Blowing Smoke: The Lost Legacy of the Surgeon General’s Report on Smoking and Health

“Never before had the government branded a product a threat to public health. Those who later would lament the growing involvement of government into Americans’ lives would trace the trend to this landmark report.”
–LOST EMPIRE: The Fall of R.J. Reynolds Tobacco Company

On January 11, 1964, at a packed press conference for over 200 reporters at the State Department in Washington, DC, US Surgeon General Luther L. Terry released what would become one of the most important and most widely cited documents in the annals of medicine: Smoking and Health—Report of the Advisory Committee of the Surgeon General of the Public Health Service.

“Few medical questions have stirred such public interest or created more scientific debate than the tobacco–health controversy,” Terry noted. But the findings of the 14-month study by the 10-member committee were blunt and unequivocal. Principal among the conclusions: “Cigarette smoking is causally related to lung cancer in men; the magnitude of the effect of cigarette smoking far outweighs all other factors,” and  “it is a health hazard of sufficient importance to warrant appropriate remedial action.”

Dr. Terry’s indictment of cigarettes as the principal cause of lung cancer was intended to mark the beginning of the end of the Marlboro Man. But far from riding off into the sunset, the tobacco industry has more than met the challenge of maintaining the nicotine addiction of tens of millions of Americans and 1.3 billion people overall (22% of the world’s population). The health and economic toll taken by tobacco remains devastating.

This exhibition commemorates — but does not celebrate — the 60th anniversary of the publication of the Surgeon General’s Report. In 1995 the New York Public Library featured the Report in an exhibition of 100 “Books of the Century.” The Report was one of 10 scientific works, including Rachel Carson’s Silent Spring, James Watson’s The Double Helix, and Albert Einstein’s The Meaning of Relativity.

Drawn from the Center’s print and broadcast collections, Blowing Smoke reviews the report’s origins and the reactions to its release by the mass media, organized medicine, and the tobacco industry. It highlights Dr. Terry’s plea to physicians — the majority of whom still smoked — to advise patients to stop, as well as his leadership in urging the public health community to launch anti-smoking educational campaigns. The exhibition also includes sections on Dr. Leroy Burney, the first Surgeon General to state publicly that cigarette smoking caused lung cancer; L. Edgar Prina, the reporter who asked President John F. Kennedy the question that led to the formation of the advisory committee; Senator Maurine Neuberger, the first Member of Congress to take on the politically powerful tobacco industry and its allies such as the American Medical Association; Sir George Godber, the head of the United Kingdom’s National Health Service, who encouraged Dr. Charles Fletcher of the Royal College of Physicians to issue a public report on the health consequences of smoking;  and Senator Robert F. Kennedy, who, at the First World Conference on Smoking and Health in 1967, gave a stirring call for actions to reduce cigarettes’ devastating toll.

Blowing Smoke provides sobering lessons about the failure of government, academia, foundations, and health organizations alike to overcome their addiction to money for endless research, not action — a strategy set in motion in 1954 by the six major U.S. cigarette manufacturers when they created the Tobacco Industry Research Committee [renamed the Council for Tobacco Research in 1964 following publication of the Surgeon General’s Report], which offered lucrative employment for scientists willing to cast doubt on the growing evidence of cigarette smoking as a major cause of death and disease. Although the state attorneys general would force the tobacco industry to shut down the Council in the late-1990s and publish corrective advertisements acknowledging that smoking causes cancer, these manufacturers, led by Philip Morris International, now portray themselves as veritable pharmaceutical companies offering not just their ever-profitable cigarette brands but also a range of smoke-free, “reduced harm” products touted by hirelings from academia, the World Health Organization, the Food and Drug Administration, and the American Legacy Foundation–as if addiction to nicotine were just a minor side effect.

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

The Immediate Reaction to the Report

Exhibition curator Alan Blum, MD, sets the stage for one of the major announcements in the history of public health. (01:32)

SMOKING and HEALTH
REPORT OF THE ADVISORY COMMITTEE TO THE SURGEON GENERAL OF THE PUBLIC HEALTH SERVICE (29-page excerpt)

Front cover; click on image to read Part I: Introduction, Summaries, and Conclusions
Washington, DC: US Department of Health, Education, and Welfare
Public Health Service Publication No. 1103
387 pages
January 11, 1964

“Since the turn of the [20th] century, scientists have become increasingly interested in the effects of tobacco on health. Only within the past few decades, however, has a broad experimental and clinical approach to the subject been manifest; within this period the most extensive and definitive studies have been undertaken since 1950.
“Few medial questions have stirred such public interest or created more scientific debate than the tobacco-health controversy. The interrelationships of smoking and health undoubtedly are complex. The subject does not lend itself to easy answers. Nevertheless, it has been increasingly apparent that answers must be found…”

— Foreword by Luther L. Terry, Surgeon General

“Verdict on Cigarets: Guilty as Charged” (17 pages)

News article; three cigarette advertisements; one cigar advertisement
LIFE Magazine
January 24, 1964

“The 10-man jury had been out for more than a year weighing the case against cigarets. Now surgeon general Luther L. Terry, holding in his hand the jury’s 387-page report, announced to the nation its unanimous verdict on the cigaret: guilty as charged of being a menace to health.

“Cigarets, said the report, are a major cause of lung cancer and chronic bronchitis. And they help shorten a smoker’s life in a number of other ways. This had been said before. But now it was being said with greater authority by the Surgeon General’s Advisory Committee, a group distinguished medical men whose appointments were approved by the tobacco industry.

“Many Americans had hoped the verdict would be different: tobacco people, farmers, politicians, suppliers, salesmen, advertising men — and, not least of all, the American smoker, who has mightily resisted the idea that his old and comforting friend, the cigaret, had all along been a villain…”

(Curator’s note: This issue also included advertisements by RJ Reynolds Tobacco Company for Winston cigarettes (back cover), P. Lorillard Tobacco Company for Newport cigarettes,  Philip Morris Inc. for LARK cigarettes,  and General Cigar Company for White Owl cigars.)

“WASHINGTON, Jan. 11 — SAYS SMOKING IS DAMAGING — Dr. Luther Terry, U.S. Surgeon General, answers a question at news conference discussion of blue ribbon federal panel’s studies of the dangers of smoking on health. He said he would warn his patients against smoking and if they insisted on doing it he would make sure they understood they would face serious health hazards.”

Assocated Press Wirephoto
Jamuary 11, 1964

“CIGARETTES PERIL HEALTH,
U.S. REPORT CONCLUDES;
‘REMEDIAL ACTION’ URGED;
CANCER LINK CITED;
Smoking Is Also Found ‘Important’ Cause of Chronic Bronchitis” (5 pages)

Article by Walter Sullivan
The New York Times
January 12, 1964

14 related articles:

“Summary and Conclusions of U.S. Report on Links Between Smoking and Health”

“Industry Is Still Prospering;
CIGARETTE SALES CONTINUE TO RISE”
By Alexander H. Hammer

“3 Networks Will Review Policy On Use of Tobacco Advertising”

“Clergy Is Urged to Set Example on Cigarettes”

“Increase Is Expected in Suits Over Cancer”

“Tobacco Institute Says Report ‘Is Not Final Chapter’ In Debate Over Health Issue
RESEARCH URGED BY ITS PRESIDENT”
By John H. Allan

“SMOKING BANNED AT NEWS PARLEY
But Some Reporters Puff Sheepishly in Corridors”
By Marjorie Hunter

“Medical Study in 1859 First Cited Hazards;
Tobacco Linked to Cancers by French Doctor [Dr. Bouisson of Montpelier]
— Other Data Made Little Stir”
By Harold M. Schmeck, Jr.

“SMOKER IN STREET LARGELY DEFIANT
But Some Concede They’re Frightened by the Report”
By Douglas Robinson

“Pending Smoking Bills”

“Sketches of Members of Government Study Panel”

“Smoking Report Poses Issue of Public Policy”

“Head of Cancer Society Asks Follow Up Action”

“Report Not Convincing to a Scientist at Yale”

See also The Dallas Morning News, January 12, 1964: “Smoking Held Cancer Cause” (4 pages)

“U.S. Plans Legal War to Cut Cigaret Smoking” (2 pages)

News article by Robert C. Toth
The Detroit News
January 11, 1964

(Curator’s note: In the 1960s most US cities still had morning newspapers and afternoon newspapers. This issue of The Detroit News and the adjacent issue of The Macon News are the only examples in the Center’s collection of newspapers that reported on the Surgeon General’s Report within hours after it was  published.)

“Smoking Called Major Cause of Lung Cancer;
Panel Finds Filters Do Not Cut Hazard” (2 pages)

News article by the Associated Press
THE MACON NEWS
January 11, 1964

“Senator Neuberger Asks Government To Curtail the Hazards of Smoking”

“Sen. Maurine B. Neuberger, Democrat-Oregon, today called for a sweeping national program to control the hazards of smoking…
“Mrs. Neuberger, who has campaigned for many years against smoking, said she planned to introduce two bills — one to give the Federal Trade Commission the power to regulate cigarette advertising and labeling, and the other to provide education and research on smoking.”

“Smoking Held Cancer Cause
Scientists Urge Remedial Action”

News article by the Associated Press
The Dallas Morning News
January 12, 1964

“THE CIGARET REPORT: Links Cancer, Other Diseases”

Front page coverage of Surgeon General’s Report: Articles by Jack Pickering and Emil J. Steinbruner
New York Journal American
January 12, 1964

“TIE CANCER TO CIGARETS
SCIENTIFIC REPORT REVIEWS RESEARCH ON HEALTH” (8 pages)

Front page article by Michael Pakenham; four pages of related articles, including

“SMOKE REPORT SCARES SOME, ANGERS OTHERS”

“Smoke Panel’s Credentials Told
Variety of Fields Represented by 10 Members”

“U.S. Report on Smoking Seen as a Best Seller”

“U.S. May Seek Cigaret Curbs
Industry Urges Wider Study of Smoking”

Chicago Tribune
January 12, 1964

“Head of A.M.A. Asks Public to Take Heed”

Chicago Tribune

January 12, 1964

“The president of the American Medical Association urged Americans yesterday to give ‘careful and thoughtful attention’ to the report of the surgeon general’s advisory committee on smoking and health, and also to the ‘strong evidence linking smoking to cancer and other diseaases.’
“But Dr. Edward R. Annis, of Miami, Fla., said in a statement issued thru A.M.A. headquarters in Chicago that it is ‘unrealistic to assume that the American people are suddenly going to quit smoking.’…
“Dr. Annis’ statement called for research efforts to try to find ‘how tobacco smoke affects health, and if possible, to eliminate whatever element in the smoke may induce disease.’
“The A.M.A, in a planned research project on tobacco and health, hopes to do this, Dr. Annis said…”

“SMOKING AND HEALTH”/
“For Satisfying Pleasure…Kent with the Micronite Filter…” (5 pages)

Cover story and back cover advertisement by P. Lorillard Tobacco Company for Kent cigarettes

Newsweek
November 18, 1963

(Curator’s note: This article is the most definitive coverage in any news magazine about the U.S. Surgeon General’s Advisory Committee on Smoking and Health in the lead up to the publication of the committee’s findings. Just as the committee was winding up its top-secret investigation, and only a few days after this issue of Newsweek was published, President Kennedy was assassinated. There were concerns that the Report would not be released, because President Johns[whom he would nominate to the Supreme Court], had represented the tobacco industry.

The article includes statements from the Tobacco Industry Research Council and several physicians who cast doubt on the evidence that smoking caused cancer. The issue features an advertisement for Kent cigarettes on its back cover.)

“SPOTLIGHT ON BUSINESS: To Smoke — Or Not to Smoke?” (6 pages)

Article by Lawrence S. Martz
Newsweek
January 27, 1964

“MEDICINE: Smoking: The Government Report” (5 pages)

Article on the publication of the Surgeon General’s Report; advertisement by the American Tobacco Company for Montclair cigarettes

TIME Magazine
January 17, 1964

Three of the Most Important National Television Documentaries about the Release of the Surgeon General’s Report, Plus an Audio Recording of the Press Conference

“CBS News Extra: On Smoking and HealthThe Findings of the Surgeon General’s Committee” (28:14)

Harry Reasoner anchors this documentary aired on the day of the release of the Report
Columbia Broadcasting System (CBS Television Network)
January 11, 1964

“In the history of the world, no non-essential habit ever got so entrenched so fast. 70 million Americans smoke. Today they got a message from the United States Surgeon General…

“In this half-hour, we will confine ourselves to the Report itself, what it says, how its authors reached their conclusions, and the merits of their findings as seen by parties directly involved in the issue.”

“‘NBC News Special Report: SMOKING AND HEALTH Surgeon General’s Report,’ the background and the detailing of the report issued today by the United States Surgeon General’s Advisory Committee on Smoking and Health, brought to you by Alka Seltzer for effective, speedy relief of headache and upset stomach, and by One-A-Day brand multiple vitamins, the label with the big red 1″ (59:07)

Reported by Frank McGee
National Broadcasting Corporation (NBC-TV)
January 11, 1964

“In the case of carcinoma of the lung, where mortality rates are the highest, there are about 41,000 [annual] deaths, and the committee in this instance feels that the major causal factor is smoking.”

–Walter J. Burdette, MD
Professor of Surgery, University of Utah

“There is no evidence which will establish the fact that filters have had any effect in reducing the health hazards of cigarette smoking.”

— Dr. James M. Hundley
Assistant Surgeon General

“CIGARETTES: A COLLISION OF INTERESTS” (54:24)

Reported by Harry Reasoner
Produced and written by Arthur D. Morse
CBS Reports documentary
Columbia Broadcasting System (CBS Television Network)
April 15, 1964

Film donated to Alan Blum, MD by J. Fred MacDonald, PhD in 1983

(Curator’s note: This is the most in depth, balanced documentary ever made about the manufacture, promotion, consumption, and regulation of cigarettes.)

