discussed in internal memos in 1963 that addicting people to nicotine is the core of their business, it was another 25 years before the Surgeon General published a report on nicotine addiction. And still today, each day, 1,000 more children become daily smokers.
We know how to end the tobacco epidemic. What is lacking is the political will. By increasing taxes on cigarettes, making all workplaces throughout the United States smoke free, stopping all advertising and promotion of cigarettes, and providing treatment to all who want to stop, we can put an end to the biggest threat to public health in our lifetime, a threat we’ve known about for fifty years.