Smoking and the Surgeon General

In January 1964, the Surgeon General of the United States, Luther Terry, did something extraordinary.  Dr. Terry released a report, on behalf of the U.S. government, that stated to the American people that something in their lifestyle was harming them.  Smoking up to that point was not commonly viewed as a health hazard. The most popular people in America promoted smoking (including a future President). Doctors frequently were smokers (including Dr. Terry) and advice from doctors was prominent in tobacco advertising. At the time, over 40 percent of Americans were smokers. In those days, government health programs were mostly focused on communicable disease prevention efforts.

Dr. Terry's report awoke Americans to an awful truth: smoking is a serious, deadly health problem.  It causes cancer, heart disease, respiratory conditions, pediatric problems, injury from house fires, and more.  Even though the Surgeon General's report began a series of actions to reduce the harmful effects and to counter widespread marketing, sales, and use of tobacco products, we continue to suffer from the burden today, as millions still smoke, many former smokers eventually have compromised health or die early, and many non-smokers (including children) suffer health problems from second-hand smoke.

Since 1964, 29 Surgeon General's reports have been issued.  Topics have ranged from the health risks of specific diseases like cancer, lung, and heart disease to ways to quit.  Another report addressed the health effects from second-hand smoke effects. Many others have become involved, including the CDC, NIH, FDA, World Health Organization (WHO), non-government groups like the American Cancer Society and the American Lung Association, medical doctors, and nearly every state or local health department.

The latest report, The Health Consequences of Smoking: Fifty Years of Progress, documents how we have made progress in addressing this scourge.  The rate of smoking in the U.S. has fall by over one-half. Millions of premature deaths have been prevented because of the efforts of public health workers, politicians, educators, and citizens who have taken a stand against tobacco. The Surgeon General documents many of the personal battles to break free from tobacco addiction.  The report also discusses what needs to be done in the future to eliminate disease, disability, and death from tobacco.

Unfortunately, tobacco continues to be the cause of a huge burden of death and illness. Over 40 million American adults continue to smoke, according to the CDC. The rate of smoking (and health burden) worldwide continues to increase. New challenges have been introduced like e-cigarettes, little cigars, hookah, and flavored tobaccos. Public health personnel, including environmental health, are on the front lines of the effort to address smoking, still rightfully called the leading preventable cause of death in the U.S.  It continues to be a major priority for public health and will continue to be for the foreseeable future.