“Quitting smoking is an old American hobby, a joke and a goal ever since the habit began. But since January 11, since the Surgeon General’s report, it has achieved a new urgency and a new respectability…Whether sales fall, rise, or remain the same, whether there is Congressional pressure or long litigation, our free enterprise system faces one of its strongest trials…That which is good for the state of our economy is not, in the opinion of most medical authorities, good for the sake of our health. The real test is how we cope with this knowledge. It is one small way by which we measure the effectiveness of a free society.”
–Harry Reasoner

Press Conference by Luther Terry, MD, Surgeon General of the United States Public Health Service, and the Surgeon General’s Advisory Committee on the release of Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service (35:28)

Audiotape recording of the press conference at the State Department, copies of which were sent to US Public Health Service field offices
January 11, 1964

Sounding the Alarm About Smoking

“SMOKING AND CANCER OF THE LUNG
A Preliminary Report” (10 pages)

Article by Richard Doll and A. Bradford Hill
British Medical Journal
1950 (volume two), pages 740-748
September 30, 1950

“In England and Wales the phenomenal increase in the number of deaths attributed to cancer of the lung provides one of the most striking changes in the pattern of mortality recorded by the Registrar-General. … [I]n the quarter of a century between 1922 and 1947 the annual number of deaths recorded increased from 612 to 9,287, or roughly fifteenfold. This remarkable increase is, of course, out of all proportion to the increase of population…This increase…has occurred, too, in Switzerland, Denmark, the U.S.A., Canada, and Australia, and has been reported from Turkey and Japan…

“Many writers have studied these changes, considering whether they denote a real increase in the incidence of the disease or are due merely to improved standards of diagnosis. Some believe that the latter factor can be regarded as wholly, or at least mainly, responsible. On the other hand…the increase of certified respiratory cancer mortality during the past 20 years has been as rapid in country districts as in the cities with the best diagnostic facilities, a fact which does not support the view that such increase merely reflects improved diagnosis of cases previously certified as bronchitis or other respiratory affections…

“Two main causes have from time to time been put forward: (1) a general atmospheric pollution from the exhaust fumes of cars, from the surface dust of tarred roads, and from gas-works, industrial plants, and coal fires; and (2) the smoking of tobacco…

“From consideration of the smoking histories given by the patients without cancer of the lung a tentative estimate was made of the number of people who smoked different amounts of tobacco in Greater London, and hence the relative risks of developing the disease among different grades of smokers were calculated. The figures obtained are admittedly speculative, but suggest that, above the age of 45, the risk of developing the disease increases in simple proportion with the amount smoked, and that it may be approximately 50 times as great among those who smoke 25 or more cigarettes a day as among non-smokers…”

“CIGARETTES AND CANCER” (3 pages)

Editorial
British Medical Journal
1950 (volume 2), pages 767-768
September 30, 1950

Correspondence
British Medical Journal
1950 (volume 2), page 889
October 14, 1950

“It is not easy to adopt an unbiased attitude to the concept that smoking causes cancer: we are all either smokers or non-smokers, and each group may regard the other as prejudiced. It is said that the reader of an American magazine was so disturbed by an article on the subject of smoking and cancer that he decided to give up reading. Those who smoke more than 40 cigarettes a day, allowing ten minutes per cigarette, are occupied with smoking for about 61 hours. There are no days off, and therefore the heavy smoker smokes for about 46 hours a week. This almost amounts to an occupation. Even so, the proof that cancer of the lung is associated with smoking must obviously be based on statistical and not on clinical evidence. In this country Dr. Richard Doll and Professor A. Bradford Hill, whose paper is published in the opening pages of this issue, have carried out a meticulously conducted inquiry, the results of which have very serious implications, for they conclude that ‘smoking is a factor, and an important factor, in the production of carcinoma of the lung’…

“The practical question which the doctor in practice has to answer is whether any of his patients-for instance, those with smoker’s cough-should be advised to give up smoking…There is no evidence about the degree of risk which cigarette smokers take, but it does apparently increase in direct proportion to the amount smoked daily and to the total duration of the habit.”

“PRIMARY PULMONARY MALIGNANCY
Treatment by Total Pneumonectomy; Analysis of 70 Collected Cases and Presentation of 7 Personal Cases” (17 pages)

Original article by Alton Ochsner, MD, FACS and Michael DeBakey, MD
Surgery, Gynecology, and Obstetrics
1939 (volume 68), pages 435-451
1939

“There are several explanations for the actual increase in the incidence of pulmonary malignancies, most of which have not been satisfactory. A number of theories have been suggested. Winternitz, Wason, and McNamara, because of the presence of metaplasia in the bronchial mucosa of persons dying from influenza, suggested that this change is a precancerous lesion. The inhalation of irritating gases such as war gas or gas originating from the increased use of motor cars has been proposed as an etiological factor. In our opinion, the increase in smoking with the universal custom of inhaling is probably a responsible factor, as the inhaled smoke, constantly repeated over a long period of time, undoubtedly is a source of chronic irritation to the bronchial mucosa.”

“Tobacco Smoking As A Possible Etiologic Factor In Bronchogenic Carcinoma” (10 pages)

Original article by Ernst Wynder and Evarts A. Graham
In JAMA (Journal of the American Medical Association)
1950 (volume 143), pages 329-336

Reprinted with commentary in The Journal of NIH Research
May 1982

(Curator’s note: One of the individuals who played a major role in proving a causal association between cigarette smoking and lung cancer was a medical student, Ernst Wynder. In 1982 in The Journal of NIH Research, Dr. Wynder [1922-1999], who went on to publish over 600 papers and became a leading figure in health promotion, shared the story behind his pioneering epidemiological study.)

“In 1948, I was on fellowship grant in my sophomore year [at Washington University School of Medicine in St. Louis] with Mark Norton at New York University. The idea struck me that it would be useful to do a case-control study on lung cancer. I went across the street to Bellevue and asked permission to interview lung cancer patients and some control patients…I went back to St. Louis and introduced myself to Dr. Evarts Graham, who was the chief of surgery at Washington University and well known for his lung cancer surgery. He gave me permission to interview his patients during my junior year…I went to the American Cancer Society (ACS) in New York and met with the medical director at that time, Dr. Charles Cameron. He agreed to give me a grant to expand my studies. I suppose I was one of the few junior medical students to receive a grant from ACS… I was able to travel around the country introducing patients in various cities. Our new data confirmed the association between smoking and lung cancer.

“We published our paper in JAMA in May 1950. I probably wouldn’t haven’t got any attention, or, for that matter, I might never have been published in those days, without Dr. Graham’s name on the paper. He was a major figure in cancer surgery. At first he thought that maybe there wasn’t too much to my idea. But later on, he became very supportive of my work. And lucky for me I worked in an institution with such a famous person who was supportive of my findings, even though his close associate Thomas Burford told him that smoking couldn’t possibly cause lung cancer. So it was certainly fortunate for my career that Dr. Graham sided with a medical student rather than his associate. Dr. Graham was, incidentally, a smoker until 1951, and ironically, even though he did the first surgery on  lung cancer surgery [in 1933] he died of lung cancer himself in 1957. Dr. Burford, also a heavy smoker, died some years ago of emphysema…

“It was not until 14 years after we published our paper was published that the first surgeon general’s report determined that our conclusion was right…There was little recognition that in the absence of smoking lung cancer could have been just as rare as it was at the beginning of the century…”

“Alton Ochsner, M.D., 1896-1981
Anti-Smoking Pioneer” (4 pages)

An appreciation by Alan Blum, MD
The Ochsner Journal
1999 (volume 1), pages 102-105
July 1999

Quote by Michael DeBakey, MD, about the toll taken by cigarette smoking (00:00:18)

From the documentary Medicine vs. Madison Avenue: Fighting Smoke with Fire,
Co-written by Alan Blum, MD and Eric Solberg, MA
Doctors Ought to Care
1994

_________________________________________________________________________________________________________

From “Alton Ochsner, M.D., 1896-1981: Anti-Smoking Pioneer”

An appreciation by Alan Blum, MD:

“Alton Ochsner’s persistent belief that cigarette smoking was the principal cause of the growing epidemic of lung cancer — a theory he publicized throughout the 1940s in the face of ridicule and vituperative attacks even from within the medical profession — symbolized his energetic drive to improve public health.

“He sardonically contrasted the Food and Drug Administration’s quick removal of thalidomide from the market with government inaction on cigarettes. ‘If there were one tenth the evidence that the Brooklyn Bridge was unsafe for traffic as there is that cancer of the lung is caused by cigarette smoking, the Brooklyn Bridge would be closed to traffic within 24 hours until it could be determined whether it was safe.’ It was all about money: Our complacency about this much greater health hazard is undoubtedly due to the economic significance of tobacco”…

“Among the first to debunk the government’s $40 million research effort to develop a ‘safe cigarette’, Ochsner, whenever he was asked if filtered cigarettes had any value, would reply, ‘Yes, for the tobacco industry.  They help sell more cigarettes’…

“Obituaries of Ochsner depicted him as a foe of smoking and a nemesis of the tobacco industry. It would be more accurate to depict him as a forceful advocate for good health. Although a surgeon, he preferred to speak out about measures that could prevent the need for the knife. ‘Even though relief of symptoms and prolongation of life can be obtained by surgery and other therapeutic measures,” he wrote in 1966, ‘only through prevention, mainly abstinence from smoking, can one hope to obtain better results from the treatment of lung cancer.'”

Huffing and Puffing by the Tobacco Industry

“Raps Charges That Smoking Causes Cancer”

News article
THE TOBACCO LEAF (tobacco industry trade weekly)
November 28, 1953

“It has not been proved that cigarettes have ever caused a single case of lung cancer, a statement by Mr.[Paul M.] Hahn [president of the American Tobacco Company] declared. The American Tobacco Company, which sold $1,065,738,454 worth of cigarettes and other tobacco products last year, is convinced that there is no connection between tobacco and lung cancer, he said
“Mr. Hahn also took the occasion to observe that within the last 350 years at one time or another virtually every known disease of the human body had been ascribed to the use of tobacco. One by one these charges have been abandoned for lack of evidence…”

“Darr Derides Cigarette and Cancer  Link;
There’s as Much Evidence Smoking Prolongs Life As That It Causes Cancer”

News article
THE TOBACCO LEAF (tobacco industry trade weekly)
December 5, 1953

“E.A. Darr, president of R.J. Reynolds Tobacco Co., in a recent interview with a TOBACCO LEAF staff writer, asserted that no real evidence that there is any relationship whatever between lung cancer and cigarette smoking has ever been produced.
“Mr. Darr pointed out that doctors contradict themselves, and commented that one of the best ways of getting publicity is for a doctor to make some startling claim relative to people’s health, regardless whether that statement is based on fact or theory…”

“A FRANK STATEMENT TO CIGARETTE SMOKERS”

Advertisement by the Tobacco Industry Research Committee (comprised of the major cigarette manufacturers), Empire State Building, New York, New York
Indianapolis News (the advertisement was also published in more than 300 other daily newspapers across the country, as well as in tobacco industry trade publications)
January 4, 1954

“A Frank Statement to Cigarette Smokers”

Advertisement by the Tobacco Industry Research Committee
THE TOBACCO LEAF (tobacco industry trade weekly; the advertisement was also published in 335 daily newspapers across the U.S.)
January 9, 1954

“Distinguished authorities point out:

  1. That medical research of recent years indicates many possible causes of cancer.
  2. That there is no agreement among the authorities regarding what the cause is.
  3. That there is no proof that cigarette smoking is one of the causes.
  4. That statistics purporting to link cigarette smoking with the disease could apply with equal force to any one of many other aspects of modern life. Indeed the validity of the statistics themselves is questioned by numerous scientists.

“…We accept an interest in people’s health as a basic responsibility, paramount to every other consideration in our business.

“We believe the products we make are not injurious to health.

“We always have and always will cooperate closely with those whose task it is to safeguard the public health .

“For more than 300 years tobacco has given solace, relaxation, and enjoyment to mankind. At one time or another during those years critics have held it responsible for practically every disease of the human body.one by one these charges have been abandoned for lack of evidence…

“Many people have asked us what we are doing to meet the public’s concern aroused by the recent reports. Here is the answer:

“1.We are pledging aid and assistance to the research effort into all phases of tobacco use and health. This joint financial aid will of course be in addition to what is already being cntributed by individual companies…”

“Tobacco Companies Establish Research Group To Study Tobacco Health Angle:
Tobacco Industry Research Committee Will Be Headed by Scientist of National Repute,
Aided by Advisory Board of Scientists Not Interested in Cigarette Industry —
Industry Statement Carried in Page Ad Forum by 335 Daily Newspapers Throughout the Country.”

THE TOBACCO LEAF
January 9, 1954

“Contention that Tobacco Causes Disease Does Not Agree with Authentic Biological Conceptions” (4 pages)

Column by James Coughlin, MD, FACS
THE TOBACCO LEAF
March 13, 1954

“For thousands of years, primitive and aboriginal people used tobacco in different ways without harmful effects, but modern man has been and is trying to prove the plant is harmful and disease forming. That is not so…”

“Statistics Do Not Imply Cause and Effect…
An Address Delivered at the New York Medical College” (2 pages)

Transcript of presentation by Dr. Milton B. Rosenblatt
THE TOBACCO LEAF
March 27, 1954

“Reports of Hoffman, Schrek, Muller, Mills and Porter, Ochsner, Wynder and Graham and Watson appear to show that smoking is involved in lung cancer. They merely show ta statistical correlation between the two phenomena without any proof that there is a cause and effect relationship.”

