GREETINGS, ETC.
A THOUSAND AMERICANS WILL STOP SMOKING TODAY. ...

THEIR FUNERALS WILL BE HELD WITHIN THE NEXT THREE OR

FOUR DAYS.

THAT'S THE WAY I HAVE STARTED A NUMBER OF LECTURES ON
SMOKING.

IT GETS PEOPLE'S ATTENTION.

I FEEL I HAVE TO SAY SOMETHING DRAMATIC TO GET THEIR
ATTENTION.
I SHOULDN'T HAVE TO.
WHAT IS IT ABOUT TOBACCO THAT NUMBS THE AMERICAN

PEOPLE?

IF ANYTHING ELSE KILLED 390,000 OF OUR FELLOW-CITIZENS
EACH YEAR, THE PUBLIC WOULD DEMAND ACTION FROM OUR

GOVERNMENT.

INSTEAD, TOBACCO HAS, FROM THE BEGINNING, BEEN CODDLED

BY OUR GOVERNMENT.
THIS DISTINGUISHED AUDIENCE KNOWS ABOUT THAT, AND ASA
PHYSICIAN AND FORMER PUBLIC HEALTH OFFICER, I DON'T
WANT TO RAISE YOUR BLOOD PRESSURE --OR MAKE YOUR
BLOOD BOIL-- BY REVIEWING THE SORRY STORY IN GREAT

DETAIL.

BUT IN A FEW WORDS, I'LL REMIND YOU THAT TOBACCO HAS
BEEN ASSOCIATED NOT ONLY WITH DISEASE AND DEATH, BUT

ALSO WITH MONEY.
THAT, OF COURSE IS THE REASON FOR ITS SPECIAL TREATMENT.

TOBACCO WAS THE CASH CROP THAT FINANCED THE AMERICAN
REVOLUTION --THOSE VIRGINIA PLANTERS FETCHED A GREATER
RETURN FOR TOBACCO LEAVES THAN DID THE HARDY NEW
ENGLANDERS FOR THEIR PUMPKINS.

CONGRESS HAS BEEN HELD HOSTAGE EVER SINCE.

DESPITE THE SINISTER ASSOCIATIONS, FIRST WITH SLAVERY, AND
LATER WITH CANCER AND HEART DISEASE, AMERICAN TOBACCO

HAS ENJOYED GOVERNMENT PROTECTION.
TOBACCO MONEY EXPLAINS THE RELUCTANCE OF CONGRESS TO
TOLERATE ANY REGULATION OF TOBACCO, SO IT HAS BEEN
DECLARED TO BE NEITHER A FOOD, NOR A DRUG, NORA

COSMETIC.

ANY SPEECH ON SMOKING BECOMES A "GOOD NEWS/BAD NEWS"

STORY.

THE GOOD NEWS IS THAT WE ARE --AT LAST-- WINNING THE WAR
AGAINST TOBACCO.
THE BAD NEWS IS THAT THERE ARE MANY BATTLES STILL TO

FIGHT.

SOME OF THE MOST CRUCIAL ARE AT THE WORKSITE.

IN MY FINAL YEAR AS YOUR SURGEON GENERAL I WAS
PRIVILEGED TO COMMEMORATE WITH A SPECIAL REPORT THE
25TH ANNIVERSARY OF THE FIRST SURGEON GENERAL'S REPORT
ON SMOKING.
THAT FIRST, HISTORY-MAKING REPORT WAS TITLED "SMOKING
AND HEALTH: THE REPORT OF THE ADVISORY COMMITTEE TO
THE SURGEON GENERAL."

IT WAS RELEASED TO THE PUBLIC ON JANUARY 11, 1964, BY THE
LATE DR. LUTHER L. TERRY, A COURAGEOUS PHYSICIAN WHO
WAS SURGEON GENERAL OF THE U.S. PUBLIC HEALTH SERVICE AT

THAT TIME.
HOW MUCH DID WE REALLY KNOW IN 1964 ABOUT SMOKING AS A
CAUSE OF CANCER?
AND HOW MUCH DO WE REALLY KNOW TODAY?

LET ME BEGIN BY OBSERVING THAT THE FIRST REPORT BY DR.
TERRY

DID NOT INITIATE A RESEARCH PROGRAM LINKING SMOKING
WITH MAJOR DISEASE CONDITIONS. SUCH RESEARCH WAS

ALREADY GOING ON.
MEDICAL CONCERN ABOUT SMOKING DID NOT POP OUT OF
NOWHERE IN 1964. LONG BEFORE THAT THERE WAS A CORE OF
CONCERNED PHYSICIANS, ESPECIALLY CONCERNED ABOUT THE
CLEAR CONNECTIONS BETWEEN LUNG CANCER AND SMOKING IN

THEIR MALE PATIENTS.

DR. TERRY'S REPORT GAVE NEW ENERGY AND NEW DIRECTION
TO AN ALREADY IMPRESSIVE RESEARCH EFFORT.

