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Cigarettes are Hazardous to Your Health Day

Cigarettes Are Hazardous to Your Health Day marks the anniversary of the 1964 release of a landmark report that outlined the detrimental health effects of smoking. Earlier in the twentieth century, there had been a huge increase in cigarette smoking in the United States, which gave rise to anti-smoking efforts. A body of evidence of the deleterious effects of smoking was gathered during the 1930s, '40s, and '50s. The effects were argued by public health officials, hygienists, and reformers. Through case-control studies, epidemiologists found links between lung cancer mortality and smoking, and pathologists and lab scientists found links between smoking and lung cancer, bronchitis, emphysema, and coronary heart disease. They found that the greatest cause of lung cancer in the twentieth century was smoking—not asbestos contamination, air pollution, or radioactive materials. While not an official report on smoking and health, like that which would come later, on October 12, 1957, U.S. Surgeon General Leroy E. Burney, M.D. declared the official position of the U.S. Public Health Service to be that evidence showed a causal relationship between smoking and lung cancer.

In June 1961, the American Cancer Society, American Heart Association, National Tuberculosis Association, and American Public Health Association collectively wrote a letter to President John F. Kennedy that called for a national commission on smoking dedicated to "seeking a solution to this health problem that would interfere least with the freedom of industry or the happiness of individuals." Also affected by a study critical of cigarette smoking released by the Royal College of Physicians of London, the Kennedy administration was convinced there must be movement on the issue. In 1962, recently appointed U.S. Surgeon General Luther L Terry, M.D. announced he would convene experts to conduct a comprehensive review of the scientific literature that examined smoking.

Terry invited representatives from the four organizations who proposed the commission, as well as the American Medical Association, the Food and Drug Administration, the Federal Trade Commission, the Tobacco Institute—the lobbier for the tobacco industry—and a few others. Together, they represented the fields of medicine, surgery, pharmacology, and statistics, and all had previously taken a stand on tobacco use. From November 1962 through January 1964 they met at the National Library of Medicine at the National Institutes of Health campus in Bethesda, Maryland, and reviewed 7,000 articles in biomedical literature about the effects of smoking.

On January 11, 1964—on the date that we observe today as Cigarettes Are Hazardous to Your Health Day—Surgeon General Terry issued his report, Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. He released it on a Saturday to minimize the effects it could have on the stock market and to maximize its effect in Sunday newspapers. It concluded that smoking was a cause of lung cancer and laryngeal cancer in men, a probable cause of lung cancer in women, and the biggest cause of chronic bronchitis. It said there was a correlation between heart disease and smoking and emphysema and smoking. It said that smoking during pregnancy reduced the weight of newborns and that smoking was responsible for increasing the death rate of smokers to 70 percent more than non-smokers.

The release of the report was on the front pages of newspapers, the lead story on television and radio, and ultimately one of the biggest news stories of the year. Not everyone accepted the report at the time, though the percentage of people who believed smoking caused cancer jumped from 44 percent to 78 percent between 1958 and 1968. The report said "cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action," but it didn't outline exactly what those remedies should be. Still, it became the first in many steps taken to reduce the risks of smoking and tobacco use on Americans. Citizens, public agencies, and elected officials have followed the report's call for action, and organizations such as the Truth Initiative, Smokefree, and Campaign for Tobacco-Free Kids have continued to warn that cigarettes are hazardous.

In 1965, Congress passed the Federal Cigarette Labeling and Advertising Act. This was followed by the Public Health Cigarette Smoking Act of 1969. The laws required a health warning on cigarette packages, banned cigarette advertising in the broadcasting media, and called for an annual report on the health effects of smoking. In 1965, the Public Health Service established the National Clearinghouse for Smoking and Health, later called the Office on Smoking and Health of the Centers for Disease Control and Prevention, which by 2023 had put out 29 reports on smoking. The Public Health Service has also supported local and state programs to reduce tobacco use, shared research findings about tobacco use, and kept anti-smoking messages in the public eye.

Despite the addictiveness of tobacco and powerful entities promoting its use, the anti-smoking campaign has largely been a great success. Today, the number of people who smoke has decreased dramatically, and almost half of adults who have been smokers have quit. New challenges have arisen with the emergence of vaping, and smoking-related diseases still kill more than 480,000 Americans and cost the United States over $300 billion each year, illustrating why raising awareness remains important, which Cigarettes Are Hazardous to Your Health Day plays a role in doing.

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