“36 Distinguished Specialists
Assert There Is No Proof
Smoking Causes Lung Cancer” (2 pages)

THE TOBACCO LEAF
April 17, 1954

“Half Million Dollar Fund Set Up by
Tobacco Industry for Cancer Research”

THE TOBACCO LEAF
May 22, 1954

“Tobacco Industry Hires
Famous Cancer Scientist
To Head Research Program
Dr. Clarence Cook Little Praises Cigarette Firms for

Willingness to Investigate Possible Tie of Smoking to
Disease — Scientific Freedom in Work Guaranteed” (2 pages)

THE TOBACCO LEAF
June 19, 1954

“A BRIEF REVIEW of the SMOKING — LUNG CANCER THEORY” (6 pages)

Transcript of an address to the Monroe County (Rochester, New York) Cancer Association by Clarence Cook Little, ScD, Scientific Director of the Tobacco Industry Research Committee, and former managing director of the American Cancer Society
April 28, 1960

“AN OPEN LETTER TO DR. CLARENCE COOK LITTLE” (4 pages)

Commentary by Daniel D. Rutstein, MD, chairman of the Department of Preventive Medicine, Harvard Medical School

The Atlantic
October 1957

“Over 25,000 people in the United States die from lung cancer each year, and the number is increasing by about 2000 every year. This disease now kills more men than any other type of cancer.

“What is the evidence that cigarette smoking is responsible for most of this increase? Eighteen studies in five countries show either that patients with lung cancer are predominantly cigarette smokers, or that cigarette -smokers have more lung cancer than do non-smokers. All but one of these eighteen studies show that the more and the longer you smoke cigarettes (but not pipes or cigars), the more likely you are to get lung cancer. Depending on the amount and the duration of the smoking, the rate of occurrence of lung cancer is from five to thirty-five times greater among cigarette smokers than among non-smokers. Most important, in all of the medical literature there is not one study that shows no relationship between cigarette smoking and lung cancer. These results, it seems to me, are more than just “the opinion of a few statisticians, as you stated…

“You have stated that there is nothing new, that the evidence is just ‘statistical,’ and that no ‘cause and effect relationship has been demonstrated.’ Your statement troubles me because I had always thought that such evidence as valid; I had been taught to believe that it is essential for medical research workers to follow statistical principles in all their investigations, What is wrong with a statistical study? Do not statistical principles come into play whenever anything is counted in any scientific study, whether performed in the laboratory or in the field? Statistics are, after all, the rules by which things are counted, and it is impossible to do any experiment without counting up the results…

“Dr. Little, is there really any justification for your continuing to demand the discovery of the ‘cause’ of lung cancer before we attempt to save human lives by recommending a decrease in cigarette smoking? Lung cancer is a serious disease which causes much suffering and cuts down people in the prime of life. Should not public health authorities immediately recommend the obvious remedy suggested by sound epidemiologic observation and confirmatory laboratory evidence? If not, why not?”

“THE PUBLIC AND SMOKING: Fear or Calm Deliberation?” (4 pages)

Commentary by Dr. Clarence Cook Little, scientific director and chairman of the Scientific Advisory Board to the Tobacco Industry Research Committee, in response to the commentary by Dr. Daniel Rutstein, chairman of the Department of Preventive Medicine at Harvard Medical School

The Atlantic
December 1957

“FEAR OR CALM DELIBERATION?

“In accepting and carrying out the responsibility of developing a research program in tobacco use and health for the Tobacco Industry Research Committee, my colleagues on the Scientific Advisory Board and I believe the cause of scientific investigation is best served by adherence to our stated position that definitive conclusions and predictions of individual risks are unwarranted by the present state of knowledge in this complex field…

“The public has been heavily propagandized along one definite theory of causation by those convinced by one level of information. Some of us demand a different order and level of knowledge before we accept causation or condone presentations of conclusions to the public. We claim merely the right to pursue knowledge through scientific research, the right to hold our point of view, and the right of the public to be aware of it.”

“Edwin Wilson Joins Research Advisory Group;
French Scientists Differing On Possible Relation of Tobacco Use — Lung Cancer”

News article
THE TOBACCO LEAF
July 24, 1954

“Contemporaneously with the announcement of the addition of Dr. Edwin Wilson, professor emeritus of vital statistics at Harvard University, to the Scientific Advisory Board of the Tobacco Industry Research Committee, which is studying the relation to [sic] tobacco to health, that group gave out the opinions of a umber of high-ranking French medical scientists on the question of whether there is a relation between tobacco and cancer.
“…Professor Huguenin, member of the National Institute’s committee for the statistical study of cancer, expressed skepticism about the possibility of tobacco having a determining influence in the development of cancer of the lung. Professor Huguenin is a heavy smoker.
“Dr. Oberlin, director of the National Cancer Institute’s research center, disagreed with Professor Huguenin, and relies upon studies conducted abroad as conclusive, though he had never conducted any research into cancer. Dr. Ravine, hospital physician, accepts the findings of the American and British scientists on the subject, though he had made no systematic study of the subject. professor Piedlievre, president of the National Order of Physicians, replied that the question does not lie within the prerogative of the national Order of Physicians…”

“It Is Unlikely that Cigarette Smoking Is
Major Factor in Producing Lung Cancer

Dr. W.C. Hueper, of the National Cancer Institute,
Sees No Direct Link Between Smoking — Disease” (2 pages)

News article
The TOBACCO LEAF
July 31, 1954

“There is little if any medical evidence advanced in support of the cigarette theory.”
–Dr. W.C. Hoeper addressing the Sixth International Cancer Congress, Sao Paulo, Brazil

“It may be concluded that the existing evidence neither proves nor strongly indicates that tobacco smoking and especially cigarette smoking represent a major or even predominating causal factor in the production of cancers in the respiratory tract and are the main reason for the phenomenal increase of pulmonary tumors during recent decades.  If excessive smoking actually plays a role cancer in the production of lung cancer, it seems to be a minor one if judged from the evidence on hand.”

–as quoted in “TOBACCO INDUSTRY DENIES CANCER TIE”
The New York Times
April 14, 1954

(Curator’s note: Wilhelm Carl Hueper, MD [1894 – 1978] was the first director of the Environmental Cancer Section of the National Cancer Institute, which he headed from 1948 to 1964. Hueper recognized that industrial dyes such as benzidine and β-Naphthylamine caused bladder cancer in chemical workers and that workers in the chromium industry had high levels of lung cancer. He was one of the first to raise the alarm about asbestos and about carcinogenic industrial chemicals in the air and water. His 1942 textbook Occupational Tumors and Allied Diseases was the first to list occupational causes. The tobacco industry repeatedly cited Hueper’s opinion that cigarette smoking was not a significant contributor to the development of cancer.)

“Darr Hits American Cancer Society

Cigarette Industry Destruction
Its Aim, Reynolds Chief Says”

News article
THE TOBACCO LEAF
November 27, 1954

“E.A. Darr, president of R.J. Reynolds Tobacco Co., maker of Camel, Winston and cavalier cigarettes, attacked the American Cancer Society and charged it with attempting to destroy the tobacco industry.
“This marked the first time that a tobacco company head has singled out the American Cancer Society for criticism. ‘The American Cancer Society has decided to put all its eggs in one basket and to destroy the cigarette industry,’ said Mr. Darr…
“‘I’m perfectly willing,’ Mr. Darr said, ‘to have the public compare the scientists on the tobacco industry’s research committee with those who are now getting the publicity.'”

“Johns Hopkins Cancer Expert Hits Hysteria”

News article
THE TOBACCO LEAF
December 11, 1954

“Declaring he does not believe cigarette smoking has anything whatever to do with causing lung cancer, Dr. William Rienhoff, famous lung cancer specialist of Johns Hopkins Hospital, told members of the [Baltimore] Rotary Club to ‘go ahead and smoke all you want.’
“Dr. Rienhoff characterized recent artic les concerning the relation of cigarette smoking and lung cancer as silly and irresponsible and contributing only to mass hysteria.”

(Curator’s Note: Reinhoff [1894-1981], the last surgical resident to train under Dr. William Halstead [1852-1922, one of the four founders of Johns Hopkins Hospital], was a member of the Tobacco Industry Reserach Committee.)

“Research Program Shows No Tobacco-Health Link
Dr. Little, Chairman of Scientific Advisory Board for Industry, Notes Charges Against Tobacco Use Have Not Been Substantiated” (2 pages)

News article
UNITED STATES TOBACCO JOURNAL (tobacco industry trade weekly)
December 23, 1957

“British Smoking-Cancer Study Gets ‘Strong Negative Result'”

Advertisement by the Tobacco Institute
New York Post
July 1959

“Scientist Counters Claims That Link Smoking, Disease”

News article
UNITED STATES TOBACCO JOURNAL
December 14, 1959

“EDITOR’S Forum: Crusade for Research” (6 pages)

Tobacco
October 18, 1963

Curator’s note: In his response to the publication of the Surgeon General’s Report, Tobacco Institute President George V. Allen predated President Obama’s call for a Cancer Moonshot by 53 years:

“…In a way, we have a crusade. It should be a crusade neither for nor against tobacco. it is a crusade for research in the agricultural stations, the scientific laboratories, and the great hospitals and medical centers of the nation.

“I am confident that the scientific community which discovered the secrets of the atom and is now exploring the outermost reaches of space will be able to solve these human health problems.”

Related articles:

“Tobacco-Health Theories Still Disputed, Allen Says”

“What the Industry Should Know About Smoking and Health Theories”

By George V. Allen, President, The Tobacco Institute

“Health Verdict Near”

Cites Cancer Cause…U.S. Report Blasts Cigarettes” (6 pages)

News article
Tobacco
January 17, 1964

Related articles:

“Allen: ‘This Report Is not the Final Chapter'”

“Leaf Men Take ‘Report’ With Wait-and-See View”

“Health Report Brings Strong Reaction from No. Carolina”

“Terry Promises Quick Action on Report”

“NATD [National Association of Tobacco Distributors] Warns Against Panic on Health Issue”

“Editor’s Forum: Dr. Terry’s Warning”

Tobacco
February 28, 1964

“Any hope that the furore surrounding the “tobacco industry as a result of the Surgeon General’s report on smoking and health will be allowed to diminish was dashed February 25 in Washington, D. C., by the Surgeon General himself. Addressing a luncheon group, Dr. Terry warned that a hard-hitting, long-range, anti-cigarette program will be undertaken by the government and that repressive measures will be used should the industry fail ‘to bring its house in order.’

“Dr. Terry’s chilling remarks are an omen for tobacco men. It must not be forgotten that the tobacco-health controversy now has shifted to the larger stage of political action and that the Surgeon General plays a key role in formulating government policy in matters of public health. Things will never be the same for tobacco men and all will serve the industry wisely who cooperate to the fullest in implementing, rather than opposing, government policy.

“We urge all in the tobacco trade to weigh these words of Dr. Terry:

‘…We have no interest in a 10-week flash in the pan. We are thinking in terms of a 10-year-plus program. We are aiming at a program of prevention-following the traditional and timetested public health approach-a program aimed at preventing the habit before it is established.

‘This means a program aimed at young people — teen-agers and younger. This means a research program aimed at developing a safer cigarette and other safer forms of tobacco use.

‘I wish to make a prediction that perhaps our most effective ally in this effort will be the tobacco industry itself. I am not among those who believe that the tobacco industry has a dollar bill for a conscience. Perhaps I am prejudiced by the complete cooperation we received from the industry during the advisory committee’s work.

‘In any event, the handwriting surely is on the wall. Either the industry takes some action to bring its own house in order -or someone else will do it for them.’”

A Potpourri of Television News Stories and Interviews about Smoking and Health, 1961 to 2007

A potpourri of news stories and interviews about the tobacco industry, cigarette advertising, and anti-smoking activism, 1961 to 2007 (52:30)

Compiled by The Center for the Study of Tobacco and Society

  • 1. Pioneering anti-smoking advertisement on TV, created by Tony Schwartz for the American Cancer Society, 1961 (at 00:14)
  • 2. Comments by Senator Maurine Neuberger on the power of the tobacco industry; CBS Reports (March 1964) (at 01:20)
  • 3. Senator Robert Kennedy addresses the World Conference on Smoking and Health and proposes regulation of the tobacco industry; ABC-TV News, September 11, 1967 (at 02:01)
  • 4. The targeting of African-Americans by the tobacco industry, reported by Bob Faw; CBS-TV News, ca. 1986 (at 04:14)
  • 5. How cigarette makers influence minority groups, reported by Dr. Bob Arnot; CBS-TV News, ca. 1986 (at 07:47)
  • 6. Debate on the dangers of second-hand smoke between Brennan Dawson of the Tobacco Institute and Alan Blum, MD, moderated by Paula Zahn; CBS This Morning, 1992 (at 12:53)
  • 7. Banning tobacco advertising on billboards, reported by Ned Hibberd; City Under Siege, KRIV-TV News, Houston, 1995 (at 17:13)
  • 8. Tobacco industry funding of cancer research, reported by Ned Hibberd; City Under Siege, KRIV-TV News, Houston, 1995 (at 21:19)
  • 9. Tobacco industry sponsorship of the arts, reported by Ned Hibberd; City Under Siege, KRIV-TV News, Houston, 1995 (at 28:33)
  • 10. Interview with Alan Blum, MD on DOC (Doctors Ought to Care) on the effort to create a National Tobacco Museum, KUHT-TV, Houston, 1996 (at 34:05)
  • 11. Interview of a Philip Morris recruiter by Alan Blum, MD at a reception on the University of Alabama campus, February 2006 (at 39:00)
  • 12. Testimony by Alan Blum, MD at the US Senate Committee on Health, Education, Labor, and Pensions hearing on the Family Smoking Prevention and Tobacco Control Act, February 27, 2007 (at 47:11)

The Report That Almost Did Not Happen

“The Report That Almost Did Not Happen”

Transcript of presentation by Charles A. “Mickey” LeMaistre, MD (1924-2017)
Distinguished Alumnus, University of Alabama
President, The University of Texas  M.D. Anderson Cancer Center (1978-1996)
Member, Advisory Committee to the Surgeon General of the US Public Health Service on Smoking and Health (1962-1964)

Presented at Special Emphasis Week on Cancer Prevention and Screening
University of Alabama College of Community Health Sciences
September 10, 2007

and

Cancer Prevention and Population Sciences Grand Rounds,
M.D. Anderson Cancer Center, November 16, 2007

