Published: Jan 11, 2014
Fifty years ago today -- half a century -- something miraculous happened. Had it occurred today, most people would have a reaction along the lines of "Meh. Tell me something I don't already know." But 50 years ago, it was a big deal.
It still is a big deal.
On Jan. 11, 1964, then-Surgeon General Luther Terry, MD, released a reportstating unequivocally that smoking caused lung cancer and chronic bronchitis. The report went on to assert that smoking probably caused or contributed to a number of other illnesses, including heart disease, emphysema, and other cancers.
The conclusions were based on more than 7,000 published reports. For more than a decade, evidence had been accumulating to show that smoking caused all sorts of health problems. For the most part, the implicit call for action fell on deaf ears -- or at least more ears that were deaf than were attentive to the message.
To put the report into context, consider that, in 1964, more than 40% of the U.S. population smoked (as compared with about 18% today). Anyone -- regardless of age -- could buy tobacco products wherever they were sold. Cigarettes were cheap, about 25 to 35 cents per pack (yes, a pack), depending on state and local taxes.
Tobacco companies spent millions (if not billions) on radio and television advertising to promote their products. All sorts of celebrities -- including a future president by the name of Ronald Reagan -- appeared in cigarette advertisements.
Airlines had no restrictions on smoking. Few restaurants had nonsmoking sections, and even fewer employers had limitations on smoking. The idea of designating an entire building as nonsmoking would have been as alien as the idea of depositing a check in your bank account by using a telephone or computer.
Even doctors got into the act. I will never forget a magazine advertisement (a reproduction years after the real one) that pictured a doctor saying he routinely recommended such-and-such brand of cigarettes to all of his patients who were anxious or under a lot of stress, because cigarettes had a calming effect.
True story: My uncle came for a visit and fell ill while staying at my house. My mother called the family doctor and asked whether he could stop by our house on the way home. (You're right. It was a long time ago.) When the doctor arrived, I watched him walk toward my house. He was smoking a cigarette and took one last drag before dropping it to the concrete and stepping on it.
Years later (long after the 1964 report), one of my older brothers (both of whom smoked) needed angioplasty to open up a clogged artery. After the procedure, he went to see the family doctor (the same one who came to my house). When he finished examining my brother, the doctor said, "People are going to tell you that smoking caused this. Don't you believe it. No one has proven that."
Perhaps most remarkable, most members of the Surgeon General's advisory committee were smokers.
If you didn't have an idea of what it was like in 1964, you should by now. The Surgeon General's report was like a giant steel-toed boot that wedged open a tightly closed door. The anti-smoking movement rushed through, and the door sprang wide open, never to close again.
That's why the 1964 Surgeon General's report is still a big deal. Anyone who needs even more persuasion should consider this: Since the release of the report, an estimated 8 million fewer smoking-related deaths have occurred than would have been expected. According to a study published this week in JAMA, almost 26 million deaths would have been expected, but 17.7 million were observed, meaning that the difference was attributable to tobacco control efforts enacted since 1964. That study was just one that JAMA published in a theme-based issue in recognition of the 50th anniversary of the landmark report.
The American Lung Association, American Cancer Society, American Society of Clinical Oncology, Centers for Disease Control and Prevention, and National Cancer Institute all published tributes to Terry, the advisory committee, and the report. In an editorial published this week in CA: A Cancer Journal for Clinicians , ACS chief medical officer Otis Brawley, MD, and colleagues concluded that "On Jan. 11, 1964, they and Dr. Luther Terry forever changed the landscape of public health."
A CDC study this week in MMWR. Morbidity and Mortality Weekly Reportdocumented the decline in lung cancer mortality from 2005 to 2009, continuing a trend observed in earlier studies. The report also documented how much work remains ahead. During the period reviewed, more than 1 million Americans had new diagnoses of lung cancer. However, the progress made thus far has led the CDC to call lung cancer a "winnable battle ."
1 comment:
Achutti,
I remember Luther Terry well. He lived about a kilometer from our house in Rockville, and car-pooled to work with my Dad for several years in the late 50s/early 60s. Around the time of the Surgeon General´s Report. I delivered his paper daily, as he was on my paper route. I remember he once appeared at a party at our house dressed up in military uniform, as the Public Health Service is, or at least was at that time, formally a part of the military, not the civil service.
... A long time ago.
Regards,
Bruce
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