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FDA launching $115M multimedia education campaign showing at-risk youth 'real cost' of smoking

By MICHAEL FELBERBAUM  AP Tobacco Writer
WASHINGTON — The Food and Drug Administration is using ads depicting wrinkled skin on youthful faces and teenagers paying for cigarettes with their teeth in a campaign to show the nation’s young people the costs associated with smoking.
The federal agency said Tuesday it is launching a $115 million multimedia education campaign called “The Real Cost” that’s aimed at stopping teenagers from smoking and encouraging them to quit.
Advertisements will run in more than 200 markets throughout the U.S. for at least one year beginning Feb. 11. The campaign will include ads on TV stations such as MTV and print spots in magazines like Teen Vogue. It also will use social media.
“Our kids are the replacement customers for the addicted adult smokers who die or quit each day,” said Mitch Zeller, the director of the FDA’s Center for Tobacco Products. “And that’s why we think it’s so important to reach out to them — not to lecture them, not to throw statistics at them — but to reach them in a way that will get them to rethink their relationship with tobacco use.”
Zeller, who oversaw the anti-tobacco “Truth” campaign while working at the nonprofit American Legacy Foundation in the early 2000s, called the new campaign a “compelling, provocative and somewhat graphic way” of grabbing the attention of more than 10 million young people ages 12 to 17 who are open to, or are already experimenting with, cigarettes.
According to the FDA, nearly 90 percent of adult smokers started using cigarettes by age 18 and more than 700 kids under 18 become daily smokers each day. The agency aims to reduce the number of youth cigarette smokers by at least 300,000 within three years.
“While most teens understand the serious health risks associated with tobacco use, they often don’t believe the long-term consequences will ever apply to them,” said FDA Commissioner Margaret Hamburg. “We’ll highlight some of the real costs and health consequences associated with tobacco use by focusing on some of the things that really matter to teens — their outward appearance and having control and independence over their lives.”
Two of the TV ads show teens walking into a corner store to buy cigarettes. When the cashier tells them it’s going to cost them more than they have, the teens proceed to tear off a piece of their skin and use pliers to pull out a tooth in order to pay for their cigarettes. Other ads portray cigarettes as a man dressed in a dirty white shirt and khaki pants bullying teens and another shows teeth being destroyed by a ray gun shooting cigarettes.
The FDA is evaluating the impact of the campaign by following 8,000 people between the ages of 11 and 16 for two years to assess changes in tobacco-related knowledge, attitudes and behaviors.
The campaign announced Tuesday is the first in a series of campaigns to educate the public about the dangers of tobacco use.
In 2011, the FDA said it planned to spend up to $600 million over five years on the campaigns aimed at reducing death and disease caused by tobacco, which is responsible for about 480,000 deaths a year in the U.S. Future campaigns will target minority youth, lesbian, gay, bisexual and transgender youth and youth in rural areas.
Tobacco companies are footing the bill for the campaigns through fees charged by the FDA under a 2009 law that gave the agency authority over the tobacco industry.
 http://www.therepublic.com/view/story/e2170c9ad67b4bc08ab8228b121857ea/US–FDA-Tobacco-Campaign

E-Cigarette Makers Give Public the Finger

Rob Waters, Contributor, Forbes
With Sarah Mittermaier and Lily Swartz
In 1964, smoking was everywhere: on television, on airplanes, in workplaces and movie theatres, college campuses, doctors’ offices, restaurants and bars. In the 50 years since the first Surgeon General’s report on smoking and health was released, smoking has gradually faded to the margins of public life. TheMarlboro man was bounced from the airwaves, comprehensive smoking bans were passed in hundreds of cities and 28 states, and smoking rates were cut almost in half. The struggle to protect the public’s health is far from over—and shocking disparities in tobacco use and exposure to tobacco marketing remain—but we’re now reaping some rewards, with eight million lives saved over the past half-century.
But now a new threat is emerging. The use of e-cigarettes is rising rapidly, with teenagers a key target of marketing efforts. “Vaping” is making smoking acceptable—even cool—once again as the tobacco industry returns to its old ways, putting e-cigarette commercials back on the airwaves for the first time since the 1970s.

