Christy A. Russell

Report linking tobacco use and disease proved a turning point

Published: Sunday, Jan. 19, 2014 - 12:00 am
Last Modified: Tuesday, Jan. 21, 2014 - 11:23 am

Fifty years ago, the “Nation’s Doctor” gave the country a sobering diagnosis: A nation of 50 million smokers, we were killing ourselves through the use of tobacco.

January 1964 marked a historic turning point when the U.S. surgeon general issued the first official government report on smoking and health. The report arose partly from a letter to President John F. Kennedy from the American Cancer Society and others, calling for a national commission on smoking.

Although studies had warned about smoking’s dangers, the new report provided scientific evidence and blunt language that was impossible to ignore:

“Cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate.”

Lung cancer, heart disease and emphysema were killing American smokers. Smoking was the country’s most preventable cause of death, and we were doing nothing to prevent it.

The report hit the country like a bombshell.

Despite tobacco industry spin and denial, Americans changed their attitudes on smoking and their tobacco usage. A 1958 poll found that 44 percent of Americans believed smoking caused cancer; 10 years later 78 percent did. Fifty years ago 42 percent of the population smoked, whereas today about 19 percent do.

And policies changed, too. Before the ’60s were over, Congress enacted laws requiring warning labels on cigarette packs and in print advertising, and TV and radio ads were banned. Previously, smoking was permitted virtually everywhere, including airplanes and movie theaters, exposing nonsmokers to the health risks and deadly toxins of secondhand smoke. Today, nearly half of the nation’s population is protected with smoke-free laws that prohibit lighting up in workplaces, restaurants and bars. California was the first state to pass such a law in 1994.

But the tobacco industry hasn’t sat still, spending $1 million every hour on marketing, with industry advertising expenditures within California beating state tobacco prevention investment by a 9-to-1 margin.

In just one example of manipulative industry marketing, four years after the groundbreaking surgeon general’s report, Philip Morris advertised its new female-oriented cigarette, Virginia Slims, in 1968 with the slogan, “You’ve come a long way, baby” – linking the brand to the emerging women’s movement and increasing sales among teenage girls. Today, the industry continues to design its products to make them as appealing – and addictive – as possible.

Turning that slogan on its ear, we have come a long way, reducing rates of tobacco-related diseases and changing public attitudes.

A recent study in the Journal of the American Medical Association demonstrates how far. From 1964-2012:

• Premature, smoking-related deaths were prevented for at least 8 million, with these individuals gaining an average 20 years of life.

• Reductions in smoking contributed 30 percent of the increase in U.S. life expectancy.

But we still have a long way to go. A new surgeon general’s report issued Fridayfound that tobacco caused more than 20 million premature deaths in the last 50 years – and that if current trends continue, 5.6 million American youth currently under 18 will die prematurely from smoking.

Today, tobacco use remains the leading preventable cause of death in the United States, killing 480,000 Americans annually – more than AIDS, alcohol, murders, car accidents, suicides and fires combined. Nearly 90 percent of lung cancer cases, one-third of total cancer deaths, and one-fifth of deaths from heart disease are tobacco-related. Tobacco’s health risks are far reaching, with the new surgeon general report concluding that smoking also is a cause of colorectal and liver cancers. Smoking costs the nation $300 billion annually in health care expenditures and lost productivity.

In California, the number of smokers exceeds the population of Oregon: 3.6 million adult and 200,000 youth smokers. Tobacco use rates are notably higher among California’s African Americans, Korean and white men, and military personnel, as well as in low-income, rural and gay communities. Ethnic groups are particular targets of the tobacco industry’s predatory marketing. California’s annual health care costs directly caused by smoking amount to $9 billion.

For these reasons, it’s time to restore our state’s leadership role in the battle against smoking. Today, nearly half of the states have more comprehensive anti-smoking laws than California. California spends just 14 percent of what the Centers for Disease Control and Prevention recommends on tobacco prevention and stop-smoking programs, a percentage lower than 22 states. Investing in tobacco prevention is a smart investment, saving lives and money.

We haven’t raised the state tobacco tax in more than 15 years, through legislation or by initiative. California ranks 33rd among states on tobacco taxes, and there is a direct correlation between tobacco tax rates and a decline in smoking.

Smoking prevention is a public health success story with an ending yet to be written. Through political will and an investment in scientifically proven solutions, we can overcome tobacco industry opposition to reach achievable goals: eliminating secondhand smoke exposure within five years and reducing smoking rates to 10 percent or less in 10 years.

We must use this historic 50-year anniversary to reinvigorate California’s fight against Big Tobacco. Our citizens deserve nothing less.


Dr. Christy Russell is the national chair of the American Cancer Society Cancer Action Network, an oncologist at the University of Southern California’s Norris Comprehensive Cancer Center, and an associate professor at Keck School of Medicine of USC.

Read more articles by Christy A. Russell



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