IN FACT, AS OF 1964 THERE WERE 7,000 ARTICLES IN THE WORLD
BIOMEDICAL LITERATURE DEALING WITH THE LINKAGE

BETWEEN SMOKING AND HEALTH.

10
AFTER REVIEWING THOSE RESEARCH PAPERS, THE SURGEON
GENERAL'S ADVISORY COMMITTEE CAME TO THE FOLLOWING

CONCLUSIONS ABOUT CIGARETTE SMOKING IN 1964:

FIRST, THAT MEN WHO SMOKED HAD AN OVERALL HIGHER

 

MORTALITY RATE THAN MEN WHO DID NOT SMOKE.

SECOND, THAT SMOKERS HAD INCREASED MORTALITY RATES

FROM CORONARY HEART DISEASE, CEREBROVASCULAR DISEASE,

AND OTHER CARDIOVASCULAR DISEASE CONDITIONS.

11
THIRD, THE ADVISORY COMMITTEE SAID CIGARETTES WERE A
MAJOR CAUSE OF CHRONIC BRONCHITIS AND CONTRIBUTED TO

THE HIGH MORTALITY RATE FOR EMPHYSEMA.

FOURTH, THE COMMITTEE SAID -- IN 1964, REMEMBER -- THAT

 

CIGARETTE SMOKING WAS THE MAJOR CAUSE OF LUNG CANCER

IN MEN AND MAYBE FOR WOMEN, ALSO.

12
FIFTH, THE COMMITTEE ALSO SAID THAT SMOKING WAS, AT THE
VERY LEAST, A CONTRIBUTING CAUSE OF ESOPHAGEAL CANCER,
BLADDER CANCER, AND PANCREATIC CANCER, AND THAT PIPE

SMOKING CONTRIBUTED TO CANCER OF THE LIP AND THE ORAL

CAVITY.

FINALLY, THE COMMITTEE CONCLUDED THAT "CIGARETTE
SMOKING IS A HEALTH HAZARD OF SUFFICIENT IMPORTANCE IN
THE UNITED STATES TO WARRANT APPROPRIATE REMEDIAL

ACTION."

13
SUCH "APPROPRIATE REMEDIAL ACTION" WAS TAKEN ALMOST
IMMEDIATELY. THE UNITED STATES CONGRESS SOON PASSED A
LAW REQUIRING ALL CIGARETTE PACKAGES TO CARRY THE

FOLLOWING MESSAGE:

"CAUTION: CIGARETTE SMOKING MAY BE HAZARDOUS TO YOUR

HEALTH."

14
SIX YEARS AFTER THE RELEASE OF THE FIRST REPORT ON
SMOKING AND HEALTH, THE CONGRESS ENACTED A SWEEPING
LAW THAT BANNED CIGARETTE ADVERTISING FROM RADIO AND

TELEVISION.
THE NEW LAW ALSO TOUGHENED UP THE HEALTH WARNING ON

CIGARETTE PACKAGES. THE NEW LANGUAGE SAID...

"WARNING: THE SURGEON GENERAL HAS DETERMINED THAT

CIGARETTE SMOKING IS DANGEROUS TO YOUR HEALTH."

15
HOW DID THAT COME ABOUT?

BY 1970, WHEN THE NEW LAW WAS PASSED, THE ORIGINAL BASE
OF 7,000 RESEARCH ARTICLES HAD ALMOST TRIPLED --
APPROXIMATELY 19,000 RESEARCH PAPERS WERE THEN IN THE
INTERNATIONAL LITERATURE -- AND THE NEW MATERIAL WAS
ALSO VIRTUALLY UNANIMOUS IN IDENTIFYING CIGARETTES AS
THE MAJOR CAUSE OF MORBIDITY AND MORTALITY ACROSS A

BROAD SPECTRUM OF DISEASE CONDITIONS.

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THE NEW INFORMATION NOT ONLY CONFIRMED THE FINDINGS
PUBLISHED IN 1964, BUT ALSO IT LINKED CIGARETTE SMOKING
TO PANCREATIC, GASTRIC, RENAL, AND CERVICAL CANCERS.
CIGARETTES WERE ALSO IDENTIFIED AS THE CHIEF CULPRIT IN
ATHEROSCLEROSIS ... IN PEPTIC ULCERS ... IN COMPLICATIONS
OF PREGNANCY ... IN INTERACTIONS WITH ALCOHOL AND

CERTAIN PRESCRIPTION DRUGS ... AND SO ON.

17
IN OTHER WORDS, 6 OR 7 MORE YEARS OF RESEARCH DID NOT
WEAKEN OR COMPROMISE THE EARLIER FINDINGS. IT MADE

THEM ALL THE MORE FORMIDABLE.

BY THE TIME I ARRIVED IN WASHINGTON IN 1981 TO TAKE UP THE
POSITION OF SURGEON GENERAL, THERE WERE NEARLY 50,000
PIECES OF PUBLISHED RESEARCH WORLDWIDE.