Right now, e-cigarettes exist in what tobacco control researcher Stanton Glanz calls a regulatory “Wild West,” with no federal regulation of the manufacturing, marketing and sales of these products. This regulatory vacuum threatens to undo the hard-won victories of the past 50 years in tobacco control.
E-cigarette companies are taking a page right out of Big Tobacco’s old-school playbook: marketing their products with sex appeal, celebrity endorsements, even cartoons. The companies argue that “vaping” is safer than traditional smoking and that may or may not be true—there are far too few studies to back up that claim or refute it. But it’s also a smokescreen.
The tobacco industry is out to hook kids, and it’s working. E-cigarettes come in an array of kid-friendly flavors, from“Cherry Crush” to “Coca Cola.” And unlike conventional cigarettes, e-cigarettes can legally be sold to kids in most US states. Data released last year by the Centers for Disease Control and Prevention showed that e-cigarette use more than doubled among middle and high school students in the previous year. For 20 percent of the middle schoolers, e-cigarettes were their first experience with smoking, raising concerns that e-cigarettes may act as a gateway to the use of other tobacco products.
E-cigarettes also threaten to reintroduce smoking to workplaces, restaurants, bars and other public spaces where hard-fought public health campaigns have succeeded in banning cigarettes. These policies have changed our communities from the ground up, creating new expectations and norms around smoking. The science is still out on whether e-cigarettes threaten non-smokers with toxic exposure, but their use in public legitimizes their use, making them seem acceptable, even Golden Globes-glamorous. We can’t let e-cigarettes undo the hard work tobacco control advocates have achieved over the past 50 years.
Some cities and states are pushing back against e-cigarettes, taking steps to regulate the sale and public use of e-cigarettes. Over the past few months, New York and Chicago city councils voted to regulate e-cigarettes as tobacco products, extending existing smoking bans to cover vaping. The Los Angeles City Council voted unanimously to regulate the sales of e-cigarettes. Boston has banned e-cigarette smoking in workplaces. States such as Utah, New Jersey, and North Dakota ban the use of e-cigarettes in indoor public spaces.
These local and state efforts should be followed—and strengthened—by federal action. Attorneys general from 40 states have called on the Food and Drug Administration to regulate e-cigarettes as tobacco products, a move that would give the FDA the power to impose age restrictions and limit marketing of e-cigarettes. Proposed rules drafted by the agency have not yet been released publicly.
We can’t wait years for scientists to conduct new studies on the health risks of vaping before we take action. We know better than to trust the tobacco industry’s health claims about their products—or to trust the industry with our children’s future. The time for action is now. To paraphrase one anti-cigarette commercial in California: “Some people will say anything to sell (e-) cigarettes.”
http://www.forbes.com/sites/robwaters/2014/01/27/e-cigarette-makers-give-public-the-finger/

U.S. senators slam 'glamorization' of e-cigarettes at Golden Globes

WASHINGTON (Reuters) – A group of U.S. senators is taking the Golden Globes to task for showing celebrities puffing on electronic cigarettes at this year’s awards show, complaining such depictions glamorize smoking.
“The Golden Globes celebrates entertainers who are an influence on young fans,” the four Democratic senators wrote on Tuesday. “We ask the Hollywood Foreign Press Association and NBC Universal to take actions to ensure that future broadcasts of the Golden Globes do not intentionally feature images of e-cigarettes.”
“Such action would help to avoid the glamorization of smoking and protect the health of young fans,” said the letter signed by Dick Durbin of Illinois, Richard Blumenthal of Connecticut, Sherrod Brown of Ohio and Edward Markey of Massachusetts.”
The Golden Globes ceremony that aired on Comcast Corp-owned NBC on Sunday night showed actor Leonardo DiCaprio smoking an e-cigarette during the broadcast, as well as nominee Julia Louis-Dreyfus puffing on one as part of an opening skit.
The Golden Globes, which honor achievement in film and television, are handed out by the Hollywood Foreign Press Association. The show drew its best television audience in a decade.
E-cigarettes are battery-powered metal tubes that turn nicotine-laced liquid into vapor. Some analysts predict that the fast-growing market for the product could outpace that of conventional cigarettes within a decade.
Regulators are agonizing over whether to restrict the product as a “gateway” to nicotine addiction and tobacco smoking, or to embrace them as treatments for would-be quitters.
NBC Universal and the Hollywood Foreign Press Association did not immediately respond to requests for comment.
(Writing by Peter Cooney; Additional reporting by Patricia Zengerle; Editing by Lisa Shumaker)
http://www.chicagotribune.com/entertainment/sns-rt-us-goldenglobes-ecigarettes-20140114,0,981972.story

Cigarette ads from the 20th century

Fifty years ago, on January 11, 1964, U.S. Surgeon General Luther Terry issued a landmark report on the negative health risks caused by smoking tobacco.
To view cigarette ads from the 20th century, click on the link below:
http://www.cnn.com/2014/01/10/health/gallery/historic-cigarette-ads/

Tobacco companies will say they lied, via advertising

Liz Szabo, USA TODAY

The nation’s tobacco companies and the Justice Department have reached an agreement on publishing corrective statements that say the companies lied about the dangers of smoking.

