Jimmy Carter: Pro-Tobacco President, Anti-Smoking Ex-President

On the subject of smoking, President Jimmy Carter was a paradox. Two of his best appointments were Joseph Califano, Jr., a former aide to President Lyndon Johnson, as Secretary of Health, Education and Welfare (HEW) and Harvard pediatrician Dr. Julius Richmond as Surgeon General and Assistant HEW Secretary. The Surgeon General’s Report of 1979, written under their guidance and released on the 15th anniversary of the publication of the first report by the Surgeon General on smoking and health, was the most comprehensive document on smoking ever published by the federal government.  A year later, the Surgeon General’s Report on the health consequences of smoking for women made front-page news around the world. Carter’s other significant contribution to fighting tobacco use was his appointment of Dr. Vincent DeVita to head the National Cancer Institute (NCI). Under DeVita and his cancer prevention director Joe Cullen, the NCI changed course from trying to find a safer cigarette to promoting ways to get people to stop smoking.

Ultimately, though, President Carter’s major contribution to anti-smoking efforts was his firing of Califano for having incurred the wrath of voters in tobacco-growing states, which sparked public outrage and drew even greater attention to the issue.  It was best summed up in the headline, “Carter fired Califano for doing his job”. The author of that column, conservative William Buckley, was no friend of Democrats, but he saw past Califano’s public letter of resignation. Buckley recognized that he’d been booted because of his “anti-tobacco stand, which hurt the feelings of tobacco growers.” Even President Ronald Reagan, who quipped before assuming office that he would be too busy to deal with issues like smoking, unwittingly made a greater contribution than President Carter to tackling tobacco-related health problems by his appointment of Dr. C. Everett Koop as Surgeon General. Although most public health and medical organizations opposed Koop’s nomination because of his outspoken opposition to abortion, he would soon become the national voice of the anti-smoking movement — or the new head of the nanny state, according to his detractors in tobacco country.

In September 1985, nearly five years after leaving office, former President Carter convened a conflict resolution retreat on the tobacco issue at Calloway Gardens, Georgia, patterned after his Camp David meetings to forge a peace accord in the Middle East. He invited the heads of major health organizations, tobacco growers, elected officials from tobacco-growing states, tobacco industry executives, and anti-smoking activists – thirty participants in all. Although only one tobacco industry representative attended the retreat (the director of the Smokeless Tobacco Council), most tobacco state agriculture commissioners were there, as were the heads of the American Cancer Society, the American Heart Association, the American Lung Association, the American Public Health Association, and Doctors Ought to Care. It was arguably the first time that face-to-face discussions were held between pro-tobacco interests and anti-smoking groups. This exhibition features documents from the three-day conflict resolution retreat at Calloway Gardens.

Participants ultimately agreed on two main points: that the tobacco farmer wasn’t the main obstacle to curbing teen smoking — the cigarette manufacturers were — and that America’s adolescents needed stronger education on the harmfulness of smoking. Dayle E. Powell, JD, the founding Director of the Conflict Resolution Programs at the Carter Center at Emory University, wrote about the tobacco symposium, which she coordinated, in an essay in the Negotiation Journal, which is included in this exhibition. In May 2024, Powell, now Dayle E. Spencer, offered this remembrance: 

“The symposium had two significant outcomes. First it led to a compromise between the smokeless tobacco industry and the health advocates to jointly support legislation that became the Smokeless Tobacco Act of 1986, which forbade advertising of smokeless products on TV and radio [which had not been included in Congress’s 1971 broadcast ban on cigarettes ads], and required disease specific warning labels on all smokeless products. Second, this early success caused the Carter Center to pivot to international conflicts such as Ethiopia and Eritrea, Sudan and South Sudan, and North and South Korea.

“The tobacco symposium was a test case that proved the model we later used in civil war situations throughout the world.”

In recent years, although the Carter Center has not focused its attention on the world tobacco pandemic, it has been dedicated to eradicating global parasitic diseases such as guinea worm and schistosomiasis.

Alan Blum, MD
Director, The Center for the Study of Tobacco and Society
May 24, 2024