Introduction
To observe the 1980 World Health Organization’s theme of “Smoking or Health—The Choice is Yours,” 24 countries issued an anti-smoking stamp. Since then, 41 other countries have recognized the importance of tackling the cigarette pandemic by issuing such stamps. The United States is not among those 65 countries with an anti-smoking stamp.
In 1986, Dr. James Lutschg, a pulmonary physician in Baton Rouge, Louisiana and a stamp collector, first proposed that the US Citizens Stamp Advisory Committee issue a stamp to commemorate the 25th anniversary in 1989 of the publication of the US Surgeon General’s report on smoking and health by Dr. Luther Terry. The landmark report, which concluded that cigarette smoking was a major cause of lung cancer and other diseases, is one of the most significant public health documents of the 20th century.
The report was the culmination of growing scientific concerns about cigarette smoking over the previous four decades. By 1940 chest surgeons Dr. Alton Ochnsner and Michael DeBakey at Tulane University would publish their observations on the association between cigarette smoking and lung cancer, citing more than 400 articles in medical journals. In 1961 the presidents of several national health organizations urged President John F. Kennedy to establish a commission to review the mounting evidence of the adverse impact of smoking on society. Following the publication by the Royal College of Physicians of the United Kingdom in 1962 that indicted cigarette smoking, Kennedy was pressed into asking US Surgeon General Dr. Luther Terry to produce an expert scientific review of the subject.
Meeting in secret for 14 months at the National Library of Medicine, an advisory committee of 10 biomedical scientists reviewed more than 7000 scientific articles on smoking, as well as information provided by the tobacco industry. The 387-page report, issued on January 11, 1964 at a packed press conference in the US State Department, made front-page headlines in virtually every newspaper in the country.
In just the two decades following the release of the report, more than 20 million Americans stopped smoking, resulting in a dramatic decline in heart attacks and a slow but steady decrease in lung cancer in men.
Writing in the New York State Journal of Medicine in 1983, Dr. Terry recalled, “The report not only carried a strong condemnation of tobacco usage, especially cigarette smoking, but conveyed its message in such clear and concise language that it could not be misunderstood.” Dr. Terry was exceptionally proud of the fact that of the “more than 30,000 articles published in the 20 years since the report, almost without exception they confirm the committee’s findings and extend the knowledge of the health hazards of smoking.” Terry, who died in 1985, spent the rest of his life as a spokesperson for the anti-smoking movement and fought hard to eliminate smoking from the workplace. In 2002 he was inducted posthumously into the Alabama Healthcare Hall of Fame
When Dr. Lutschg was informed that stamps commemorating historic events are only issued at 50-year anniversaries, he began laying the groundwork for a campaign to have such a stamp issued in 2014. In 1992 the covers of the first several issues of the new journal Tobacco Control depicted anti-smoking stamps from his collection. In 2000 Dr. Lutschg displayed a research poster featuring highlights of his anti-smoking stamp collection at the 11th World Conference on Tobacco or Health. In 2008 he donated his collection to the University of Alabama Center for the Study of Tobacco and Society, which produced a traveling exhibition on the world’s anti-smoking stamps that was on view at medical libraries of the University of Alabama at Birmingham, the University of Buffalo, and other venues. (This online exhibition expands upon the original one.) In 2010 the House of Delegates of the American Medical Association passed a resolution introduced by Dr. W. Jeff Terry, president-elect of the Medical Association of the State of Alabama and a cousin of Dr. Luther Terry, calling on physicians to campaign for such a stamp.
The US Postal Service’s Citizens Stamp Advisory Committee (CSAC), created in 1957, reviews and selects stamps that commemorate individuals, history, culture, sports, and science and technology. Upwards of 25-30 stamp subjects are produced each year, selected from among thousands of proposals. CSAC, an extremely secretive government agency consisting of ten appointees, does not publish the minutes of its meetings and in 2014 it did not issue a stamp commemorating Dr. Terry and the Surgeon General’s Report. Its failure to do so is all the more puzzling and disappointing because the US Postal Service (USPS) has gone to great lengths to avoid any depictions of tobacco use on its stamps, to the point of airbrushing away the cigarette in at least five stamps that were in the original photographs on which these stamps are based. USPS has also issued stamps that salute the crusade against cancer (1965) as well as research aimed at finding cures for breast cancer (1998, 2014) and prostate cancer (1999). Meanwhile, lung cancer is the leading cause of cancer deaths, and it is almost entirely caused by cigarette smoking—and almost entirely preventable by not taking up cigarette smoking.
It is fitting to recall Dr. Terry’s appeal to physicians in 1983 not to be complacent about fighting cigarette smoking—or the tobacco industry: “The abuses of the cigarette companies are too numerous to mention. It is clear that they do not want the public to recognize the health hazards and the enormous financial cost to society caused by smoking. Therefore, health professionals must take back the leadership role.
“I hope that every member of the medical profession will recognize this responsibility and will be committed to spreading the message that tobacco smoking is the single most preventable cause of disability and death in the United States.”
More than half a century after the Surgeon General’s report, cigarettes still kill more Americans than AIDS, motor vehicle accidents, breast cancer, sickle cell disease, alcohol, illegal drugs, homicides, suicides, and fires combined. A stamp commemorating Dr. Terry’s monumental report would still be an important symbol to remind us how we can help protect the next generation from the needless suffering caused by cigarette smoking.
Alan Blum, MD
Gerald Leon Wallace, MD, Endowed Chair in Family Medicine
Director, The Center form the Study of Tobacco and Society
University of Alabama School of Medicine
This exhibition is dedicated to Dr. James Lutschg, who has led the campaign for a US anti-smoking stamp; to Julia Purpera, Dr. K. Michael Cummings, and Anthony Brown of Roswell Park Cancer Institute who helped organize the campaign and enhance the exhibition in 2010; and the late Dr. Jeff Terry and the late Dr. Ron Davis who galvanize the involvement of the American Medical Association in the campaign.