Tobacco companies are a step closer today to putting out “corrective statements” about their history of defrauding the American public by hiding the dangers of smoking, according to an agreement reached Friday with the Department of Justice.
The agreement was reached the day before the 50th anniversary of the Surgeon General warning on tobacco and lung cancer, released Jan. 11, 1964.
The long-awaited advertising campaign was ordered in 2006 by U.S. District Court Judge Gladys Kessler, who found tobacco companies guilty of violating civil racketeering laws and lying to the public about the dangers of smoking and their marketing to children. Kessler must approve the agreement.
That verdict was the culmination of a lawsuit brought by the Department of Justice in 1999, when it sued tobacco companies under the Racketeer Influenced and Corrupt Organizations Act (RICO).
Kessler made five key “findings of fact,” detailing how tobacco makers defrauded the public, including lying about the health damage caused by smoking; the addictive nature of nicotine; their marketing and promotion of “low tar” and “light” cigarettes as healthier when there are no clear health benefits; designing tobacco products to be as addictive as possible; and engaging in a massive effort to hide the dangers of secondhand smoke. The corrective statements must address each of these five areas.
Kessler found that the RICO statute did not allow for monetary damages. But she did order tobacco companies to make “corrective statements” about their history of fraud.
According to the agreement, the campaign will include online and full-page print ads in the Sunday editions of the top 35 newspapers in the country, including USA TODAY, as well as prime-time TV spots on the three major networks for one year. The corrective statements also must be attached to packages of cigarettes in what marketers call an “outsert.”
Spokesmen for the leading tobacco companies — Philip Morris USA and RJ Reynolds Tobacco — declined to comment.
The U.S. Court of Appeals for the D.C. Circuit has rejected two industry appeals. Tobacco companies are still suing over Kessler’s order to include the corrective statements in “point of sale” displays at retail stores.
In a statement, leading anti-smoking groups said, “Tobacco companies have filed time-consuming appeals at every stage . . . We urge them to end their delay tactics and finally tell the truth.” The statement was signed by the Tobacco-Free Kids Action Fund, the American Cancer Society, the American Heart Association, the American Lung Association, Americans for Nonsmokers’ Rights and the National African-American Tobacco Prevention Network. The groups joined the case as intervenors in 2005.
The corrective statements “are necessary reminders that tobacco’s devastating toll over the past 50-plus years is no accident,” the group statement says. “It stems directly from the tobacco industry’s deceptive and even illegal practices.”
In her 2006 verdict, Kessler described the tobacco industry as one that “survives, and profits, from selling a highly addictive product which causes diseases that lead to a staggering number of deaths per year, an immeasurable amount of human suffering and economic loss, and a profound burden on our national health care system. . . (Tobacco companies) have consistently, repeatedly and with enormous skill and sophistication, denied these facts to the public.”
http://www.usatoday.com/story/news/nation/2014/01/10/tobacco-corrective-statements/4409501/

Tobacco Companies Agree on Ads Admitting Smoking Lies

By Andrew Zajac, Bloomberg News
Altria Group Inc. (MO), Reynolds American Inc. (RAI) and other tobacco companies agreed with the U.S. on how they will publicize admissions that they deceived the American public on the dangers of smoking.
The companies and the Justice Department resolved that “corrective statements” will appear in the print and online editions of newspapers and on television as well as on the companies’ websites. Expanded information on the adverse health effects of smoking will appear on cigarette packages, according to the agreement filed yesterday in federal court in Washington.
The plan for the statements is another stage in a 15-year-old civil racketeering case against the tobacco companies brought by the U.S.
The ads, fought over in court for more than two years, were ordered by U.S. District Judge Gladys Kessler, who in 2006 found the tobacco companies violated anti-racketeering laws by conspiring to hide cigarettes’ risks. The defendants in the case include Lorillard Inc. (LO)
Kessler also ordered the companies to stop marketing cigarettes as “light” and “low-tar.”
She later approved the text of corrective messages. The tobacco companies lost their bid to overturn Kessler’s decisions on the statements at the U.S. Court of Appeals in Washington in 2012.

