Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States
Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States was a landmark report published on January 11, 1964 by the Surgeon General's Advisory Committee on Smoking and Health, chaired by then-Surgeon General of the United States Luther Terry regarding the negative health effects of smoking. Although it was not the first such declaration, or the first declaration by an official of the United States of America, it is notable for being arguably the most famous, and certainly had lasting and widespread effects on the tobacco industry and on the worldwide perception of smoking.
The health effects of tobacco had been debated by users, medical experts, and governments alike since its introduction to European culture. Hard evidence for the ill effects of smoking became apparent with the results of several long-term studies conducted in the early to middle twentieth century, such as the epidemiology studies of Richard Doll and pathology studies of Oscar Auerbach. On June 12, 1957, then-Surgeon General Leroy Burney "declared it the official position of the U.S. Public Health Service that the evidence pointed to a causal relationship between smoking and lung cancer." A committee of the United Kingdom's Royal College of Physicians issued a report on On March 7, 1962 which "clearly indicted cigarette smoking as a cause of lung cancer and bronchitis" and argued that "it probably contributed to cardiovascular disease as well." After pressure from the American Cancer Society, the American Heart Association, the National Tuberculosis Association, and the American Public Health Association, President John F. Kennedy authorized Surgeon General Terry's creation of the Advisory Committee. The committee met from November 1962 to January 1964 and analyzed over 7,000 scientific articles and papers.
The report's conclusions were almost entirely focused on the negative health effects of cigarette smoking. It found:
- cigarette smokers had a seventy percent increase in age-corrected mortality rate
- cigarette smoke was the primary cause of chronic bronchitis
- a correlation between smoking, emphysema, and heart disease.
In addition, it reported:
- a causative link between smoking and a ten- to twentyfold increase in the occurrence of lung cancer
- a positive correlation between pregnant women who smoke and underweight newborns.
Like the World Health Organization during this period, but possibly influenced by the fact that they were themselves smokers, the Committee defined cigarette smoking as a "habituation" rather than an overpowering "addiction." Committee members agreed with most Americans that this habit (though often strong) was possible for individuals to break. In the years after the Surgeon General's report, millions of Americans successfully chose to quit smoking, with two-thirds to three-quarters of ex-smokers quitting unaided by nicotine replacement methods. In addition, the "cold turkey" method has been found to be the most successful in terms stopping smoking over long periods of time. However in a controversial move in 1989, later surgeon general C. Everett Koop shifted course and redefined cigarette smoking as "an addiction" rather than a habit.
The report's publication had wide effects across the United States and the world. It was deliberately published on a Saturday to minimize the negative effect on the American stock markets, while maximizing the coverage in Sunday newspapers. It led to policy and public opinion changes such as warning labels and restrictions on advertising, large scale anti-smoking campaigns, and questioning from the tobacco industry.
- Terry, Luther et al. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States. U-23 Department of Health, Education, and Welfare. Public Health Service Publication No. 1103. 1964 May be downloaded from: http://profiles.nlm.nih.gov/ps/retrieve/ResourceMetadata/NNBBMQ
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