THE INTERNATIONAL POWER AND PROFITS OF THE TOBACCO
INDUSTRY MAKE MORE DIFFICULT OUR TASK IN REACHING A
SMOKE-FREE SOCIETY BY 2000. WE AMERICANS MUST CONDUCT
THE BATTLE AGAINST THE TOBACCO GIANTS ON THE HOME

FRONT AS WELL AS OVERSEAS.

HERE AT HOME, WHILE WE WORK THROUGH THE LEGISLATIVE
AND REGULATORY PROCESS TO CHANGE AMERICAN TRADE
POLICIES, WE MUST CONTINUE THE ECONOMIC PRESSURE

AGAINST THE TOBACCO COMPANIES IN THE UNITED STATES.

51
EVEN THOUGH THE TIDE IS RUNNING AGAINST THEM, WE
CANNOT GIVE THEM A RESPITE.

WE MUST CONTINUE THE MOMENTUM TOWARD A SMOKE-FREE
SOCIETY BY THE YEAR 2000.

OUR EDUCATIONAL EFFORTS ARE SUCCESSFUL, AND THEY MUST

BE EXPANDED.

WE MUST TARGET INDIVIDUAL ISSUES, FOCUS OUR EFFORTS, AND

PREVAIL.

52
IN SOME CRITICAL AREAS THERE IS STILL LITTLE MORE THAN
LIP SERVICE PAID TO STOPPING SMOKING.

FOR EXAMPLE, MEDICAL SCHOOL CURRICULA SPEND TOO
LITTLE TIME ON ADDICTION AND THE WAYS THAT DOCTORS CAN

TEACH THEIR PATIENTS HOW TO STOP SMOKING.

53
THE SAD FACT IS PROBABLY ONE HALF THE DOCTORS IN
AMERICA FAIL TO PROVIDE ADVICE AGAINST SMOKING, EVEN
THOUGH WE KNOW THAT A DOCTOR'S ADVICE IS THE SINGLE

MOST EFFECTIVE STIMULUS TO STOP SMOKING.

THERE IS NO MONETARY INCENTIVE FOR PHYSICIANS TO TREAT

SMOKING.

54
ALTHOUGH STATES REQUIRE INSURANCE COVERAGE FOR
ALCOHOL AND DRUG TREATMENT, NO STATE REQUIRES
COVERAGE FOR NICOTINE CESSATION PROGRAMS, EVEN THOUGH

THE HEALTH COST OF NICOTINE ADDICTION IS MUCH HIGHER.

FOLLOWING THE SURGEON GENERAL'S REPORT OF 1988, THERE
WAS CLEAR EVIDENCE OF THE SKYROCKETING COST OF HEALTH
CARE, AND YET THE HEALTH INSURANCE INDUSTRY HAS

RESPONDED LIKE NERO.

55
THEY SAY THEY USUALLY DON'T COVER PREVENTIVE PROGRAMS.

WHAT SENSE DOES IT MAKES TO SPEND $150,000 ON THE
TERMINAL CANCER ILLNESS OF ONE OF THEIR INSURED, BUT
NOT BE WILLING TO FORK OVER ABOUT $200 TO GET THE SPOUSE
OF THAT PERSON TO STOP SMOKING AND PREVENT THE SAME

DISEASE DOWN THE ROAD?

WITH OVER 90% OF THE SMOKERS WANTING TO QUIT, IT IS AN
OUTRAGE THAT THEIR IS NOT LEGISLATION REQUIRING
REIMBURSEMENT FOR APPROVED SMOKING CESSATION

PROGRAMS.

56
WE ALSO NEED TO WEAKEN THE INTERNATIONAL TOBACCO
INDUSTRY BY ELIMINATING CIGARETTE ADVERTISING, HERE AND

ABROAD.

THE ADS HAVE BEEN BANNED FROM AMERICAN TELEVISION,
THANK GOD, --ALTHOUGH THEY ARE SNEAKING BACK THROUGH
VIDEOS-- BUT CIGARETTE ADVERTISING STILL ASSAULTS OUR
SOCIETY IN PRINT AND BILLBOARDS.

THE TOBACCO INDUSTRY SPENDS $4,000 PER MINUTE ON

PROMOTION ($2.5 BILLION A YEAR).

57
ONLY THE GROTESQUE ECONOMIC POWER OF THE
INTERNATIONAL TOBACCO COMPANIES CAN SUSTAIN THIS
OUTRAGE, AS THEY USE ECONOMIC BLACKMAIL TO INTIMIDATE

PUBLISHERS AND GOVERNMENTS.

I AM PARTICULARLY DISTURBED BY CIGARETTE ADVERTISING
THAT TARGETS VULNERABLE GROUPS WITHIN OUR POPULATION
AND ABROAD.