Judge’s Approval

The agreement on the dissemination of the ads, which covers details such as the size of lettering and schedules of publication, is subject to Kessler’s approval.
Negotiations are continuing on whether the corrective ads will be required in retail locations, according to the agreement.
The consent order was filed the day before the 50th anniversary of the U.S. Surgeon General’s watershed Jan. 11, 1964, report warning of the health consequences of smoking.
Each of the ads begins by declaring that a federal court found that the four companies “deliberately deceived the American public” and goes on to state “here is the truth.” A description of companies’ wrongdoing follows, along with correct public health information in five areas including the dangers of smoking and its addictiveness, second-hand smoke and false advertising about low-tar and light cigarettes.

Appeals Pending

The ads are scheduled to begin after companies’ appeals connected to Kessler’s order have run their course.
The “agreement ensures that when all potential appeals are exhausted, the corrective statements will be ready to run without further delay,” according to a statement by Tobacco-Free Kids Action Fund and five other public health groups that joined the case.
Brian May, a spokesman for Richmond, Virginia-based Altria and its Philip Morris USA unit, declined to comment on the agreement
Bryan Hatchell, a spokesman for Winston-Salem, North Carolina-based Reynolds American, didn’t immediately respond after regular business hours yesterday to a phone message seeking comment on the agreement. No one responded to an e-mail to Lorillard’s press contact address after regular business hours yesterday.
The case is U.S. v. Philip Morris USA Inc., 99-cv-2496, U.S. District Court, District of Columbia (Washington).
http://www.bloomberg.com/news/2014-01-10/tobacco-companies-u-s-agree-on-ads-admitting-smoking-lies-1-.html

Deal reached on tobacco firm corrective statements

By MICHAEL FELBERBAUM, AP Tobacco Writer
RICHMOND, Va. (AP) — The nation’s tobacco companies and the federal government have reached an agreement on publishing corrective statements that say the companies lied about the dangers of smoking and requires them to disclose smoking’s health effects, including the death on average of 1,200 people a day.
The agreement filed Friday in U.S. District Court in Washington, D.C., follows a 2012 ruling ordering the industry to pay for corrective statements in various advertisements. The judge in the case ordered the parties to meet to discuss how to implement the statements, including whether they would be put in inserts with cigarette packs and on websites, TV and newspaper ads.
The court must still approve the agreement and the parties are discussing whether retailers will be required to post large displays with the industry’s admissions.
The corrective statements are part of a case the government brought in 1999 under the Racketeer Influenced and Corrupt Organizations. U.S. District Judge Gladys Kessler ruled in that case in 2006 that the nation’s largest cigarette makers concealed the dangers of smoking for decades. The companies involved in the case include Richmond, Va.-based Altria Group Inc., owner of the biggest U.S. tobacco company, Philip Morris USA; No. 2 cigarette maker, R.J. Reynolds Tobacco Co., owned by Winston-Salem, N.C.-based Reynolds American Inc.; and No. 3 cigarette maker Lorillard Inc., based in Greensboro, N.C.
Under the agreement with the Justice Department, each of the companies must publish full-page ads in the Sunday editions of 35 newspapers and on the newspapers’ websites, as well as air prime-time TV spots on CBS, ABC or NBC five times per week for a year. The companies also must publish the statements on their websites and affix them to a certain number of cigarette packs three times per year for two years.
Each corrective ad is to be prefaced by a statement that a federal court has concluded that the defendant tobacco companies “deliberately deceived the American public.” Among the required statements are that smoking kills more people than murder, AIDS, suicide, drugs, car crashes and alcohol combined, and that “secondhand smoke kills over 38,000 Americans a year.”
Tobacco companies had urged Kessler to reject the government’s proposed corrective statements; the companies called them “forced public confessions.” They also said the statements were designed to “shame and humiliate” them. They had argued for statements that include the health effects and addictive qualities of smoking.
A federal appeals court also rejected efforts by the tobacco companies to overrule Kessler’s ruling requiring corrective statements.
Representatives for Altria, R.J. Reynolds and Lorillard each declined to comment.
Several public health groups, including the American Cancer Society, American Heart Association and American Lung Association, intervened in the case. In a statement Friday, the groups said the corrective statements are “necessary reminders that tobacco’s devastating toll over the past 50-plus years is no accident. It stems directly from the tobacco industry’s deceptive and even illegal practices.”
The corrective statements include five categories: adverse health effects of smoking; addictiveness of smoking and nicotine; lack of significant health benefit from smoking cigarettes marked as “low tar,” ”light,” etc.; manipulation of cigarette design and composition to ensure optimum nicotine delivery; and adverse health effects of exposure to secondhand smoke.
Among the statements within those categories:
“Smoking kills, on average, 1,200 Americans. Every day.”
“Philip Morris USA, R.J. Reynolds Tobacco, Lorillard, and Altria intentionally designed cigarettes to make them more addictive.”
“When you smoke, the nicotine actually changes the brain — that’s why quitting is so hard.”
“All cigarettes cause cancer, lung disease, heart attacks, and premature disease, heart attacks, and premature death — lights, low tar, ultra lights, and naturals. There is no safe cigarette.”
“Secondhand smoke causes lung cancer and coronary heart disease in adults who do not smoke.”
“Children exposed to secondhand smoke are at an increased risk for sudden infant death syndrome (SIDS), acute respiratory infections, ear problems, severe asthma, and reduced lung function.”
“There is no safe level of exposure to secondhand smoke.”
http://www.seattlepi.com/news/article/Deal-reached-on-tobacco-firm-corrective-statements-5131393.php