“Betrayal: How Political Pressure Almost Destroyed the 1964 Surgeon General’s Report on Smoking and Health” (1:01.57)

Presentation by Charles A. “Mickey” LeMaistre, MD (1924-2017)
President, The University of Texas  M.D. Anderson Cancer Center (1978-1996)
Member, Advisory Committee to the Surgeon General of the US Public Health Service on Smoking and Health (1962-1964)
Presented at Cancer Prevention and Population Sciences Grand Rounds
M.D. Anderson Cancer Center

Introduced by Shine Chang, PhD
Professor, Department of Epidemiology,
Division of Cancer Prevention and Population Sciences

November 17, 2007

Correspondence between Charles A. LeMaistre, MD,  and Alan Blum, MD about telling the behind-the-scenes story of the Surgeon General’s Report

“When the Smoke Clears” (8 pages)

Article by Caroline Gwalney
University of Alabama Alumni Magazine
2007

A Photographic Look at the Advisory Committee to the Surgeon General and Its Support Staff

“Allen Says Industry Hails Smoking-Health Committee” (3 pages)

Article in Tobacco (weekly US tobacco industry trade journal)
June 1, 1962

“WASHINGTON, Nov. 2 — SWITCHES TO PIPE — Surgeon General Dr. Luther Terry puffs ion a pipe — his favorite smoke since giving up cigarette smoking. Dr. Terry said his switching from cigarettes to a pipe was not based on any knowledge of the content of an upcoming report on [sic] his special advisory committee on smoking and health. He said he had been a cigarette smoker ‘for many years’ and at one time smoked a pack to a pack and a half a day,”

Associated Press Wirephoto
November 2, 1963

“PANEL MEMBERS–Above are photos of members of the ten-man federal scientific advisory committee that conducted a study on smoking and health”

Associated Press Wire Photo
January 11, 1964

“WASHINGTON, Jan. 10 [sic] — NO SMOKING DURING CONFERENCE — A No Smoking sign is prominent as reporters in the State Department auditorium hear an explanation by Surgeon General Luther Terry, at rostrum, of the smoking report issued today by a scientific panel. Men who prepared report are seated behind Terry. The sign is not new.”

Associated Press Wirephoto
January 11, 1964

Meeting of the Advisory Council to the Surgeon General at the National Library of Medicine

1963

Members of the Advisory Council to the Surgeon General at the entrance to the National Library of Medicine

1963

Charles A. LeMaistre, MD (1924-2017), medical director of Woodlawn Hospital and professor of medicine, Southwestern Medical College, Dallas. Fields: Internal medicine, infectious diseases, preventive medicine

Walter J. Burdette, PhD, MD (1915-2006), head of Department of Surgery, University of Utah School of Medicine, Salt lake City. Fields: Clinical and experimental surgery, genetics

Maurice H. Seevers, PhD, MD, chairman, Department of Pharmacology, University of Michigan, Ann Arbor. Field: Pharmacology of anesthesia and habit-forming drugs

“Seevers had consulted for the cigarette industry and had been a long-standing advocate for judging nicotine use a drug habituation. He was primarily responsible for cigarettes being judged not addictive in 1964, over objections of other committee members. According to selection rules, he should have been ineligible for committee membership.”

“Nicotine Addiction, Maurice Seevers, and the First Surgeon General Report on Cigarette Smoking and Health: Conflicting Terms and Interests”
Article by Lynn Kozlowski, PhD
Journal of Studies on Alcohol and Drugs
2021 (volume 82), pages 536-543
July 2021

William G. Cochran, MA (1909-1980), professor of statistics, Harvard from 1957 to 1976. Field: Mathematical statistics, with special application to biologic populations

Peter V. V. Hamill, MD (1927-2007), an epidemiologist, served as the medical coordinator of the Advisory Committee – and its driving force — from November 1962 to August 1963 until he was forced to take an emergency medical leave because of exhaustion and intractable pain. “I… ruptured… three cervical discs in my neck,” he said in an interview in 1969 for the John F. Kennedy Library Oral History Project. “I literally broke my neck on the study.”

Eugene H. Guthrie, MD (1924-2014), was Director of Chronic Diseases of the United States Public Health Service when he was urgently appointed by Dr. Terry in August 1963 to fill the Advisory Committee’s staff director role. A consummate administrator, he is credited with the on-time completion of the report.

Stanhope Bayne-Jones, MD, LLD (1888-1970), former dean, Yale School of Medicine (1935-1940), former president, Joint Administrative Board, Cornell University, New York Hospital Medical Center (1947-1952); former president, Society of American Bacteriologists (1929), and the American Society of Pathology and Bacteriology (1940). Dr. Bayne-Jones also served as a brigadier general in the United States Army in both world wars. Field: Nature and causation of disease in human populations

Louis F. Fieser, PhD (1899-1977), Sheldon Emory professor of organic chemistry, Harvard. Dr. Fieser is credited with the first synthesis of Vitamin K. He was also the inventor of napalm. A chain-smoker, he stopped smoking after being diagnosed with lung cancer in 1965. Field: Chemistry of tobacco smoke

Emmanuel Farber, MD, PhD (1918-2014), chairman, Department of Pathology, University of Pittsburgh. Dr. Farber’s research demonstrated that carcinogens can bind to DNA. Field: Experimental and clinical pathology

John B. Hickam, MD (1914-1970), chairman, Department of internal Medicine, University of Indiana, Indianapolis. Fields: Internal medicine, physiology of cardiopulmonary diseases

Jacob Furth, MD (1896-1979), professor of pathology, Francis Delafield Hospital, New York, New York. Dr. Furth served as president of the American Society for Experimental Pathology and president of the American Society for Cancer Research. Field: Cancer biology

Leonard. M. Schuman, MD (1913-2005), professor of epidemiology, University of Minnesota School of Public Health, Minneapolis. Dr. Schuman established the first PhD program in epidemiology in the nation at the University of Minnesota. Field: Health and its relationship to the total environment

“DOCTORS CHECK REPORT ON SMOKING — Looking over a copy of the report of the Surgeon General’s Committee of [sic] Smoking and Health during a news conference in the State Department auditorium are three members of the committee. From left are Dr. James M. Hundley, vice-chairman and assistant surgeon general; Dr. Luther L. Terry, surgeon general; and Dr. Eugene H. Guthrie, staff director.”

UPI (United Press International) Telephoto
January 11, 1964

Photograph of the Surgeon General’s Advisory Committee staff taken with Dr. Luther Terry at an awards ceremony held in his office in the summer of 1964.

Source: Personal photo of Donald R. Shopland, Sr.

Janet Terry, daughter of Surgeon General Dr. Luther Terry, snubbing out cigarettes following the publication of the Report on Smoking and Health

Associated Press Wirephoto
January 14, 1964

“WASHINGTON, JAN. 15 — APPOINTEE AND FAMILY — Dr. Luther Terry poses with his wife and their 14-year-old son, Michael, at their nearby Rockville, Md., home after he was appointed Surgeon General for the new administration, President-elect Kennedy announced the appointment from Palm Beach, Fla., earlier today.” 

Associated Press Wirephoto
January 15, 1961

LeRoy Burney, MD, the First Surgeon General to Warn that Cigarette Smoking Caused Lung Cancer

“The unsung public health hero who helped launch the war on tobacco” (2 pages)

Article by Dennis Breo about Louis W. Robbins, MD (1910-1990), the first chief of cancer control programs for the Public Health Service (1957-1965), who wrote the article that provided the basis for Surgeon General Leroy Burney’s indictment of cigarette smoking.
JAMA
1990 (volume 264), pages 1597-1598
September 26, 1990

“That seminal paper, which went through 42 drafts over an 18-month period, was published over the signature of Surgeon General Leroy E. Burney.”

Surgeon General Leroy E. Burney shortly after publishing an article in the Journal of the American Medical Association (JAMA) in which he concluded that the weight of scientific evidence leaves little doubt that smoking is the main cause of lung cancer

Associated Press Wirephoto
November 25, 1959

“SMOKING AND LUNG CANCER: A Statement of the Public Health Service ” (8 pages)

Article by Leroy E. Burney, MD
JAMA
1959 (volume 171), pages 1829-1837
November 28, 1959

“It is a statutory responsibility of the Public Health Service to inform members of the medical profession and the public on all matters relating to important public health issues. The relationship between smoking and lung cancer constitutes such an issue and falls within this responsibility of the Public Health Service.

“The Public Health Service believes that the following statements are justified by studies to date. 1. The weight of evidence at present implicates smoking as the principal etiological factor in the increased incidence of lung cancer. 2. Cigarette smoking particularly is associated with an increased chance of developing lung cancer. 3.Stopping cigarette smoking even after long exposure is beneficial. 4. No method of treating tobacco or filtering the smoke has been demonstrated to be effective in materially reducing or eliminating the hazard of lung cancer. 5. The nonsmoker has a lower incidence of lung cancer than the smoker in all controlled studies, whether analyzed in terms of rural areas, urban regions, industrial occupations, or sex. 6.Persons who have never smoked at all (cigarettes, cigars, or pipe) have the best chance of escaping lung cancer. 7. Unless the use of tobacco can be made safe, the individual person’s risk of lung cancer can best be reduced by the elimination of smoking.”

“SMOKING AND LUNG CANCER”

Editorial by John H. Talbott, MD, Editor
JAMA
1959 (volume 171), page 2104
December 12, 1959 

“A summary of pertinent data relating to smoking and lung cancer appeared in The Journal, Nov. 28, pages 1829 to 1837. Written by Dr. Leroy E. Burney, surgeon general of the Public Health Service, the report documents the major researches and identifies the Public Health Service with those who consider that the evidence to date implicates smoking as the principal etiological factor in the increase in lung cancer. A number of authorities who have examined the same evidence cited by Dr. Burney do not agree with his conclusions…Neither the proponents nor the opponents of the smoking theory have sufficient evidence to warrant the assumption of an all-or-none authoritative position. Until definitive studies are forthcoming, the physician can fulfill his responsibility by watching the situation closely, keeping courant of the facts, and advising his patients on the basis of his appraisal of those facts.”

“Policy over politics: The first statement on smoking and health by the Surgeon General of the United States Public Health Service” (2 pages)

Article by Leroy E. Burney, MD
New York State Journal of Medicine
1983 (volume 83), pages 1252-1253
December 1983

“As a courtesy to the tobacco industry, which was attempting to refute all evidence on the hazard of cigarette smoking, I sent a copy of the press release to their representative a few days prior to the conference. My courtesy was repaid by their simultaneously releasing a lengthy, harsh rebuttal to the statement. I continue to be surprised by any action of a vested interest which puts profits above human welfare.

“The reaction of organized medicine was muted—and for several years after 1957. The American Medical Association had a rather detached, arms-length attitude…

“Progress has occurred during these 26 years, but the battle is far from won. Special economic interests and the politicians they influence still refuse to drop their membership in the Flat Earth Society and acknowledge that cigarette smoking is killing hundreds of thousands of Americans each year…

“…[P]hysicians have the most important role in changing the smoking habits of the public. They will not, I am sure, adopt the life style of Henry Adams who described himself (in The Education of Henry Adams) as follows: ‘As it happened, he never got to the point of playing the game at all; he lost himself in the study of it, watching the errors of the players’…”

“Leroy Burney, 91 , Early Critic of Effects of Cigarette Smoking”

Obituary by Lawrence Altman, MD
The New York Times
August 4, 1998

“On July 12, 1957, after organizing a group of scientists to appraise 18 studies on smoking and health, Dr. Burney, himself a smoker, issued a report saying, ‘It is clear that there is an increasing and consistent body of evidence that excessive cigarette smoking is one of the causative factors in lung cancer.’…

“Dr. Burney’s first statement, and a stronger one in 1959, paved the way for Luther Terry, surgeon general under President Lyndon B. Johnson to issue a landmark report on smoking and health in 1964.”

The 1962 Report of the Royal College of Physicians on Smoking and Health

“THE HISTORY HOUR” (09:30)

The story behind the publication on March 7, 1962 of the Royal College of Physicians’ Report on Smoking and Health
Host, Max Pearson; Reporter, Claire Bowes
British Broadcasting Corporation (BBC)
March 7, 2022

SMOKING AND HEALTH
A Report of The Royal College of Physicians on smoking in relation to cancer of the lung and other diseases (5-page excerpt)

Summary the Report
London: Pitman Medical Publishing Co. Ltd.
70 pages
March 7, 1962

“The benefits of smoking are almost entirely psychological and social ..Cigarette smoking is a cause of lung cancer and bronchitis and probably contributes to the development of coronary heart disease and various other less common diseases…The number of deaths caused by diseases associated with smoking is large…”

“THE HISTORY HOUR,” BBC, March 7, 2022 [3-Page Transcript]

In 1962 a group of UK doctors warned people of the direct link between cigarettes and lung cancer, adding that smokers were more likely to die before the age of 65. The association wasn‘t new, but the startling figures were, and the doctors wanted the British government to act. Clair Bose reports.

[BBC reporter, 1962:] “Today, the Royal College of Physicians published their report on smoking and lung cancer. They say conclusively and authoritatively that cigarette smoking is a cause of lung cancer, causes bronchitis, and contributes to coronary heart disease.”

At the time, half of all women in Britain smoked and three quarters of all men…This was the first time such stark figures had been released to the public. But the picture was complicated. People loved smoking. Politicians, scientists, doctors, and all….For decades cigarette smoking had been an important part of British life. During the second World War, tobacco was seen as an essential, and government efforts were made to encourage smoking rather than  prevent it…The disaster had been brewing since before the war when it was first suggested that the increasing prevalence of a rare form of cancer of the lung might be due to cigarette smoking. Britain’s Medical Research Council began to investigate possible causes: televisions, saucepan, bananas, tarring of the roads, air pollution, and, as an afterthought, smoking.