AND AGAIN, THE OVERWHELMING MAJORITY OF THAT RESEARCH
ONLY STRENGTHENED THE PUBLIC'S CASE AGAINST SMOKING.

18
THE EVIDENCE AGAINST SMOKING BUILDS EVERY YEAR, AND THE
AMERICAN PEOPLE ARE BELIEVING IT.

AS YOUR SURGEON GENERAL I RELEASED 8 ANNUAL REPORTS ON
SMOKING. THEY HAVE DEALT WITH CANCER, CARDIOVASCULAR
DISEASE, CANCER IN WOMEN, SMOKING IN THE WORKPLACE,
CHRONIC OBSTRUCTIVE LUNG DISEASE, INVOLUNTARY SMOKING
OR WHAT IS SOMETIMES CALLED "PASSIVE SMOKING," AND THE

ADDICTIVE QUALITIES OF NICOTINE.

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EACH ONE HAS ITS OWN SPECIFIC AND IMPRESSIVE DATA BASE.

TODAY, THE SMOKING-AND-HEALTH RESEARCH BASE IS STILL
GROWING. NOW IT IS COMPRISED OF MORE THAN 60,000
PUBLISHED ARTICLES. AGAIN, THE VAST MAJORITY QUITE
CLEARLY REINFORCES THE FACT THAT CIGARETTE SMOKING IS
THE SINGLE MOST IMPORTANT FACTOR BEHIND ACUTE AND
CHRONIC MORBIDITY AND PREMATURE MORTALITY AMONG

ADULTS.

OR, IN OTHER WORDS, CIGARETTE SMOKING IS THE SINGLE
MOST IMPORTANT REASON WHY AMERICANS GET SICK, THE
SINGLE MOST IMPORTANT REASON WHY THEY DIE BEFORE THEY

SHOULD.

20
AS THIS RESEARCH BASE EXPANDED, SO DID OUR EFFORTS TO
EDUCATE THE PUBLIC ... TO GET THOSE WHO SMOKE, TO STOP ...

AND THOSE WHO DON'T SMOKE, TO NEVER START.

IN 1984, I WAS PERSONALLY SO CONVINCED BY THE DATA
ACCUMULATED THUS FAR THAT I CALLED UPON MY FELLOW

CITIZENS TO MAKE THE UNITED STATES A "SMOKE-FREE SOCIETY

BY THE YEAR 2000."

21
WE'LL ACHIEVE THAT SMOKE-FREE SOCIETY BECAUSE WE WILL
GRADUATE A CLASS FROM HIGH SCHOOL IN 2000 THAT WILL
HAVE HAD 12 YEARS OF ANTI-SMOKING HEALTH MESSAGES.

IT STARTED THE YEAR BEFORE LAST, IN THE FIRST GRADE.

TEACHING CHILDREN THAT YOUNG WILL ENABLE US TO WIN.

THE SURGEON GENERAL'S REPORTS ON SMOKING AND THE
WORKPLACE AND ON INVOLUNTARY SMOKING WORKED
TOGETHER TO GIVE THE MILITANT ANTI-SMOKERS NEW AND

POWERFUL WEAPONS.

22
THE NONSMOKER WAS MERELY IRRITATED AT FIRST...THEN
BECAME ANNOYED...AND THEN TURNED MILITANT.

STUDIES INDICATING THAT PASSIVE SMOKING LED TO 46,000
DEATHS ANNUALLY (3,000 FROM LUNG CANCER, 11,000 FROM
OTHER CANCERS, 32,000 FROM HEART DISEASE) MADE THE NON-
SMOKER MILITANT ...AND SUCCESSFUL IN ACHIEVING CHANGES
IN SOCIAL CUSTOMS AND IN LOCAL AND STATE LAW.

23
AS OF MID-1988 MORE THAN 230 LOCAL COMMUNITIES HAD
ADOPTED REGULATIONS RESTRICTING SMOKING IN PUBLIC

PLACES, A THREE-FOLD INCREASE IN THREE YEARS.

A RECENT VICTORY IS THE AIRLINE SMOKING BAN THAT BECAME
EFFECTIVE LAST WINTER.

OF THE 16,000 DAILY FLIGHTS IN THE USA, ONLY 28 SLIP
THROUGH THE BAN, ALLOWING SMOKERS TO FOUL THE AIR.

AND NORTHWEST AIRLINES VOLUNTARILY KEEPS THE CABIN AIR
SMOKE-FREE ALL THE WAY TO HAWAII.

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AND REMEMBER, LAST NOVEMBER A TOUGH LOCAL SMOKING
CONTROL ORDINANCE WAS APPROVED BY THE VOTERS IN

GREENSBORO, N.C. , IN SPITE OF HEAVY OPPOSITION BY

 

TOBACCO COMPANIES.

IF THE TOBACCO COMPANIES CAN BE BEATEN IN NORTH

CAROLINA, THEY CAN BE BEATEN ANYWHERE!

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