War on smoking, at 50, turns to teens: Our view

The Editorial Board, USATODAY

Want kids to quit? Raise cigarette taxes. It works.

The war on smoking, now five decades old and counting, is one of the nation’s greatest public health success stories — but not for everyone.
As a whole, the country has made amazing progress. In 1964, four in ten adults in the U.S. smoked; today fewer than two in ten do. But some states — Kentucky, South Dakota and Alabama, to name just a few — seem to have missed the message that smoking is deadly.
Their failure is the greatest disappointment in an effort to save lives that was kick-started on Jan. 11, 1964, by the first Surgeon General’s Report on Smoking and Health. Its finding that smoking is a cause of lung cancer and other diseases was major news then. The hazards of smoking, long hidden by a duplicitous industry, were just starting to emerge.
The report led to cigarette warning labels, a ban on TV ads and eventually an anti-smoking movement that shifted the nation’s attitude on smoking. Then, smokers were cool. Today, many are outcasts, banished from restaurants, bars, public buildings and even their own workplaces. Millions of lives have been saved.
The formula for success is no longer guesswork: Adopt tough warning labels, air public service ads, fund smoking cessation programs and impose smoke-free laws. But the surest way to prevent smoking, particularly among price-sensitive teens, is to raise taxes. If you can stop them from smoking, you’ve won the war. Few people start smoking after turning 19.
Long before health advocates discovered this, the tobacco industry knew that high taxes kill smoking as surely as cigarettes kill smokers. “Of all the concerns … taxation … alarms us the most,” says an internal Philip Morris document, turned over in a gaggle of anti-smoking lawsuits in the 1990s.
The real-life evidence of taxing power is overwhelming, too. The 10 states with the lowest adult smoking rates slap an average tax of $2.42 on every pack — three times the average tax in the states with the highest smoking rates.
New York has the highest cigarette tax in the country, at $4.35 per pack, and just 12% of teens smoke — far below the national average of 18%. Compare that with Kentucky, where taxes are low (60 cents), smoking restrictions are weak and the teen smoking rate is double New York’s. Other low-tax states have similarly dismal records.
Foes of high tobacco taxes cling to the tired argument that they fall disproportionately on the poor. True, but so do the deadly effects of smoking — far worse than a tax. The effect of the taxes is amplified further when the revenue is used to fund initiatives that help smokers quit or persuade teens not to start.
Anti-smoking forces have plenty to celebrate this week, having helped avert 8 million premature deaths in the past 50 years. But as long as 3,000 adolescents and teens take their first puff each day, the war is not won.
USA TODAY’s editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.
http://www.usatoday.com/story/opinion/2014/01/08/war-on-smoking-50th-anniversary-cigarette-tax-editorials-debates/4381299/

Are e-cigarettes dangerous?