[Virginia Berridge:] “In 1950, the statisticians Sir Austin Bradford Hill and Richard Doll published some research, and that indicated that there was an association between the rise in smoking and the rise in lung cancer deaths.”

Throughout the 1950s, more and more evidence emerged. But in the smoke-filled, yellow-walled rooms of the Houses of Parliament, little was said. One man walking those same halls was Sir George Godber, a doctor and high-ranking civil servant whose job was to advise the government on health…As a non-smoker, he was in a small minority…His hands were tied. It was, after all, up to his boss, the Chief Medical Officer, to get the Ministry of Health to take action, and his boss wasn’t keen to rock the boat. So George Godber decided to get someone else outside of government to stir things up: Charles Fletcher from the Royal College of Physicians.

[Charles Fletcher:] “We discussed what the Ministry of Health might do: and we thought of those things like trying to stop smoking in trains, trying to put posters up. But none of those seemed very likely. And at that time the Chief Medical Officer was obviously frightened of anything about it. He didn’t want to offend industry and the public. At the end of our lunch, I said to George Godber, ‘Do you think it would help if our college, meaning the College of Physicians, were to produce a report about the evidence on this?’ And he said, ‘Yes, I think that might be very helpful. It might stimulate my minister to do something about it.’”

Charles Fletcher wrote the report himself. It was released in March 1962, and more than 80,000 copies of it were sold in the UK and the US. Charles Fletcher wanted to prompt government action. But he also wanted these horrific figures to be understood by anyone interested.

[Charles Fletcher:] “And we didn’t mince our words. We really did write it in simple words. We really made a parallel between this and tuberculosis and the big plagues of the past. And it was absolutely staggering. Every front page of every newspaper, ‘Doctors Say Smoking Dangerous.’ They’d never taken any notice before.”

Read More…

“IF YOU ARE A SMOKER–Turn to Page Four for a report on smoking and the nation’s health together with the views of the tobacco manufacturers”

“These Men Present Their Findings; SMOKING: Nine-Man Report and a Reply”

Article by Robert Chapman
The Evening News (London)
Front page and page 4
March 7, 1962

“Smoking and Your Health
THE DOCTORS’ REPORT”  (3 pages)

Article by Peter Fairly
and Editorial “Good Sense and Good Health”
Evening Standard (London)
March 7, 1962

“DOCTORS URGE GOVERNMENT TO CURB SMOKING;
PROPOSED HIGHER TAXATION AND ADVERTISING RESTRICTIONS”

“WHERE THERE’S SMOKE” [Editorial] (2 pages)

The Times (London)
March 8, 1962

“The tobacco manufacturers…have an interest in dissuading people from jumping to9 the obvious conclusion so long as any other conclusion remains open: hence their reminders about other possible interpretations of the evidence and their emphasis on the present gaps  in the aetiology of cancer. The chain smoker may choose to console himself with the reflection that ‘statistics can be made to prove anything.’  The thoughts of the schoolboy who is in the process of contracting the habit are far removed from mortality. Meanwhile there is the steady pressure of social imitation and ubiquitous advertising…”

The Times’ editorial

“SMOKING and HEALTH: The medical evidence” (3 pages)

Article by Nicholas Lloyd
The Daily Herald (London)
March 8, 1962

“THE DANGER
DOCTORS URGE GOVERNMENT ‘ACT AGAINST SMOKING'” (2 pages)

Article by Charles Douglas-Howe
Daily Express (London)
March 8, 1962

“U.K. Medicos Prepare Shock Report on Cigarettes” (2 pages)

Tobacco (tobacco industry trade weekly)
March 2, 1962

“Share Values Rise as Medicos Blast Smoking” (2 pages)

Tobacco
March 16, 1962

“British Government Plans Anti-Cigarette Campaign” (2 pages)

Tobacco
March 23, 1962

“TIRC (Tobacco Industry Research Committee) Rips British Health Report
Industry Body Calls Data Old, Not Conclusive”

THE TOBACCO LEAF
March 17, 1962

“A Sickening Situation”

Editorial
THE TOBACCO LEAF
March 17, 1962

“Research or Conspiracy?”

Editorial
THE TOBACCO LEAF
April 1962

“Tobaccodom’s Best Weapon”

Editorial
THE TOBACCO LEAF
June 1962

“HERE ARE THE LATEST SCIENTIFIC FINDINGS REPORTED IN JUNE Reader’s Digest ON Lung Cancer and Cigarettes”

Advertisement for the June 1962 issue of Reader’s Digest
The New York Times
May 23, 1962

“WITHOUT pulling any punches this article Lung Cancer and Cigarettes, condenses the recent report of the famous Royal College of Physicians in London on the crucial problems of Smoking and Health — ‘probably the best factual statement to be written in plain English which the average layman as well as the doctor can understand.’

“Here are the facts about the effects of cigarettes on the human body, which every thoughtful smoker has been waiting for.  Not the excited opinions of reformers… not the defensive arguments set up by ‘the interests’…but an unvarnished statement of the proved facts, buttressed by scientifically controlled tests and established findings from more than 200 impartial, authoritative sources…

“In six fast-reading Reader’s Digest pages, this report cuts through the smoke of attack and counterattack which up to now has befogged the issue…”

“Smoking and Health: The Doctors’ Report” (12 pages)

Article by Lois Mattox Miller
Reader’s Digest, United Kingdom Edition
June 1962

“About Cigarette Advertising

“The Publishers of the Reader’s Digest can find little room for further doubt that cigarettes are harmful to the health of smokers.  The following article constitutes an important addition to the body of evidence leading to that conclusion. It is to be expected that other articles, keeping our readers informed of facts and developments in this important area, will appear in the Digest from time to time.

“In these circumstances, and as long as these circumstances exist, the Publishers feel that they should not continue to accept advertising which has as its purpose the encouragement of cigarette smoking. We are accordingly advising our advertisers of this policy decision, which will take place after the completion of fulfilment of existing contracts.”

“‘Several diseases, in particular lung cancer, affect smokers more often than nonsmokers…’ This chillblast sobered smokers and jolted the tobacco industry on both sides of the Atlantic last March. The venerable 444-year-old Royal College of Physicians, which never deals with trivia or sensationalism, had completed an exhaustive study and published a fact-filled report, Smoking and Health, ‘intended to give to doctors and others, evidence on the hazards of smoking so that they may decide what should be done…'”

[Curator’s Note: The issue includes advertisements by British American Tobacco for duMaurier cigarettes, John Player & Sons for Player’s Navy Cut pipe tobacco, and two advertisements for Tricel men’s clothing with images of models smoking.]

“SMOKING AND HEALTH” (8 pages)

Essay by Albert Byrne, MD
The Atlantic
June 1962

“The Royal College of Physicians of London selected Ash Wednesday of this year to make an ominous
public pronouncement on the dangers of tobacco smoking. During the past decade the British public had
repeatedly been informed of medicoscientific studies relating lung cancer to smoking and to general
pollution of the atmosphere. None of them, however, had been thought sufficiently conclusive to move
the government to initiate measures seriously calculated to discourage smoking. Any such movement
would, of course, jeopardize the £850 million ($2.4 billion) which comes into the national exchequer
from tobacco taxation each year.

“Five years ago the state-sponsored Medical Research Council advised the government that the
relationship between smoking and lung cancer was one of direct cause and effect. Even then the
Minister of Health evaded responsibility by delegating to his local health authorities the task of
publicizing the risk. As a result of the official policy of laissez-faire, local authorities spent only £3624
($10,147) on educational material relating to smoking in the years 1956 to 1960. Over the same period
the tobacco industry spent £38 million ($106.4 million) in advertising tobacco…

“There are no zealots among the nine specialists under the chairmanship of Sir Robert Platt, professor of
medicine at Manchester University, who interpreted the evidence on smoking. (Atmospheric pollution
will be examined in a later survey.) Their verdict is presented unemotionally and in language
comprehensible to any smoker. From their scrutiny of the scientific literature, the physicians conclude
that cigarette smoking is a cause of both lung cancer and bronchitis. It delays healing of gastric and
duodenal ulcers and probably contributes to the development of coronary heart disease, cancer of the
male bladder, and the arterial disorder, found mainly in the legs, known as thromboangiitis obliterans; it
may also play a part in causing cancer of the mouth, pharynx, and gullet. Smoking during pregnancy, it is
stated, may result in smaller babies than those born to nonsmoking mothers.

“With these conclusions in mind, the British doctors urge their government to take seven decisive steps
to curb the rising consumption of tobacco, especially cigarettes. Their most striking proposal is that a
law should be passed to prevent, or at least restrict, the advertisement of smoking… Read More

Sir George E. Godber

Sir George in his rose garden in Cambridge

Sir George E. Godber, DM

Impressions of Sir George Godber by Alan Blum, MD (02:44)

Letter from Sir George Godber to Alan Blum, MD
August 23, 1983

“I am still slightly surprised that this piece got the reception it did, for it must prove to be my swan song. But I am very happy to be linked with five surgeons general. I knew Tom Parrin and from him to Julius Richmond, was on friendly terms with them all. For years we had tripartite meetings twice a year with Canada alternately in the three capitals, and the exchange of information was among the most valuable assets of my job…”

“Health versus greed” (2 pages)

Article by Sir George E. Godber, DM
New York State Journal of Medicine
1983 (volume 83), pages 1248-1249
December 1983

“The World Conference on Smoking and Health began in New York at the instance of the American Cancer Society in 1967 and have continued at four-year intervals since. The conferences have been unusual in their provenance because none has been promoted by a government or a national medical organization. We have come together from many different backgrounds and with various support because we know what harm smoking does and want to see that harm reduced. In 1967 some of those attending may have thought there was still a case to prove, although I recall that even the television technicians had put out their cigarettes before Robert Kennedy was halfway through his  remarkable speech at the opening session. I do not imagine there is anyone attending the Fifth World Conference — even the odd agent from the industry — who still doubts that smoking is the largest single avoidable cause of  ill health and premature death in the industrialized world today. Our problem is not whether but how we should persuade smokers to stop and and others to refrain from starting. We all know that it is the active efforts of the promoters of smoking that has made it so difficult for the promoters of health…

“Looking back over 33 years, one can recognize three phases in the campaign, each lasting roughly a decade. First there was the period of proving the case, ending with the first major reports of 1962 and 1964. Second was the period of seeking ways of convincing the public and governments. Third came the period of more intensive study of the factors which make escape from cigarette dependence so difficult. It is probable that in the first phase the tobacco interests simply treated the  health campaign as a scare which would die down. In the second phase they took a placating action which they implied would minimize the risk (a risk they never have acknowledged in the first place) of trying to make smoking materials less carcinogenic. That theory blown, in the third phase they have m mounted a two-pronged promotional effort aimed at maintaining lucrative sales — namely, visible corporate philanthropy to cultural and sports organizations on the one hand and a barrage of sophisticated advertising imagery on the other — and the notion that the regrettable harm to health can be made to appear socially acceptable in return for the pleasure tobacco provides.

“…In 1967, I first wondered just how useful a world conference could be. Now as I enter my membership of this, the fifth, i have no doubt that the series has helped to give the campaign against smoking an impetus it would not otherwise have had. But how many more conferences is the world condemned to need? 

“…Do governments have a secret reservation of their own that they can seem to fight for our cause so long as they do not actually work?

“How many more times must we restate the formula?”

L. Edgar Prina, the Washington Evening Star Reporter Who Asked President John F. Kennedy About His Administration’s Position on Smoking and Health

L. Edgar Prina (1918-2013), a foreign affairs and military intelligence reporter at The Washington Evening Star from 1950 to 1966  where he was twice nominated for the Pulitzer Prize, was assigned to cover a press conference by President John F. Kennedy on May 23, 1962. Having read about the recently published report on smoking and health by the Royal College of Physicians in the United Kingdom that summarized the devastating toll taken by cigarettes, Prina posed a question to President Kennedy that would lead to the formation of the Advisory Committee to the Surgeon General on smoking and health…and the publication on January 11, 1964 of the committee’s landmark report:

“Mr. President, there is another health problem that seems to be causing growing concern here and abroad, and I think this has largely been provoked by a series of independent scientific investigations which have concluded that cigarette smoking and certain types of cancer and heart disease have a causal connection. I have two questions: Do you and your health advisers agree or disagree with these findings, and secondly, what, if anything should and can the Federal Government do in the circumstances?”

President Kennedy’s reply:

“The—that matter is sensitive enough and the stock market is in sufficient difficulty without my giving you and answer which is not based on complete information, which I don’t have, and therefore perhaps we could—I’d be glad to respond to that question in more detail next week.”

A 1940 graduate of Syracuse University’s journalism school, Prina served in the U.S. Navy throughout throughout World War II and was recalled to active duty in the Korean War. After his long tenure at The Star, he worked for the Copley News Service from 1966 to 1987, where he became chief of the Washington bureau. On May 14, 2013 he died from pneumonia at age 95.

On June 12, 2012, Alan Blum, MD. interviewed Mr. Prina at his apartment in Washington, DC, during which Prina recalled his surprise that presidential press secretary Pierre Salinger had not prepared President Kennedy for a question about the increasing number of published reports that found cigarette smoking was a major cause of lung cancer and other diseases.

Interview of L. Edgar Prina by Alan Blum, MD, in Washington, DC on June 12, 2012 (47:31)

Excerpt of President John Fitzgerald Kennedy’s press conference of May 23, 1962 at which Washington Evening Star reporter L. Edgar Prina asked President John F. Kennedy what his administration planned to do about the health problems caused by smoking. (00:57)

Source: John F. Kennedy Presidential Library

“Transcript of the President’s News Conference on Foreign and Domestic Matters”

The New York Times
May 24, 1962

Washington Evening Star reporter L. Edgard Prina’s question to President Kennedy about smoking and health, and President Kennedy’s reply

Transcript
The New York Times
May 24, 1962

“KENNEDY PROMISES REPLY ON SMOKING”

News article
The New York Times
May 24, 1962

“Pres. Kennedy Refuses Tobacco-Health Comment”

News article
Tobacco
June 1, 1962

How the weekly trade publication Tobacco covered Washington Evening Star reporter Edgar Prina’s question:

“President Kennedy neatly ducked a press conference question last week which might have entangled him in the cigarette-health hazard controversy.

