SPEECH

COUNTDOWN 2000
WASHINGTON, DC
AMERICAN LUNG ASSOCIATION

SEPTEMBER 11, 1990

C. EVERETT KOOP, MD

IF |

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GREETINGS, ETC.
IT IS A SPECIAL TREAT FOR ME TO BE YOUR SEND-OFF SPEAKER
TODAY. I FEEL FAMILIAR IN THIS ROLE, BECAUSE I'VE DONE IT

ONCE BEFORE, BUT NOW I FEEL MUCH MORE CONFIDENT.

IT WAS, REALLY, A SEND-OFF SPEECH TO THE ENTIRE COUNTRY

IN WHICH I FIRST CALLED FOR A SMOKE-FREE TETY IN

AMERICA BY THE YEAR 2000.
THAT WAS IN 1984, AT THE MEETING OF THE AMERICAN LUNG
ASSOCIATION AND THE AMERICAN THORACIC SOCIETY IN MIAMI.
BACK THEN, ONLY 6 YEARS AGO, A SMOKE-FREE SOCIETY BY THE
YEAR 2000 SEEMED LIKE A RADICAL IDEA.

I EVEN TOOK THE PRECAUTIONARY STEP OF HAVING MY SPEECH
TYPED OUTSIDE OF GOVERNMENT OFFICES, AND OF AVOIDING
THE NORMAL CLEARANCE PROCESS, SO CERTAIN WAS I THAT
SOME OFFICIAL BEHOLDEN TO THE TOBACCO INTERESTS WOULD

ATTEMPT TO SNUFF OUT THE IDEA.
BUT NOW IT IS VERY MUCH AN IDEA WHOSE TIME HAS COME.
AND WE HAVE A DECADE --JUST ENOUGH TIME TO SEE IT
HAPPEN,

JUST ENOUGH TIME TO MAKE IT HAPPEN.

AND YOU ARE THE PEOPLE WHO CAN MAKE IT HAPPEN.
WHEN I FIRST CALLED FOR A SMOKE-FREE SOCIETY BY 2000, I
SAID VERY CLEARLY THAT I WASN'T PROPOSING ANOTHER
GOVERNMENT PROGRAM. THIS WAS NOT GOING TO BE A PUBLIC
HEALTH SERVICE INITIATIVE...NOR WAS THIS GOING TO BE

ANOTHER PET PROJECT OF THE U.S. SURGEON GENERAL.

INSTEAD, I RAISED THE IDEA AS A CALL...A CALL FROM THE

SURGEON GENERAL TO THE PEOPLE OF THIS COUNTRY.
YOU MAY RECALL THAT I DESIGNATED CERTAIN GROUPS TO DO
CERTAIN THINGS: THE BOY SCOUTS, THE CAMPFIRE GIRLS,
RESPIRATORY THERAPISTS, THE COALITION ON SMOKING OR

HEALTH.

IN THE YEARS SINCE, EACH GROUP HAS RESPONDED, AND

RESPONDED GENEROUSLY.
AND I AM PARTICULARLY PLEASED WITH YOUR RESPONSE, YOUR
COMMITMENT, DEMONSTRATED SO CLEARLY DURING THE
COUNTDOWN 2000 CONFERENCE THESE LAST TWO DAYS.

I HOPE YOU PAY ATTENTION TO MY BRIEF REMARKS, BUT I ALSO
HOPE YOU HAVE ONE EYE ONE THE DOOR BECAUSE YOU ARE SO
EAGER TO GET OUT THERE AND TO APPLY WHAT YOU'VE

LEARNED TOGETHER HERE.
THE INITIAL CALL FOR A SMOKE-FREE SOCIETY HAS BEEN
STRENGTHENED BY THE RECEPTION AFFORDED A NUMBER OF
SURGEON GENERAL'S REPORTS ON SMOKING.

IN PARTICULAR, THE SURGEON GENERAL'S REPORTS ON
INVOLUNTARY SMOKING, AND ON NICOTINE ADDICTION WORKED
TOGETHER TO GIVE THE MILITANT ANTI-SMOKERS NEW AND

POWERFUL WEAPONS.
THE RECENT WIDELY PRAISED AND QUOTED STUDY OF EPA ON
ILL EFFECTS OF PASSIVE SMOKING SHOWS THE CAUSE IS BEING
TAKEN UP OUTSIDE THE HEALTHCARE AGENCIES, . .

ALTHOUGH I AM LESS THAN PLEASED BY THE STRANGE SILENCE
OF THE CURRENT SURGEON GENERAL, AND BY THE SECRETARY
OF HEALTH AND HUMAN SERVICES UNDERCUTTING HIS SEVERAL
STRONG ANTI-SMOKING STATEMENTS BY HIS TOLERATION OF

TOBACCO EXPORTS.
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.
NOW, AS MANY AS 425 COMMUNITIES HAVE ADOPTED

ORDINANCES RESTRICTING SMOKING IN PUBLIC

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A MOST SATISFYING 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. OTHER AIRLINES --
ALASKA, DELTA, EASTERN, AND U.S. AIR-- HAVE ALSO EXTENDED

THE BAN BEYOND THE REQUIREMENTS OF THE LAW.

