The 1964 Surgeon General Report

Long, long ago, in a time period that seems far, far away, ashtrays and decorative lighters were commonplace on coffee tables and work desks, and cigarettes were given as gifts.  You didn’t need to take a smoke break because you could smoke wherever and whenever you pleased, including offices, restaurants and airplanes.  There were few, if any, non-smoking areas.  Tobacco companies used athletes and cartoon characters like the Flintstones to pitch their favorite cigarette brands to adults, and advertisements were everywhere.  Those under 18 could easily walk into a store and purchase cigarettes without much hassle.  You might say we’ve come a long way baby, but we still have a road ahead of us.

1964_SG_ReportFifty years ago this month the first report on the health effects of smoking was released by the U.S. Surgeon General Luther Terry and alerted us to the damage caused by smoking.  The report did not use new research,  but rather it evaluated “more than 8,000 studies already published on the effect of smoking on health,”  and came to the conclusion that heavy smoking “is the principal cause of cancer of the lungs.”   Simply stated, “the more you smoke, the more you risk early death.”  In that aspect, nothing much has changed.

Lung cancer wasn’t the only disease caused by cigarette smoking according to the panel; chronic bronchitis and cancer of the larynx were also cited.  While they didn’t say smoking caused heart disease and coronary artery disease, they did report male smokers “had a higher death rate from coronary artery disease than non-smoking males.”   Pipe smokers were also at risk for developing lung cancer, but at a lower risk than cigarette smokers, yet at a higher rate than non-smokers.

Other diseases caused by smoking were listed but studies at the time were not clear.  In some cases the panel found “evidence of an association” between smoking and the disease; in other cases there wasn’t enough “evidence to establish a cause-and-effect link.”  These included: cancer of the esophagus, cancer of the urinary bladder, peptic ulcer, amblyopia or dimness of vision, infant birth weight, and death from influenza and pneumonia.  SG_Terry

Studies used for this report found that “the death rate for cigarette smokers is about 70% higher than for non-smokers” and increases with the amount smoked.  The report went into more detail stating men who smoked fewer than 10 cigarettes  had a 40% higher death rate than for non-smokers, 10-19 cigarettes a day have about a 70% higher rate than non-smokers.  And those who smoke 20-39 cigarettes a day have a 90% higher death rate.  For those smoking more than 40 cigarettes a day, the report gave the death rate at 120% higher than nonsmokers.  And these numbers came from data gathered prior to 1964!  The report even stated that lung cancer “diminished by discontinuing smoking.”   Most medical studies at the time were conducted on men; however, the report did state that although data for women was less extensive, it points “in the same direction.”

The panel also reported the addictive properties of tobacco as “reinforced and perpetuated by pharmacological (drug) actions of nicotine.”  They cited stress as a factor in the amount smoked.  And they dismissed the notion that youth smoked as “an expression of rebellion again authority,” but rather as “social stimulation.”  The report did state that those who start smoking before age 20 “have substantially higher death rate than those who began after 25.”

While the committee compiled the report, it did not provide “what ‘appropriate remedial action’ might be.”   The Surgeon General wanted the views of the public health service before the committee made any recommendations.   Still, the Surgeon General side stepped any questions as to the report representing “the government’s office thinking on the subject.”

It’s been 50 years since this first report on smoking and health and some things haven’t changed.  The tobacco industry is still allowed to market “a consumer product that kills when used as intended by its manufacturers.”  And even though the number of people smoking in the U.S. has decreased since 1964, tobacco is now the leading cause of preventable illness and death in the United States.   We have made progress in the past 50 years, but should we pat ourselves on the back for the decrease in the number of smokers, or do we really need to question why we continue to allow an industry to market and sell a deadly product after all this time?

To read the Associated Press report on the findings of the 1964 Surgeon General Report, click here.

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