“Asked whether he sided or disagreed with certain scientific views on the relationship of cigarette smoking and health hazards, the President, not without a characteristic subtlety, said:

“‘That matter is sensitive enough, and the stock market is in sufficient difficulties to prevent me from giving you an answer that is not based on complete information which I do not have.'”

“July 25 STARTS SMOKING STUDY — Surgeon General Luther L. Terry, above, said today he will name a 12-member scientific panel to conduct a new and independent study of the effects of smoking and air pollution on health. Terry, head of the Public  Health Service, said the committee will be made up of scientists who have not taken strong public stands on the subject.”

Associated Press Wirephoto
July 25, 1962

The great tobacco ad ban debate: It’s time to treat it as a life-or-death story” (28 pages)

Cover article by Alan Blum, MD
The QUILL
Published by the Society of Professional Journalists, Sigma Delta Chi
December 1986

Other articles (and numerous letters to the editor) include the following:

“The tobacco shell game”
by Mike Moore (1938-2022)
Editor, The QUILL

“A newspaper kicks the habit”
by Harris Rayl (1953-2019)
Editor and publisher, The Salina (Kansas) Journal

“A ban on advertising would be ineffective…And dangerously paternalistic”
by Scott Ward
Professor of Marketing at the Wharton School, University of Pennsylvania
and witness in behalf of the tobacco industry in the August 1, 1986 House Subcommittee hearing on cigarette advertising
(In 2013, Ward was sentenced in federal court in Philadelphia to 25 years in prison for producing child pornography.)

“Prodding the President”

Letter by L. Edgar Prina in The Quill, the journal of the Society of Professional Journalists, responding to the article on the ethical responsibility of newspapers to decline cigarette advertising, and commenting on his question to President Kennedy in 1962
May 1987

“GLOBAL HEALTH: New Surgeon General Report on Smoking and Health Released: Progress Made; Battle Not Won” (5 pages)

Essay by Lee-Lee Prina (daughter of L. Edgar Prina)
Health Affairs Blog
January 21, 2014

The American Medical Association, Longtime Ally of the Tobacco Industry

Dancing around the growing evidence in the 1950s implicating cigarette smoking as a major cause of lung cancer, each tobacco company claimed that its leading brand was safer than all the others. R.J. Reynolds led the pack with the slogan, “More Doctors Smoke Camels!” in advertisements that even appeared in medical journals. JAMA accepted cigarette advertising from 1934 to 1954.

“Old Gold cures just one thing: The World’s Best Tobacco!”

Advertisement by Lorillard Tobacco Company for Old Gold cigarettes, with AMA seral of recognition
JAMA

“WHY MANY LEADING NOSE AND THROAT SPECIALISTS SUGGEST ‘change to PHILIP MORRIS'”

Advertisement by Philip Morris Inc.
JAMA
August 14, 1948

“THE OPERATION IS A SUCCESS!”

Advertisement by Brown and Williamson Tobacco Company for KOOL cigarettes
Journal of the American Medical Association, vol. 114, no. 14, page 37
April 4, 1940

“AMA Journal Bans Cigarette, Liquor Advertisements”

News article
THE TOBACCO LEAF
November 14, 1953

“AMA Will Undertake Smoking-Health Study”

News article
Tobacco
December 13, 1963

“No Strings Attached…Cigarette Producers Donate $10 Million to AMA Research” (10 pages)

News article
Tobacco
February 14, 1964

Related articles:

“TIRC [Tobacco Industry Research Committee] Director [Dr. Clarence Cook Little] Hails Industry AMA Donation”

“EDITOR’S Forum: Grand Gesture”

“Perhaps the most revealing footnote on the unrestricted offer of the six major United States cigarette manufacturers to donate $10 million to the American Medical Association to finance research on tobacco use and health is that this grand gesture has moved even the American Cancer Society to applause. It’s been a long, long time since the tobacco industry and the Cancer Society have seen eye to eye.

“It is hopped that the lavish monetary resource placed in the hands of the AMA by the cigarette producers will be instrumental in expanding the frontier of scientific knowledge. It is hoped, too, that their public spirited ness of the cigarette manufacturers will signalize ta new approach to the grave problem of tobacco and disease by the tobacco industry and by its antagonists.

“Unresolved question…

“The very fact that the nation’s largest medical organization has instituted this research project and has accepted this generous financing from the tobacco industry places dramatic emphasis on the unresolved nature of the tobacco-health question,.

It should not be overlooked that the AMA research program is being launched despite the position taken by the Surgeon General and his advisory committee that there exists a causal link between tobacco use and the incidence of lung cancer.

It is pertinent, too, to point out that the Surgeon General and the committee have not closed the case against tobacco by any means. Actually, as Alan Donnahoe demonstrates in his incisive analysis of the Surgeon General’s report in this issue of Tobacco, they have raised more questions than they have answered…

“N.C. Candidates Pledge Aid in Tobacco Crisis”

“The tobacco crisis continues to figure in North Carolina’s campaign for governor…Dan K. Moore described tobacco as the lifeblood of North Carolina’s economy and said the state could become a ‘blighted area’ like West Virginia unless steps are taken to meet the emergency.

“He called for support of the state’s congressional delegation to resist ‘impetuous actions on the part of the federal government which would damage our tobacco industry.’ He urged ‘greatly expanded research on tobacco, with special attention to the health aspect of the problem.'”

“The Surgeon Genera’s Report: Its Inconsistencies and Contradictions”

“Drivers and Industrial Workers Frequent Lung Cancer Victims”

“Indications Are For Higher Sales And Earnings;
Convinced Cigarettes Will Be Exonerated
On Health Charges — Cullman Tells Stockholders”

Front page article in THE PHILIP MORRIS CALL NEWS (in-house newspaper for Philip Morris employees)
April 30, 1963

“Cancer Link Fading

“Of the cigarette-health question, Mr. [Joseph F.] Cullman {president of Philip Morris Inc.] said, ‘there is increasing evidence that implicates factors other than smoking.’

“As an example of the current direction of research in the field, stockholders were reminded that the National Cancer institute and the Atomic Energy Commission several weeks ago announced a joint research project ‘to investigate the roles of radiation, viruses and chemicals in causes of cancer.’

“‘I am personally convinced that  cigarettes will ultimately be exonerated,’ Mr. Cullman said. He also pointed out that ‘increasing attention is being  given to the benefits of smoking in a tension ridden world. Cigarette smoking is a source of pleasure and comfort to people all over the world. the continuing increase in smoking vindicates  our faith in the cigarette industry and the good judgment of smokers everywhere.’

“‘The people of this industry are responsible citizens and have reacted to the charges against tobacco with restraint and with logic. the ultimate answers will be found in the laboratories and the industry is working toward this and through the Tobacco Industry Research Committee,’ he said.”

“Long Range AMA Study Announced”

Front page article in THE PHILIP MORRIS CALL NEWS (in-house newspaper for Philip Morris employees)

December 9, 1963

“”PORTLAND, ORE.–The American Medical Association meeting here has voted to begin a long range research program into the subject of tobacco and health. The AMA project will concentrate, in part, on laboratory studies as opposed to statistical research. Laboratory research is based on actual experimentation. The AMA board expressed its conviction that ‘fundamental long-term research needs to be conducted because it is certain that large gaps in knowledge will remain after the Public Health Service committee reports on its appraisal of the literature and makes its recommendations.’

“When sked for comment on the AMA move, Dr. Clarence Cook Little. Scientific Director of the Tobacco Industry Research Committee said:

“‘We are gratified by reports of the American Medical Association’s recognition of the need for additional research on smoking and health.

“‘The beginning of such  a major research program by the AMA’s Education and Research Foundation should speed the day when science will learn the causes of major health problems, such as lung cancer and heart disease, and what role, if any, smoking may have…”

“Industry Studying Surgeon General’s Report”
“President Cullman Endorses Tobacco institute Statement”

Front page article in THE PHILIP MORRIS CALL NEWS (in-house newspaper for Philip Morris employees)
January 26, 1964

“PM’s Reaction

“‘I am sure you are interested in the company’s reaction to the Report of the Surgeon General’s Advisory Committee.

“The Tobacco Institute  represents Philip Morris and  other cigarette  manufacturers in matters of industry-wide  importance and at the present time is reflecting our reviews of the report…”

“Big Six Tobacco Mftrs. Give AMA $10 Million For Smoking Research”

Front page article in THE PHILIP MORRIS CALL NEWS (in-house newspaper for Philip Morris employees)
February 14, 1864

“CHICAGO–Philip Morris Inc. and five other major tobacco companies have offered its American Medical Association Education and Research Foundation $10 million to help finance basic research on the relationship of smoking to disease. The offer has been accepted, Raymond M. McKeown, M.D., Foundation president, announced February 7.

“Dr. McKeown said, ‘The members of the Board of Directors of the Foundation were pleased to accept the generous offer of these companies.’

“…A joint letter signed by the Presidents of the six companies said they were willing to contribute $10 million to the Foundation’s previously announced research project on tobacco or health ‘in the hope and expectation that the research project proposed  will aid materially in finding solutions to public health problems of national and international concern.”

TOBACCO AND HEALTH
Research Studies of
The Relationship of Tobacco and Health
(18 pages)

American Medical Association Education and Research Foundation (AMA – ERF)
Chicago
1978

Curator’s note: In December 1963, one month before the highly anticipated publication of the Report of the Advisory Committee to the Surgeon General on smoking and health, the House of Delegates of the American Medical Association (AMA) surprisingly voted to ask the AMA’s board of trustees to launch an AMA-led research program on tobacco and health “devoted to the study of human ailments that may be caused or aggravated by smoking, the particular element or elements that may be causal or aggravating agents, and mechanisms of their action.”

Although the deal between the tobacco industry and the AMA to conduct such a research program that would be funded by the major cigarette companies had been made behind closed doors weeks before, the industry’s role as the sole funding source was not revealed until fully a month after the publication of the Surgeon General’s report. Indeed, an article in the December 13 issue of the trade weekly Tobacco about the proposed AMA study cited the AMA board’s hope that the research would be financed by “industry, foundations, voluntary health organizations, and private physicians.” The board “emphasized, however, that no restrictions would be permitted with contributions.”

Beginning in 1964, then, and rather than joining forces with other health groups to support Surgeon General Luther L. Terry’s call for “remedial action” to reduce cigarette consumption, the AMA-ERF committee (three of whose members had served on the Surgeon General’s advisory committee) awarded grants from the $18 million in tobacco money to 196 researchers at 85 institutions in the US (including 54 medical schools) and 13 outside of the US, (including medical schools in Australia, Canada, England, Italy, Japan, and Sweden).

As virtually the lone hold-out among health organizations of an endorsement of the Surgeon General’s Report in 1964, one might have expected the AMA to issue a strong endorsement at the conclusion of its own research program 14 years later. Instead, a terse 2-page “Statement” by the AMA-ERF Committee in TOBACCO AND HEALTH alluded only to a comment in 1968 that “the research completed under the aegis of the project had not altered the conclusions of the 1963 report of the Surgeon General.”

In a brief preface to the AMA-ERF’s final report, a lavishly bound, 370-page book in a slipcase, AMA executive vice president James H. Sammons wrote, “The American Medical Association and its Educational and Research Foundation wish to express its [sic] gratitude to the Tobacco Industry [sic] for its financial support.” The only external sources acknowledged by the AMA – ERF were the six major cigarette companies (American, Brown and Williamson, Liggett, Lorillard, Philip Morris, RJ Reynolds).

By sidetracking the AMA in its own redundant research effort, the tobacco industry succeeded in buying the silence and inaction of organized medicine in the crucial decade following publication of the Surgeon General’s Report.

Senator Maurine Neuberger

The most outspoken Congressional critic of the tobacco industry and its allies, including the American Medical Association

“Sen. Neuberger Blasts Tobacco As Dangerous”
The TOBACCO LEAF

March 17, 1962

“One of the most venomous attacks ever made on the tobacco industry in the U.S. Congress was directed in the Senate on March 8 by Senator Maurine B. Neuberger, Democrat of Oregon.

“She succeeded her husband, Richard L. Neuberger, in the Senate after his death. Her husband was one of the most vicious anti-tobacco spokesmen during his Senate career.

“The following is [part of]  the statement issued by Mrs. Neuberger after the Royal College of Physicians in London released a report, ‘Smoking and Health.’ That report has been thoroughly riddled by the Tobacco industry Research Committee as being a completely one-sided recitation of old and inconclusive statistical data.

“Said Mrs. Neuberger:

“’Mr. President, what does it take to convince us that cigarettes are poisoning and killing a substantial segment of our population? Yesterday, in London, a committee of Royal College of Surgeons [sic] added its venerable voice to the already vast body of medical testimony on the direct cause of lung cancer by cigarette smoking. In stark and unflinching terms the Society reported that the total risk of dying of lung cancer for a smoker of twenty-five or more cigarettes a day is 1 in 9 between the ages of 35 and 84.

“’…Today, Dr. Kenneth Endicott, Director of the National Cancer Institute, issued the following statement:

‘”'”The National Cancer Institute and then U.S. Public [Health] Service for several years have considered that the evidence that excessive cigarette smoking seriously increases the risk of lung cancer is very strong. We are pleased that our position haws been supported by such a distinguished body as the Royal College of Surgeons [sic].””

“‘Mr. President, the evidence is in. No jury of 12 men and women could possibly escape the conclusion that tobacco in the form of cigarettes, is a poison more lethal than the deadliest narcotic.

“’The public has been told the facts. But the facts have been obfuscated by an expensively financed smoke screen – a smoker screen of quibble, distorted fact and half-truth.