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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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SMOKING HABITS HAVE CHANGED.

FIFTEEN YEARS AGO, AT MEDICAL MEETINGS, WHERE DOCTORS

SHOULD HAVE KNOWN BETTER, THE AIR WAS BLUE WITH SMOKE.

NOW YOU RARELY SEE A PHYSICIAN SMOKE;

IN 1964, BEFORE THE FIRST SURGEON GENERAL'S REPORT ON |

SMOKING, OVER HALF OF ADULT AMERICANS SMOKED.

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WHEN I BECAME SURGEON GENERAL IN 1981, THE NUMBER HAD
DECLINED TO 33 PERCENT.

WHEN I LEFT OFFICE 8 YEARS LATER, THE NUMBER OF AMERICAN
SMOKERS HAD SHRUNK EVEN MORE, TO 26 PERCENT.

FEW THINGS GIVE ME AS MUCH SATISFACTION AS THAT
DRAMATIC DECREASE, FROM 33 PERCENT TO 26 PERCENT.

AND IT NOW APPEARS THAT DURING MY LAST YEAR IN OFFICE,

SMOKING DROPPED ANOTHER 4 PERCENT.

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BETWEEN 1964 AND 1985 APPROXIMATELY THREE-QUARTERS OF A
MILLION SMOKING-RELATED DEATHS WERE AVOIDED OR

POSTPONED BY DECISIONS TO QUIT OR NOT TO START SMOKING.

EACH POSTPONED DEATH REPRESENTED AN AVERAGE GAIN OF 2
DECADES OF LIFE EXPECTANCY.
NEARLY HALF OF ALL LIVING ADULTS WHO HAVE EVER SMOKED

HAVE QUIT.

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BUT, SIMPLY QUITTING IS STILL NOT THE WAY MOST SMOKERS
STOP SMOKING.

I OFTEN BEGIN ONE OF MY LECTURES ON SMOKING WITH THE
REMINDER THAT

"A THOUSAND AMERICANS WILL STOP SMOKING TODAY....
THEIR FUNERALS WILL BE HELD WITHIN THE NEXT THREE OR

FOUR DAYS."

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WHY DO I FEEL I HAVE TO SAY SOMETHING DRAMATIC TO GET
PEOPLE'S 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.

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INSTEAD, TOBACCO HAS, FROM THE BEGINNING, BEEN CODDLED
BY OUR GOVERNMENT.

THIS DISTINGUISHED AUDIENCE KNOWS ABOUT THAT.

AS A 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.

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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
AND FOR ITS INTERNATIONAL POWER.

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 WHO GREW PUMPKINS IN THE FIELDS AROUND

BOSTON.

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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:

A LOOSE CANNON ON THE DECK OF SPACESHIP EARTH.

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

STORY.

THE GOOD NEWS IS THAT WE ARE --AT LAST, AND SLOWLY--

WINNING THE WAR AGAINST TOBACCO.

THE BAD NEWS IS THAT THERE ARE MANY BATTLES STILL TO

FIGHT.

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FIRST, SOME OF THE GOOD NEWS.

THE NON-SMOKERS ARE ON THE OFFENSIVE, AND THEY ARE
WINNING.

I'M SURE YOUR SESSIONS HAVE PROVIDED MANY EXAMPLES OF
VICTORIES, LARGE AND SMALL.

HOSPITAL STAFFS ARE DEMANDING THAT THEIR FACILITIES BE

MADE SMOKE-FREE.

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WORKING PEOPLE ARE ASKING FOR SMOKE-FREE

ENVIRONMENTS WHERE THEY WORK.

IN 1980 ONLY 16 PERCENT OF AMERICAN COMPANIES HAD A
SMOKING POLICY; BY LAST YEAR 68 PERCENT HAD SMOKING
POLICIES. IN 1988 1 OUT OF 4 COMPANIES BANNED ALL
SMOKING, AND JUST ONE YEAR LATER THE FIGURE WAS 38

PERCENT.

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PROFESSIONAL PEOPLE ARE HANGING THOSE "THANK YOU FOR

NOT SMOKING SIGNS" IN THEIR WAITING ROOMS.

AND HOUSEHOLDERS ARE TACKING UP THE SAME SIGN OVER

THEIR FRONT DOORBELLS.

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JUST LAST SPRING, UNIVERSITIES LIKE HARVARD, C.U.N.Y.,
SOUTHERN ILLINOIS TOOK THE EXEMPLARY STEP OF DIVESTING
TOBACCO STOCKS, OFTEN IN RESPONSE TO STUDENT PROTEST. ...
A GOOD TREND.

LET'S KEEP UP THIS PRESSURE ON THEM.

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