Comprehensive Smoking Education Act
|Other short titles||Rotational Warning Act|
|Long title||An Act to establish a national program to increase the availability of information on the health consequences of smoking, to amend the Federal Cigarette Labeling and Advertising Act to change the label requirements for cigarettes, and for other purposes.|
|Nicknames||Comprehensive Smoking Education Act of 1984|
|Enacted by||the 98th United States Congress|
|Effective||October 12, 1984|
|Statutes at Large||98 Stat. 2200|
|Acts amended||Cigarette Labeling and Advertising Act
Public Health Cigarette Smoking Act
|Titles amended||15 U.S.C.: Commerce and Trade|
|U.S.C. sections amended||15 U.S.C. ch. 36 § 1331 et seq.|
The Comprehensive Smoking Education Act of 1984 (also known as the Rotational Warning Act) is an act of the Congress of the United States. A national program established in order to improve the availability of information on health risks related to smoking, to amend the Federal Cigarette Labeling and Advertising Act so that cigarette warning labels would be different, and for other reasons, the Comprehensive Smoking Education Act was enacted with a purpose to, as stated in Section 1 of the Act, "provide a new strategy for making Americans more aware of any adverse health effects of smoking, to assure the timely and widespread dissemination of research findings and to enable individuals to make informed decisions about smoking". Adopted by Congress in 1984 and effective October 12, 1984, the Comprehensive Smoking Education Act created a rotational warning system that required all cigarette packages and advertisements to rotate the following four warnings every three months:
- SURGEON GENERAL'S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema, and May Complicate Pregnancy.
- SURGEON GENERAL'S WARNING: Smoking by Pregnant Women May Result in Fetal Injury, Premature Birth, and Low Birth Weight.
- SURGEON GENERAL'S WARNING: Cigarette Smoke Contains Carbon Monoxide.
- SURGEON GENERAL'S WARNING: Quitting Smoking Now Greatly Reduces Serious Risks to Your Health.
- 1 History of tobacco
- 2 The economy of cigarettes
- 3 Brief overview of cigarette warning labels
- 4 Regulations of Comprehensive Smoking Education Act
- 5 Health
- 6 References
- 7 External links
History of tobacco
The history of tobacco dates back to 600 through 900 AD from carvings by the Mayans. They were growing tobacco before the Europeans arrived in North America. Tobacco was primarily used for religious and medicinal purposes before 1612, the year that it because North American's most lucrative cash crop. Tobacco was used in Native American religious ceremonies as a peace pipe. Two tribe leaders would smoke a peace pipe to symbolize the new peaceful relations that would be held between the tribes. It was as binding as a written contract. Tobacco was also believed to be a cure-all, and was used to dress wounds and was also used as a pain killer. Chewing tobacco was believed to relieve the pain of a toothache.
New World discovery of tobacco
On October 15, 1492, Christopher Columbus was offered dried tobacco leaves as a gift from the American Indians that he met when landing upon the New World. Soon after, sailors brought back tobacco to Europe and the plant started to be grown all over the Old World. The main reason for tobacco's growing popularity in Europe was its supposed healing qualities. Europeans believed that tobacco was a cure-all and could cure anything from halitosis to cancer. In support of this, in 1571, a Spanish doctor by the name of Nicolás Monardes wrote a book about the history of medicinal plants of the new world, one of them being tobacco. In his book he claimed that tobacco could cure 36 health problems. During the 1600s tobacco was so popular that it was often used as currency. It was the first crop grown for profit in Jamestown, Virginia, the first city in the first colony of the New World. It became North America's main source of income and helped fund the American Revolutionary War.
The economy of cigarettes
As mentioned above, in 1776 during the American Revolutionary War, tobacco helped finance the revolution by serving as collateral for loans that the Americans borrowed from France.