“‘The Committee of the Royal College has called upon governments to act to inform and protect their children. In this country, the Federal government can n more permit the restricted sale of narcotics in drug stores, supermarkets, restaurants, newsstands, and in the halls of every commercial and residential building in our country…’”

“American Tobacco Official Enlightens Antibac Senator” (2 pages)

THE TOBACCO LEAF
April 14, 1962

“THE AMA– HANDMAIDEN TO THE TOBACCO INDUSTRY?” (4 pages)

Speech by Senator Maurine Neuberger
Congressional Record
December 1963

“Future historians may look upon many of our most cherished institutions as quaint and quizzical, and one of these may be the American Medical Association.

“The latest AMA exercise in errant behavior took place just yesterday in my own city of Portland, at present host to the AMA House of Delegates convention.

“Yesterday morning, the delegates received a monumental report from Dr. E. Cuyler Hammond, director of research for the American Cancer Society. The report…was designed to test criticisms of earlier statistical researches which had been interpreted as demonstrating a causal relationship between smoking and disease. In the words of Dr. Hammond, the ‘results fully confirm findings in previous studies.’

“The unequivocal nature of the report left the AMA two rational courses of action: First, the delegates could accord official sanction to the Cancer Society’s findings. The AMA, virtually alone among major medical groups, has failed to take an official position the relationship between smoking and health…

“As a second alternative, the delegates might reasonably have determined to abide by the March 13, 1963, statement by Dr. Blasingame, executive vice president of the AMA, that the AMA would wait upon the pending report of the Surgeon General’s Advisory Committee on Smoking and Health and would, ‘after a study of the report, make a statement based on a critical evaluation of the data.”

“…Which course did the delegates select? Neither. Without acknowledging the Cancer Society report or the pending Surgeon General’s report, the delegates adopted a ‘long range, comprehensive program of research on tobacco or health’ proposed by the AMA board of trustees. Why? ‘Because so many gaps exist in knowledge about the relationship of smoking and health.’

“…[T]he undeniable import of the board’s statement and the delegates’ action: That not enough is known of the relationship between smoking and disease to justify remedial action now.

“Thus, the board of trustees’ statement never acknowledges the extraordinary body of evidence incriminating smoking, and in so doing magnifies the ‘gaps.’

“…[T]his has been a long established excuse of the tobacco industry, and now of the AMA, for not further exploring the relationship between smoking and health. They say, ‘We do not know what causes cancer.’ I may say…that we treat the common cold without knowing its cause.

“The board expressed the need ‘to go beyond statistical evidence, to search for answers not now available to such question as which diseases ion man may be caused or induced by the use of tobacco.’ Beyond statistics to what? Occult inspiration?

“…The board acknowledges the ‘extraordinary social, legislative, and economic implications’ of the evidence and gratuitously suggest that ‘prohibition’ would be ‘unrealistic, even if causal relationships were irrefutably established’

“Yet no responsible medical or public official is recommending prohibition.

“What is being recommended is a moderate and rational program, designed to meet the severe medical evidence against smoking, within the democratic framework…

“In other words, because prohibition is unrealistic, all that this nation can do, to respond to the evidence that smokers are dying at twice the rate of nonsmokers, is to engage in long-term research.

“Is it not a little late fort the AMA to tell us top start at the beginning? Of course, we need additional research; but what we need more, and now, is unequivocal warning to every American that smoking, by whatever mechanism, is a serious threat to health.

“…Since the AMA feels that it should be ‘the’ organization, and that it occupies a ‘unique position’ of respect, I take it that the Public Health Service is therefore an inappropriate agency to evaluate the evidence against smoking. This is, of course, sheer nonsense.

“Moreover, the board self-righteously announces that –

‘A Director for this project will be procured whose experience, qualifications and integrity will insure that such a research project will be conducted exhaustively and with complete objectivity.’

“Are we to conclude, therefore, that the scientists selected by the Surgeon General somehow lack these qualities?

“…Nowhere does the Boar’s’ statement contemplate a time limit for an authoritative e conclusion vy the AMA that ‘cigarette smoking is harmful.’

“…I do not know why the AMA has taken this action in this way, at this time. But I do know that this action could not have been better designed to achieve the objectives of the American tobacco industry. So long as the industry succeeds in convincing the American public that the verdict on smoking is not in, that great ‘gaps’ of knowledge remain, that the evidence is still subject to ‘debate,’ the vast majority of habitual smokers will be able to rationalize their habit, comforting themselves with the belief that the case against the cigarette remains ‘unproved.’

“…In 4 weeks or so, when the Surgeon General’s Committee announces its conclusions, what will the response of the Tobacco institute be?

“‘Yes, but the AMA, which speaks for the Nation’s doctors….” And once again, as it has for the last 15 years, the tobacco industry will possess a weapon, however shoddy, to stave off a meaningful public health response to the evidence against smoking…”

SMOKE SCREEN
Tobacco and the Public Welfare
A U.S. Senator examines the controversial facts about cigarette smoking (20-page excerpt)
By Maurine B. Neuberger
Englewood Cliffs, New Jersey: Prentice-Hall, Inc,
151 pages
1963

“Shortly after the publication…of the Royal College of Physicians; exhaustive documentation of the case against smoking, a journalist writing in the noted British medical journal, The Lancet, had this to say:

Future historians will have views on our failure to find even a partial solution to the problem of smoking during the first ten years after its dangers were revealed. the enormous and increasing number of deaths from smoker’s cancer may go down in history as a strong indictment of our political and economic ways of life.

“Yet, which segments of our society and which institutions will these future historians indict’? The tobacco industry, for its callous and myopic pursuit of its own self-interest? The government, for its timidity and inertia in failing to formulate a positive program of prophylaxis? The medical professions, for abdicating its role of leader in this crucial are of public health? Or is the individual–smoker and nonsmoker alike–incriminated by his failure to accept responsibility for his own and his society’s well-being? I am convinced that no indictment would be sufficient if it failed to name each of these parties jointly responsible for the ‘cigarette pandemic.'”

“THEIR VIEWS DIFFER”

“WASHINGTON, June 23 — THEIR VIEWS DIFFER — Surgeon General Luther L. Terry talks with Sen. Maurine Neuberger, D-Ore., today in a House Commerce Committee hearing room. Terry told the committee more legislation is needed before the federal government can regulate the advertising and labeling of cigarettes. His testimony drew sharp opposition from Mrs. Neuberger, also a witness.”

Associated Press Wirephoto
June 23, 1964

Senator Maurine Neuberger and Surgeon General Luther Terry

“1/11/65 WASHINGTON: Surgeon General Luther L. Terry (right) called for a new national effort to ‘convince people of the danger of cigarette smoking.’ He made the appeal on the first anniversary of his advisory committee’s much-publicized findings that cigarette smoking could cause lung cancer and other diseases. At left is Sen. Maurine Neuberger, D-Ore., a vigorous opponent of smoking.”

UPI (United Press International) Telephoto
January 11, 1965

In the Aftermath of the Report, the First World Conference on Smoking and Health Was Held in New York City in 1967

“Report Not Endorsed by Johnson” (4 pages)

News article
Tobacco
March 20, 1964

Related stories:

“Tobacco Institute Challenges FTC Power”

“FTC [Federal Trade Commission] Hears Testimony of Cigarette Regulation”

“Earle Clements [former U.S. Senator from Kentucky] Hired [as a lobbyist] By Six Cigarette Companies”

ABC-TV Report on the First World Conference on Smoking and Health, September 11-13, 1967 (09:55)

Approximately 500 scientists, government leaders, physicians, and journalists from 34 countries attended the three-day meeting at the Waldorf-Astoria Hotel. This ABC-TV news footage features excerpts of plenary addresses by United States Surgeon General Luther Terry and New York Senator Robert Kennedy, plus reporting by medical correspondent Jules Bergman.

The Anti-Terry Report

Covers of three issues of a publication by the German tobacco industry in response to the US Surgeon General’s Report
1971

The authors of
The Anti-Terry Report accuse the World Health Organization of being a captive of the Adventist Church:

“It was already pointed out in Part II of the Anti-Terry Report that the World Health Organization is no more and no less in certain areas (i.e. in the area of so-called Christian temperance, especially anti-tobacco), an international Adventist mission center…

“It is particularly interesting to note that certain developing countries feel threatened by increasing tobacco consumption and are therefore calling for studies on the health effects of smoking among their populations. There is little to say about this demand, except that in the countries where such planned ‘fears’ have arisen, there are undoubtedly Adventists — be they Adventist missionaries or at sectarian universities and the like, trained local officials — who want to make an attempt to advance the Adventist mission in this way, because as is well known, the “Non-smoking in 5 days” campaign is mainly a [front] to proclaim the angel’s message and prepare the people for the return of Christ…

“The World Health Organization has become the focal point for these mission efforts. The countries in which religions that do not agree with the views of the Seventh Day Adventists are predominant should therefore break with the World Health Organization in the most unambiguous manner and, above all, no longer provide it with any contributions until all Adventist Missionary efforts from the World Health Organization program have certainly been eliminated…”

Curator’s note: Andrea Wright, MLIS obtained the English translation

“There is no reason for another generation of mankind to end up disabled and the victim of premature death. We must act—and act now.” (5 pages)

Transcript of Senator Robert Kennedy’s address at the first World Conference on Smoking and Health, held at the Waldorf-Astoria Hotel, New York City
September 11-13, 1967

Danger!

HEAVY CIGARETTE SMOKERS ARE THIRTY TIMES MORELIKELY TO DIE OF LUNG CANCER THAN NON-SMOKERS. You have been warned”

“BRITISH POSTER AGAINST CIGARETTE SMOKING — This is one of three different posters being used by the British givernment in a campaign against cigarette smoking. More than 400,000 posters were dispatched by the Ministry of Health to all parts of the nation. The drive strated as a result of last month’s report by the Royal College of Physicians that there is a direct connection between cigarette smoking and lung cancer.”

Associated Press Wirephoto
April 5, 1962

“SCHOOL CHILDREN’S ANTI-SMOKING LEAGUE
LORD NEWTON addresses the children on the evils of smoking”

Keystone Press Photograph (United Kingdom)
December 13, 1963

“School children of the KINGSDALE SCHOOL in Dulwich, London, have started an Anti-smoking campaign under the chairmanship of 15-year-old BILL PRICE. Yesterday LORD NEWTON, Parliamentary Under Secretary to the Ministry of Health, who himself gave up smoking 12 years ago, lectured to more than 300 boys and girls of the school, on the evils of smoking.”

The entrance to an unidentified local office of the American Cancer Society two weeks after the publication of the Surgeon General’s Report on Smoking and Health.

Associated Press Wirephoto
January 27, 1964

“PUFFING AND PECKING”

Associated Press Wirephoto
January 30, 1963

“INDIANAPOLIS, Jan. 30 — Mrs. Dorothy Huffman, a reporter, puffs as she works at her job in the City-County Building, Indianapolis. The wife of a pipe-smoker, she started smoking a pipe at home but she brought it out in the open after the latest cigarette scare.”

“What is public opinion on ‘smoking and health’? (and how is it changing?)” (2 pages)

Article in Tobacco Reporter
December 1967

“How much of the public is actually aware of the smoking and health propaganda battle?
“A number of polls have been conducted during the past few years that may give some indication…
“In answer to [the] Gallup [Poll]’s question, “What is your opinion — do you think cigarette smoking is or is not one of the causes of cancer of the lung?” the number of affirmative answers increased almost steadily between 1954 and 1964. Importantly, the increase in affirmative answers was a gradual one that showed up continuously on the 10 polls conducted in the ten year period by Gallup. However, the increase in affirmative answers between June, 1963 and February, 1964, showed one of the largest jumps in the ten year period:
1954: All adults 39%, Smokers, 29%
1964: All adults 62%, Smokers, 53%

“…In October [1967}, C.E. Hooper, Inc., conducted…a study for one of the advertising agencies handling a cigarette account. Some 1,996 interviews were completed by telephone…
“Among the more interesting findings of the Hooper study are the following:
In response to the statement, ‘The smoker has himself to blame for any ill effects from cigarette smoking,’ some 91.2 per cent of people queried agreed. This was reinforced by responses to the statement, ‘Cigarette manufacturers should be blamed for any ill effects from cigarette smoking.’ Some 77.6 per cent of those questioned disagreed.”

“‘SMOKING and HEALTH’ (a potpourri of industry thought)” (4 pages)

Article in Tobacco Reporter
December 1967

Tobacco Reporter asked manufacturers, growing representatives and distributors to suggest ways then industry might combat anti-tobacco propaganda on ‘smoking and health.’
“…Flue-cured tobacco growers had only just recoiled from having tobacco prices plummet — coinciding pointedly with publicity generated by Senator Robert Kennedy’s cigarette restriction bills — and having their market turned upside down by increased demand for low nicotine tobacco, presumably generated by government activities, when Surgeon General William Stewart visited tobacco country.
“In North Carolina to dedicate a 500-acre tract in the Research Triangle, the Surgeon General stated flatly he felt the tobacco economy of North Carolina of little consequence compared with lives lost because of cigarette smoking. It is ‘no longer debatable,’ he said to the North Carolina audience, whether a connection exists between smoking and health. Tobacco growers are furious.
“…Distributors and retailers are beginning to complain that cigarette sales appear to be falling off in some areas of the U.S.
‘People are believing the wild statistical claims of the public Heath Service and the American Cancer Society are making,’ one distributor points out..
“What can be done?
“Many seem to feel an intensive campaign by cigarette companies to give the public the facts on smoking and health is the only way way to curb the flood of anti-tobacco mail to Congressmen and government agencies, and revive per capita consumption.
“At the same time, some point out that it is important to decide what side effects a major campaign to make the public aware of the tobacco industry’s story might have. One observer points out that the public does not seem very aware of the Surgeon General or other anti-tobacco spokesmen, and questions whether the increased public awareness of the whole problem might make smokers come to grips with the problem for the first time — possibly having the unexpected effect of curbing sales. The suggestion: a saturation test in several markets making the use of every medium to tell tobacco’s story, along with a close check on cigarette sales during that period.
“…A number of executives questioned felt an extensive media education program was important. Some references were made tat a recent project at Philip Morris involving special organized trips to Richmond, Va., for key members of the press in a company plane. In Richmond the media people visit the Philip Morris research lab and hear top executives explain the work the company is doing.
“…An official of one company…adds, ‘Most of the time we are talking to ourselves. We should be out talking to membership of the National Chamber of Commerce and groups outside the tobacco industry.”