By Harold P. Wimmer
Editor’s note: Harold P. Wimmer is the president and CEO of the American Lung Association.
(CNN) — For the makers of electronic cigarettes, today we are living in the Wild West — a lawless frontier where they can say or do whatever they want, no matter what the consequences. They are free to make unsubstantiated therapeutic claims and include myriad chemicals and additives in e-cigarettes.
Big Tobacco desperately needs new nicotine addicts and is up to its old tricks to make sure it gets them. E-cigarettes are being aggressively marketed to children with flavors like Bazooka Bubble Gum, Cap’n Crunch and Cotton Candy. Joe Camel was killed in the 1990s, but cartoon characters are back promoting e-cigarettes.
Many e-cigarettes look like Marlboro or Camel cigarettes. Like their old-Hollywood counterparts, glamorous and attractive celebrities are appearing on TV promoting specific e-cigarette brands. Free samples are even being handed out on street corners.

A report from the Centers for Disease Control and Prevention shows the promotion of e-cigarettes is reaching our children with alarming success. In just one year, e-cigarette use doubled among high school and middle school students, and 1 in 10 high school students have used an e-cigarette. Altogether, 1.78 million middle and high school students nationwide use e-cigarettes.

The three largest cigarette companies are all selling e-cigarettes. Because tobacco use kills more than 400,000 people each year and thousands more successfully quit, the industry needs to attract and addict thousands of children each day, as well as keep adults dependent to maintain its huge profits.
Nicotine is a highly addictive substance, whether delivered in a conventional cigarette or their electronic counterparts. The potential harm from exposure to secondhand emissions from e-cigarettes is unknown. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (a well-known carcinogen) coming from those secondhand emissions. We commend New York City recently for banning the use of e-cigarettes indoors.
No e-cigarette has been approved by the FDA as a safe and effective product to help people quit smoking. Yet many companies are making claims that e-cigarettes help smokers quit. When smokers are ready to quit, they should call 1-800-QUIT NOW or talk with their doctors about using one of the seven FDA-approved medications proven to be safe and effective in helping smokers quit.
According to one study, there are 250 different e-cigarette brands for sale in the U.S. today. With so many brands, there is likely to be wide variation in the chemicals — intended and unintended — that each contain.
In 2009, lab tests conducted by the FDA found detectable levels of toxic cancer-causing chemicals — including an ingredient used in anti-freeze — in two leading brands of e-cigarettes and 18 various e-cigarette cartridges.
There is no safe form of tobacco. Right now, the public health and medical community or consumers have no way of knowing what chemicals are contained in an e-cigarette or what the short and long term health implications might be.
Commonsense regulation of e-cigarettes by the U.S. Food and Drug Administration is urgently needed. In the absence of meaningful oversight, the tobacco industry has free rein to promote their products as “safe” without any proof.
A proposal to regulate e-cigarettes and other tobacco products has been under review at the White House Office of Management and Budget since October 1, 2013. The Obama administration must move forward with these rules to protect the health of everyone, especially our children.
The opinions expressed in this commentary are solely those of Harold P. Wimmer.
http://www.cnn.com/2014/01/06/opinion/wimmer-ecigarette-danger/

US is marking 50th anniversary of surgeon general report that turned the tide against smoking