The beginning of the cigarette industry began by the ingenuity of James Bonsack. Who created the first cigarette making machine that allowed his company to mass-produce a cheap, easy to use and easy to light way for Americans' to get their tobacco fix. People no longer had to roll their own smokes with paper or fill their pipes. It was a quick and convenient way for Americans to smoke. It wasn't until the 1900s that the cigarette became the major tobacco product made and sold. Still, in 1901 2.5 billion cigarettes were sold, while 6 billion hand rolled cigars were sold. In 1902, the British Philip Morris set up a New York headquarters to market its cigarettes including the now famous Marlboro brand. The company was producing 10 million cigarettes in their first year and had an exponential increase to 1 billion five years later. The number reached 300 billion by 1944 and created a multimillion-dollar business in the United States. The tobacco industry announced a 5.65 billion dollar surplus in 1992 and one company alone paid 4.5 million dollars in taxes that year. These tobacco companies clearly generated a lot of revenue for the United States.
War & Cigarettes: A Soldiers' Relief
The use of cigarettes exploded during World war I (1914-1918) where cigarettes became known as the "soldier's smoke". During World War II (1939-1945), cigarette sales soared to an all-time high. Cigarettes were even included in soldier's C-Rations. Tobacco companies sent millions of cigarettes to the soldier for free, and when these soldiers came home, the companies had a steady stream of loyally addicted customers.
Revelation of the hazards of smoking
In 1964, the Surgeon General's report on "Smoking and Health" came out. This report helped the government to regulate the advertisement and sales of cigarettes. The 1960s as a whole was a time when many of the health hazards of smoking were reported. However, the companies that made these cigarettes fought hard to keep the public buying their products. It wasn't until 1971 the television ads for cigarettes were taken off the air in the U.S.
During the 1980s there were many lawsuit filed against the tobacco industry because of the harmful effects of its products. In this time frame, smoking becomes politically incorrect and public places such as restaurants started banning smoking in their place of business. In 1985, lung cancer became the #1 killer of women, beating out breast cancer. The tobacco companies saw the trends in the market and began heavily diversifying, buying into other products like General Foods Corporation and Draft Inc in 1985. During the 80's and 90's, the tobacco industry starts marketing heavily in areas outside the U.S., especially developing countries in Asia. Marlboro is considered the word's No. 10 most valuable brand of any product with a value over $30 billion. Over this period, there was a battle between Coca Cola and Marlboro as the No. 1 brand in the world.
In recent years, there is growing evidence that the tobacco industry has known all along that cigarettes are harmful, but continued to market and sell them. There is also evidence that they knew that nicotine was addictive and exploited this hidden knowledge to get millions of people hooked on this dangerous habit. Every year, tobacco companies spend billions of dollars on advertising and promotion, and U.S. consumers spend billions of dollars on tobacco products. Tobacco use then costs the United States billions of dollars in medical expenses and lost productivity. About 1–3 Tobacco companies spend billions of dollars each year to market their products.
Example in 2006, cigarette companies spent $12.4 billion on advertising and promotional expenses in the United States alone, down from $13.1 billion in 2005, but more than double what was spent in 1997.The money cigarette companies spent on U.S. marketing in 2006 amounted to approximately $34 million per day.The five major U.S. smokeless tobacco manufacturers spent $354 million on smokeless tobacco advertising and promotion in 2006.
More than 315 billion cigarettes were purchased in the United States in 2009, with 3 major companies selling nearly 85% of them.Approximately 121.4 million pounds of smokeless tobacco were purchased in the United States in 2009 (down from 124.7 million pounds in 2008), with 3 companies selling nearly 90%. Approximately 12 billion cigars (i.e., 9.7 billion large cigars and cigarillos; 2.3 billion little cigars) were purchased in the United States in 2009, with 3 major companies selling a majority of them.
The table below shows U.S. cigarette production, exports, and consumption between 1990 and 2007. The percentage value for 17-year of cigarette production decreased by about 34%, exports decreased by about 34%, and consumption dropped by about 31%. 