“The Surgeon General’s first report on smoking and health: A challenge to the medical profession” (3 pages)

Commentary by Luther L. Terry, MD
New York State Journal of Medicine
1983 (volume 83), pages 1254-1255
December 1983

“Childish Habit”

Editorial by Alan Blum
THE ECHO (Woodmere Academy high school newspaper, Woodmere, New York)
October 30, 1964

Curator’s note: This is the first essay the curator wrote on the subject of cigarette smoking.

“Califano Declares War on Smoking
INTERAGENCY COOPERATION PLEDGED, NEW RULES AT HEW
TOBACCO INSTITUTE CHALLENGES ACTION BEFORE SPEECH” (3 pages)

The Washington Star
January 11, 1978

By the fourteenth anniversary of the Surgeon General’s Report, so little “remedial action” on smoking had been taken by the federal government that it fell to Secretary of Health, Education and Welfare Joseph A. Califano, Jr. to declare a war on cigarettes. Eighteen months later, he would be fired by President Carter, who traveled to North Carolina to assure tobacco farmers and cigarette manufacturers that we will make cigarettes “even safer than they are today.”

Interviews with former Surgeon General’s Advisory Committee Staff Assistant Donald R. Shopland, Sr. and former Secretary of Health and Human Services Louis Sullivan, MD

Donald R. Shopland, Sr., was an original member of the staff of the Advisory Committee to the Surgeon General upon its formation in 1962. Over the next 48 years, until his retirement in 2014, he served as an editor of 17 reports of the Surgeon General on smoking and health, as interim director of the Office on Smoking and Health for two years in the 1980s, and as an advisor on smoking and health at the National Cancer Institute. On December 1, 2023, Alan Blum, MD interviewed him for a podcast of the Cancer History Project (CHP), directed by Alexandria Carolan. CHP is a project of The Cancer Letter, edited and published by Paul Goldberg. (01:11.22)

Louis W. Sullivan, M.D., served as Secretary of the U.S. Department of Health and Human Services (HHS) from 1989 to 1993. A native of Atlanta, he graduated magna cum laude from Morehouse College and cum laude from Boston University School of Medicine. An internist and hematologist, he taught at Harvard Medical School and founded the Boston University Hematology Service at Boston City Hospital

In 1975, Dr. Sullivan was named founding dean and director of the Medical Education Program at Morehouse College. In 1981, the four-year Morehouse School of Medicine was established with Dr. Sullivan as dean and president. Among his achievements during his leave from Morehouse to serve as HHS Secretary were the establishment the National Institutes of Health Office of Research on Minority Health and the Women’s Health Research Program He also made smoking prevention a high priority, condemning the tobacco industry for targeting of African Americans and calling on sports organizations to reject tobacco sponsorship

Dr. Sullivan is the founding president of the Association of Minority Health Professions Schools. His most recent book, co-authored with David Chanoff, is We’ll Fight it Out Here: A History of the Ongoing Struggle for Health Equity.

On December 14, 2023, Alan Blum, MD interviewed him for a podcast of the Cancer History Project (CHP), directed by Alex Carolon. CHP is a project of The Cancer Letter, edited and published by Paul Goldberg. (01:11.06)

At left:
“Limit tobacco sale to youth, Sullivan urges;.
Ban cigarette vending machines, license retailers, he is urging states”

News article by Associated Press
The Atlanta Journal
May 20, 1990

“The Behind-the-Scenes Story of the Surgeon General’s Report on Smoking and Health” (01:30:54; begins at 01:51)

A presentation by Donald R. Shopland, Sr. on the 60th anniversary of this landmark document
The Art of Medicine Rounds
The University of Alabama College of Community Health Sciences
Tuscaloosa, Alabama
January 11, 2024

Mr. Shopland was a member of the staff of the Advisory Committee to the Surgeon General, which produced the report. Over a career in the Public Health Service that spanned five decades, he served as an editor of 17 reports of the Surgeon General on smoking and health (and a reviewer on aal 34 reports issued from 1967 to 2014), interim director of the Office on Smoking and Health, and advisor on smoking and health at the National Cancer Institute

“Blowing Smoke: The Lost Legacy of the Surgeon General’s Report” (01:19:06)

A presentation by Alan Blum, MD on the 60th anniversary of the publication of this landmark document in public health
The University of Alabama College of Community Health Sciences
Tuscaloosa, Alabama
January 11, 2024

Cover of TOBACCO AND HEALTH

“REVISIONISM, MAGICAL THINKING, AND HOKEY-POKEY OBJECTIVES IN THE ANTI-SMOKING MOVEMENT” (8 pages)

Article by Alan Blum, MD and Eric Solberg, MS
Adapted from their presentation at the 9th World Conference on Smoking and Health, Paris, September 1994
In TOBACCO AND HEALTH
Edited by Karen Slama
1995

Obituary of Dr. Luther Terry, originally published in the New York State Journal of Medicine, July 1985

___________________________________________________________________________________

“When Luther Terry was Surgeon General, he was the head of the Public Health Service. That’s what the Surgeon Generals did: They were the management arm and the administration arm of the entire Public Health Service. It was after the Report came out, which then I think put the Surgeon General’s office in the cross hairs of the politically powerful tobacco industry during the Johnson administration, that the office was downgraded, and they created a thing called the office of the Assistant Secretary of Health and made the Surgeon General an advisor to the office of the Assistant Secretary for Health–and no longer in charge of the Public Health Service.  

“And that is true today. That is why you talk about the bully pulpit, because the Surgeon General today—in fact, the Surgeon General since 1967–has had absolutely no authority over the Public Health Service. And I think that was a direct result of the Surgeon General’s Report–and the fact that the tobacco industry could wield its way, in the 1960s, with what it wanted to do both with the executive office but with the legislative office as well. There’s just no two ways about it.”

–Donald R. Shopland, Sr., in his presentation, “The Behind-the-Scenes Story of the Surgeon General’s Report on Smoking and Health”
The Art of Medicine Rounds, the University of Alabama College of Community Health Sciences, January 11, 2024
https://alabama.box.com/s/iq5ntljs1kr89tblcz9kuagrjc7fzyeh

Curator’s note: Don Shopland’s observation about the greatly diminished role of the Surgeon General following the publication of the landmark scientific document that so threatened the financial health of the tobacco industry could be considered the beginning of the lost legacy of the Surgeon General’s Report. Fifty years later, in a presentation about tobacco to a class of undergraduate premedical students, I asked if anyone knew what the Surgeon General does. A young man quickly replied, “Yeah, isn’t he the guy on the side of the dip can?”

Resolution of The Board of Trustees of The University of Alabama expressing its condolences to the family of Luther Leonidas Terry, MD on their loss (5 pages)

June 27, 1985

“WHEREAS, this Board wishes to express its appreciation of Dr. Terry’s lifelong efforts to promote good health, prevent disease, and improve the general welfare of all Americans.”

((Donated to the Center for the Study of Tobacco and Society by Dr. Terry’s son, Michael Durham Terry, 2018)

Officials photograph of Dr. Terry as Surgeon General

(Donated to the Center for the Study of Tobacco and Society by Dr. Terry’s son, Michael Durham Terry, 2018)

Certificate of Appreciation to The Luther Terry Family, 1964-2014 “In recognition of the dedication and achievements of the 9th Surgeon General, Dr. Luther Terry, a pioneer in the 50 year battle against tobacco”

Presented by Acting Surgeon General Boris Lushniak
2014

(Donated to the Center for the Study of Tobacco and Society by Dr. Terry’s son, Michael Durham Terry, 2018)

“Distinguished Alabamians”

Newspaper photograph of Luther L. Terry, MD at his induction into the Alabama Academy of Honor, created by the Alabama State Legislature in 1965 “to recognize living Alabamians whose careers and lives have benefitted and brought great credit to their state”

The Sylacauga (Alabama) News
August 29, 1974

(Donated to the Center for the Study of Tobacco and Society by Dr. Terry’s son, Michael Durham Terry, 2018)

“Distinguished Alabamians”

Newspaper photograph of Luther L. Terry, MD at his induction into the Alabama Academy of Honor, created by the Alabama State Legislature in 1965 “to recognize living Alabamians whose careers and lives have benefitted and brought great credit to their state”

The Sylacauga (Alabama) News
August 29, 1974

(Donated to the Center for the Study of Tobacco and Society by Dr. Terry’s son, Michael Durham Terry, 2018)

The Legislature of Alabama Resolution, “That though we are deeply grieved by the death of Dr. Luther Terry, we give thanks for the wife, labors and accomplishments of this distinguished Alabamian, dedicated physician, and exemplary public servant.

April 17, 1986

Part II

The Symposium and Exhibition by the Center for the Study of Tobacco and Society in 2013-2014 to Commemorate the 50th Anniversary of the Surgeon General’s Report on Smoking and Health,

“The Surgeon General vs the Marlboro Man: Who Really Won?”

This online exhibition was created in 2020

Slideshow Presentation

The Surgeon General vs. The Marlboro Man: Who Really Won?

The images in this slide presentation are highlights of the 2013 exhibition, The Surgeon General vs. The Marlboro Man: Who Really Won? which marked the 50th anniversary of the Report. The slide set originally appeared in 2014 on The Cancer Network, the website of the journal ONCOLOGY. (Visit here). The exhibition debuted at the Amelia Gayle Gorgas Library of The University of Alabama in October 2013,  then traveled in 2014 to the Lyndon Baines Johnson Presidential Library, the Texas Medical Center Library, Houston, and the Louisiana State University Health Sciences Center Library. A companion video entitled “When More Doctors Smoked Camels…” features a gallery tour of the exhibition at the Gorgas Library.

Exhibition Keys

“Alabamian Dr. Luther Terry and the Surgeon General’s Report on SMOKING and HEALTH: A commemorative exhibition to mark the 50th anniversary of one of the most important medical documents of the 20th century” (26 pages)

Illustrated exhibition key

Gorgas Library, University of Alabama
Curated by Alan Blum, MD, Director, The University of Alabama Center for the Study of Tobacco and Society
October 21 – December 1, 2013

“Supplemental Items to Alabamian Dr. Luther Terry and the Surgeon General’s Report on SMOKING and HEALTH: A commemorative exhibition to mark the 50th anniversary of one of the most important medical documents of the 20th century” (53 pages)

Supplemental key to items originally considered for the exhibition

Gorgas Library, University of Alabama
Curated by Alan Blum, MD, Director, The University of Alabama Center for the Study of Tobacco and Society
October 21 – December 1, 2013

“The Surgeon General’s Report on Smoking and Health: Marking 50 Years Since the Government’s First Call for Remedial Action” (12)

Illustrated exhibition key

Louisiana State University Health Sciences Center John P. Ische Library
Curated by Alan Blum, MD,  Director, The University of Alabama Center for the Study of Tobacco and Society
November 17 – November 18, 2014

Program

“FIGHTING SMOKE with FIRE” (Video of symposium: 57:18)

An exhibition, documentary film screening, and commentaries by guest speakers to commemorate the 50th anniversary of the publication by Alabamian Dr. Luther Terry of the landmark 1964 U.S. Surgeon General’s Report on Smoking and Health

Symposium program (4 pages)
Gorgas Library, University of Alabama
Moderated by Alan Blum, MD, Director, The University of Alabama Center for the Study of Tobacco and Society
November 20, 2013

Media

Blowing Smoke: The Lost Legacy of the Surgeon General’s Report

Documentary (23:30)
The Center for the Study of Tobacco and Society
January 2014

“Blowing Smoke: The Lost Legacy of the Surgeon General’s Report”

Film Poster
The Center for the Study of Tobacco and Society
November 2013

Video Tour of the Exhibition Gallery

Video (15:07)
The Center for the Study of Tobacco and Society
January, 2014

News

“University of Alabama to Honor Surgeon General Who Led Charge Against Smoking Culture”

Article by Melissa Brown
AL.com
November 12, 2013

(Link)

“Blowing Smoke: The Lost Legacy of the 1964 Surgeon General’s Report on Smoking and Health” (5 pages)

Invited Editorial by Alan Blum, MD
ONCOLOGY
May, 2014

“The Surgeon General vs. The Marlboro Man: Who Really Won?”

Article by Alan Blum, MD
The Pharos
Autumn 2014

“UA Exhibit Lights Up History” (2 pages)

Article by Ed Enoch
The Tuscaloosa News
November 18, 2013

Blowing Smoke: The Lost Legacy of the Surgeon General’s Report on Smoking and Health

Logo

Curated by Alan Blum, MD

Professor and Endowed Chair in Family Medicine
Director, Center for the Study of Tobacco and Society
College of Community Health Sciences
The University of Alabama School of Medicine, Tuscaloosa

“Blowing Smoke: The Lost Legacy of the Surgeon General’s Report on Smoking and Health” is Copyrighted 2024

ALL ITEMS IN THE EXHIBITION ARE FROM THE CENTER’S COLLECTION UNLESS OTHERWISE INDICATED.

Designed by Bryce Callahan

Undergraduate student majoring in computer engineering
IT Technician, College of Community Health Sciences
Technical Advisor to the Center for the Study of Tobacco and Society
The University of Alabama

Part II was designed by Kevin Bailey, MA, former collection manager of the Center for the Study of Tobacco and Society. The late Joe Parker provided items gleaned from his decades-long research on tobacco industry trade publications. The late J. Fred MacDonald, PhD, provided the film documentaries about the publication of the Surgeon General’s Report.