Article by: MIKE STOBBE , Associated Press
ATLANTA — Fifty years ago, ashtrays seemed to be on every table and desk. Athletes and even Fred Flintstone endorsed cigarettes in TV commercials. Smoke hung in the air in restaurants, offices and airplane cabins. More than 42 percent of U.S. adults smoked, and there was a good chance your doctor was among them.
The turning point came on Jan. 11, 1964. It was on that Saturday morning that U.S. Surgeon General Luther Terry released an emphatic and authoritative report that said smoking causes illness and death — and the government should do something about it.
In the decades that followed, warning labels were put on cigarette packs, cigarette commercials were banned, taxes were raised and new restrictions were placed on where people could light up.
“It was the beginning,” said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.
It was not the end. While the U.S. smoking rate has fallen by more than half to 18 percent, that still translates to more than 43 million smokers. Smoking is still far and away the leading preventable cause of death in the U.S. Some experts predict large numbers of Americans will puff away for decades to come.
Nevertheless, the Terry report has been called one of the most important documents in U.S. public health history, and on its 50th anniversary, officials are not only rolling out new anti-smoking campaigns but reflecting on what the nation did right that day.
The report’s bottom-line message was hardly revolutionary. Since 1950, head-turning studies that found higher rates of lung cancer in heavy smokers had been appearing in medical journals. A widely read article in Reader’s Digest in 1952, “Cancer by the Carton,” contributed to the largest drop in cigarette consumption since the Depression. In 1954, the American Cancer Society announced that smokers had a higher cancer risk.
But the tobacco industry fought back. Manufacturers came out with cigarettes with filters that they claimed would trap toxins before they settled into smokers’ lungs. And in 1954, they placed a full-page ad in hundreds of newspapers in which they argued that research linking their products and cancer was inconclusive.
It was a brilliant counter-offensive that left physicians and the public unsure how dangerous smoking really was. Cigarette sales rebounded.
In 1957 and 1959, Surgeon General Leroy Burney issued statements that heavy smoking causes lung cancer. But they had little impact.
Amid pressure from health advocates, President John F. Kennedy’s surgeon general, Dr. Luther Terry, announced in 1962 that he was convening an expert panel to examine all the evidence and issue a comprehensive, debate-settling report. To ensure the panel was unimpeachable, he let the tobacco industry veto any proposed members it regarded as biased.
Surveys indicated a third to a half of all physicians smoked tobacco products at the time, and the committee reflected the culture: Half its 10 members were smokers, who puffed away during committee meetings. Terry himself was a cigarette smoker.
Dr. Eugene Guthrie, an assistant surgeon general, helped persuade Terry to kick the habit a few months before the press conference releasing the report.
“I told him, ‘You gotta quit that. I think you can get away with a pipe — if you don’t do it openly.’ He said, ‘You gotta be kidding!’ I said, ‘No, I’m not. It just wouldn’t do. If you smoke any cigarettes, you better do it in a closet,'” Guthrie recalled in a recent interview with The Associated Press.
The press conference was held on a Saturday partly out of concern about its effect on the stock market. About 200 reporters attended.
The committee said cigarette smoking clearly did cause lung cancer and was responsible for the nation’s escalating male cancer death rate. It also said there was no valid evidence filters were reducing the danger. The committee also said — more vaguely — that the government should address the problem.
“This was front-page news, and every American knew it,” said Robin Koval, president of Legacy, an anti-smoking organization.
Cigarette consumption dropped a whopping 15 percent over the next three months but then began to rebound. Health officials realized it would take more than one report.
In 1965, Congress required cigarette packs to carry warning labels. Two years later, the Federal Communications Commission ordered TV and radio stations to provide free air time for anti-smoking public service announcements. Cigarette commercials were banned in 1971.
Still, progress was slow. Warner recalled teaching at the University of Michigan in 1972, when nearly half the faculty members at the school of public health were smokers. He was one of them.
“I felt like a hypocrite and an idiot,” he said. But smoking was still the norm, and it was difficult to quit, he said.
The 1970s also saw the birth of a movement to protect nonsmokers from cigarette fumes, with no-smoking sections on airplanes, in restaurants and in other places. Those eventually gave way to complete smoking bans. Cigarette machines disappeared, cigarette taxes rose, and restrictions on the sale of cigarettes to minors got tougher.
Tobacco companies also came under increasing legal attack. In the biggest case of them all, more than 40 states brought lawsuits demanding compensation for the costs of treating smoking-related illnesses. Big Tobacco settled in 1998 by agreeing to pay about $200 billion and curtail marketing of cigarettes to youths.
In 1998, while the settlement was being completed, tobacco executives appeared before Congress and publicly acknowledged for the first time that their products can cause lung cancer and be addictive.
Experts agree the Terry report clearly triggered decades of changes that whittled the smoking rate down. But it was based on data that was already out there. Why, then, did it make such a difference?
For one thing, the drumbeat about the dangers of smoking was getting louder in 1964, experts said. But the way the committee was assembled and the carefully neutral manner in which it reached its conclusion were at least as important, said Dr. Tim McAfee, director of the Office on Smoking and Health at the Centers for Disease Control and Prevention.
At the same time, he and others said any celebration of the anniversary must be tempered by the size of the problem that still exists.
Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and 8.6 million live with a serious illness caused by smoking, according to the CDC.
Donald Shopland finds that depressing.
Fifty years ago, he was a 19-year-old who smoked two packs a day while working as a clerk for the surgeon general’s committee. He quit cigarettes right after the 1964 report came out, and went on to a long and distinguished public health career in which he wrote or edited scores of books and reports on smoking’s effects.
“We should be much further along than we are,” the Georgia retiree lamented.
http://www.startribune.com/lifestyle/health/238716101.html?page=all&prepage=1&c=y#continue