Cigarette Production, Exports, and Domestic Consumption—United States, 1990–2007 (Note:Per Billions pieces)
Brief overview of cigarette warning labels
Researchers and statisticians began to suspect a link between smoking and lung cancer as early as 1900. The first medical studies linking smoking to this and other illnesses began to appear in the 1920s. Between 1920 and 1960 over 7,000 studies established a link between smoking and health problems. In 1962, with this ever-expanding body of medical research as a backdrop, Dr. Luther L. Terry, the Surgeon General of the U.S. Public Health Service, convened an advisory committee to examine the issue of the link between smoking and illness. Though there were a few restrictions during the 17th century, significant anti-smoking legislation was not enforced until later in the 19th century. According to the first Surgeon General's Report on Smoking and Health published in 1964, the Surgeon General reported not only that the nicotine and tar in cigarettes caused lung cancer, but also that smoking was the most important cause of chronic bronchitis, increased risk of dying from chronic bronchitis and emphysema, and caused coronary disease. As a result, Congress enacted the Cigarette Labeling and Advertising Act in 1965, which created the first cigarette warning label in the United States by requiring health warnings on all cigarette packages saying "Caution: Cigarette Smoking May Be Hazardous to Your Health."  A few years later, Congress passed the Public Health Cigarette Smoking Act of 1969, which banned cigarette advertising on television and radio as well as slightly changed the health warning to "Warning: The Surgeon General Has Determined That Cigarette Smoking is Dangerous to Your Health."  However, in a 1981 report to Congress, the Federal Trade Commission concluded that the health warning labels were not effective enough on public knowledge and peoples' attitudes towards smoking. This led to the Comprehensive Smoking Education Act of 1984.
Regulations of Comprehensive Smoking Education Act
As shown in Sections 3, 4, and 7 of the Comprehensive Smoking Education Act, the Act addresses and affects smoking research, education, and information, cigarette labels, and the ingredients added to tobacco in cigarettes.
Section 3 of the Comprehensive Smoking Education Act covers the subject of smoking research, education, and information, stating that the Secretary of Health and Human Services must establish and carry out a program that will inform the public of any human health risks caused by cigarette smoking. In order to do so, the Secretary must perform tasks such as conducting and supporting research on human health risks from cigarette smoking, informing the public of the effects of smoking, coordinating anything related to the effects of cigarette smoking on human health within the Department of Health and Human Services, serving as a liaison with agencies in regards to activities related to health risks from smoking, developing improved information programs related to smoking and health, compiling and disseminating information on legislation related to cigarette use, and undertaking any other additional information or action that may seem appropriate in furthering the program. There is an Interagency Committee on Smoking and Health, composed of members appointed by the Secretary, that helps the Secretary fulfill some of the responsibilities, and the Secretary must publish a biennial report to Congress.
Section 4 of the Comprehensive Smoking Education Act discusses cigarette warning labels, stating that any person manufacturing, packing, or importing the sale or distribution of cigarette packages within the United States must have one of the four labels mentioned above. Any manufacturer or importer of cigarettes advertising cigarettes in the United States through the use of any medium besides outdoor billboards must also make sure that the advertisement contains one of the four previously listed labels, and those advertising cigarettes in the United States through the use of outdoor billboards must have one of the following labels on the advertisement:
- SURGEON GENERAL'S WARNING: Smoking Causes Lung Cancer, Heart Disease, And Emphysema.
- SURGEON GENERAL'S WARNING: Quitting Smoking Now Greatly Reduces Serious Health Risks.
- SURGEON GENERAL'S WARNING: Pregnant Women Who Smoke Risk Fetal Injury and Premature Birth.
- SURGEON GENERAL'S WARNING: Cigarette Smoke Contains Carbon Monoxide.
Section 4 continues to elaborate on the visual requirements of the warning labels, listing the regulations on the size, wording, and implementation of the warning labels. For example, Section 4(b)(1) states "The phrase "Surgeon General's Warning' shall appear in capital letters and the size of all other letters in the label shall be the same as the size of such letters as of such date of enactment. All the letters in the label shall appear in conspicuous and legible type in contrast by typography, layout, or color with all tore printed material on the package." 
In addition, as stated in Section 7 of the Comprehensive Smoking Education Act, the cigarette industry must provide the Secretary an annual list of the ingredients added to cigarettes manufactured in, packaged in, or imported into the United States. The list is confidential, and with the help of an authorized agent who serves as a custodian of such information, it is the Secretary's responsibility make sure such information remains confidential.
Smoking has profound effects on the human body in many ways and contributes to the United States leading cause of death, heart disease. According to the National Cancer Institute, there are more than 440,000 early deaths each year in America due to smoking. The primary organ that is closely related to smoking are the lungs. There are two types of lung cancer, the first type is called Small Cell Lung Cancer and is accountable for 20% of all lung cancers. The cancer cells in these patients are typically smaller than regular cancer cells, but they multiply rapidly to generate massive tumors. The second type is called Non-Small Cell Lung Cancer and is responsible for 80% of call cancer cases. Cancers such as the Squamous cell carcinoma in men and Adenocarcinoma in women are the two most common form of NSCLC.
The estimated average annual number of smoking-attributable deaths in the United States during 2000 through 2004 by specific causes, as follows:Lung cancer: 128,900 deaths,Other cancers: 35,300 deaths,Ischemic Heart Disease: 126,000 deaths Chronic Obstructive Pulmonary Disease: 92,900 deaths,Stroke: 15,900 deaths andOther diagnoses: 44,000 deaths 
Second-hand smoke is also another major problem from cigarettes and it has the same effects on nonsmokers as it does to smokers. There are two types of second-hand smoke with Type 1 being Sidestream smoke and Type 2 being Mainstream smoke. Sidestream smoke is the smoke that comes from the lighted cigarette while Mainstream smoke is the smoke that is exhaled by smokers. Sidestream is the more deadly of the two because it has more carcinogens and contains smaller particles that can easily maneuver into human cells.
Smoking also causes major damages to the heart causing coronary heart disease which is the number 1 killer in the United States. Cigarette smoke causes shrinkage in the arteries which heightens their chance of developing peripheral vascular disease. According to the Control Disease Center also known as the CDC, smoking can increase a person's risk of developing heart disease and getting a stroke as much as 2 to 4 times more than an average non-smoker.
The cigarette smoking was estimated to be responsible for $193 billion in annual health-related economic losses in the United States ($96 billion in direct medical costs and approximately $97 billion in lost productivity) in 2004-2004.The total economic costs (direct medical costs and lost productivity) associated with cigarette smoking are estimated at $10.47 per pack of cigarettes sold in the United States.Cigarette smoking results in 5.1 million years of potential life lost in the United States annually.
- H.R. 98-474, 98th Cong., U.S. G.P.O. (1984) (enacted). Print.
- Marjorie, Jacobs (1997). "The History, Economics and Hazards of Tobacco". Mass. Department of Public Health.
- "Federal Cigarette Labeling and Advertising Act of 1965". 1965.
- Jacobs, Majorie. From the First to the Last Ash: The History, Economics & Hazards of Tobacco. Health & Literacy Special Collection. Web. 
- Jacobson, Peter D., Jeffrey Wasserman, and John R. Anderson. "Historical Overview of Tobacco Legislation and Regulation." Journal of Social Issues 53.1 (1997): 75-95. Wiley Online Library. Web. 
- H.R. 89-92, 89th Cong., U.S. G.P.O. (1965) (enacted). Print.
- H.R. 91-222, 91st Cong., U.S. G.P.O. (1969) (enacted). Print.
- National, Cancer Institute (2011). "Harms of Smoking and Health Benefits of Quitting". National Cancer Institute.
- Lung, Cancer (2011). "Lung Cancer 101". Lung Cancer.org.
- American, Cancer Society (2011). "Learn About Cancer". American Cancer Society.
- Centers For Disease, Center (2011). "Smoking and Tobacco Use". Centers for Disease Control.
- "Smoking and Tobacco Use: Highlights: Warning Labels." Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention. Web.
- "Smoking and Tobacco Use: Legislation: Selected Actions of the U.S. Government Regarding the Regulation of Tobacco Sales, Marketing, and Use (excluding laws pertaining to agriculture or excise tax)." Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion. Centers for Disease Control and Prevention. Web.
- Handbook of Health Behavior Research IV by Gochman, page 237, ISBN 0-306-45446-7