HERE IN AMERICA THE CIGARETTE ADVERTISERS HAVE SET

THEIR SIGHTS ON YOUNG PEOPLE, WOMEN, AND ‘MINORITIES.

58
CIGARETTE FIRMS MANIPULATE MINORITIES, WOMEN, AND
YOUNG PEOPLE BECAUSE THESE PEOPLE HAVE THE STRONGEST
ASPIRATIONS TO CHANGE THEIR STATUS.

SO THESE ADS ASSOCIATE SMOKING WITH MAKING IT...

THEY ASSOCIATE SMOKING WITH A HIGHER ECONOMIC STATUS

(WHEN REALLY HIGHER INCOME GROUPS ARE NOW SMOKING

LESS).

59
WE KNOW THAT THOSE WITH MORE EDUCATION TEND TO QUIT
MORE READILY. "THE MORE YOU KNOW, THE LESS YOU SMOKE."
BUT TOBACCO ADVERTISERS ASSOCIATE SMOKING --CONTRARY
TO ALL EVIDENCE-- WITH ROBUST ACTIVITY, ATHLETICS, SOCIAL
ACCEPTABILITY, BUSINESS AND SEXUAL SUCCESS, OUTDOOR

LEISURE, AND EVEN GOOD HEALTH.

60
ONE OF THE MORE OUTRAGEOUS ADVERTISING SLOGANS IS ONE
CIGARETTE COMPANY'S "ALIVE WITH PLEASURE" THEME.
THIS IS CLEARLY AN EFFORT TO UNDERMINE THE SURGEON

GENERAL'S WARNING ON EACH PACK.

TRUTH IN ADVERTISING SHOULD REQUIRE, NOT "ALIVE WITH

PLEASURE", BUT "DYING IN AGONY".

61
IN THE ADVERTISING WARS YOU HEAR A LOT ABOUT PROOF.

THE TOBACCO COMPANIES SAY THAT IT HAS NOT BEEN PROVEN
THAT ADVERTISING INCREASES CIGARETTE SMOKING.

OF COURSE, THE COMPLEXITY OF THIS ISSUE OF HUMAN
BEHAVIOR WILL PROBABLY PRECLUDE THE ESTABLISHMENT OF A
SCIENTIFIC PROOF OF A CAUSAL LINK.

BUT TO MY MIND THE BURDEN OF PROOF SHOULD BE ON THE
TOBACCO INDUSTRY TO SHOW THAT ADVERTISING DOES NOT
INCREASE CONSUMPTION OF A PRODUCT THAT WE KNOW LEADS

TO DEATH WHEN USED AS INTENDED.

62
IN THE 1850s JOHN SNOW ENDED THE CHOLERA EPIDEMIC IN
LONDON BY REMOVING THE HANDLE OF THE BROAD STREET
WATER PUMP, 30 YEARS BEFORE THE BACTERIUM CAUSING

CHOLERA WAS DISCOVERED.

FORTUNATELY HE DID NOT NEED TO CONTEND WITH A CHOLERA
INSTITUTE THAT DEMANDED THE PUMP KEEP WORKING UNTIL IT
WAS PROVEN THAT WATER FROM THE PUMP WAS CAUSING THE

CHOLERA.

63
FOR ALL THEIR TALK ABOUT "FREEDOM", TOBACCO INTERESTS

ARE GREAT ENEMIES OF FREEDOM.

FAR FROM BELIEVING IN FREE SPEECH, TOBACCO ADVERTISERS
USE THEIR ECONOMIC CLOUT TO FORCE PUBLISHERS NOT TO
PRINT ARTICLES ABOUT THE REAL CONSEQUENCES OF SMOKING.
CIGARETTE ADVERTISING, FAR FROM ALLOWING FREE CHOICE,
ACTUALLY UNDERMINES FREE CHOICE.

NICOTINE ADDICTS DO NOT ENJOY FREE CHOICE.

64
LET'S BE UP-FRONT ABOUT THE SPECIAL CHALLENGE FACING
TOBACCO ADVERTISERS:

MOST PEOPLE WHO USE THEIR PRODUCT WOULD RATHER NOT
USE IT.

AS MANY AS 90% WISH TO QUIT.

MANY TOUGH IT OUT, BREAK THEIR ADDICTION, AND SUCCEED IN
QUITTING.

THE ADVERTISERS NEED TO REPLENISH THE DIMINISHING
SUPPLY OF TOBACCO USERS:

REMEMBER THOSE 1,000 SMOKERS WHO DIE EVERY DAY.

65
ANOTHER ISSUE OF PUBLIC POLICY WHERE WE CAN ATTACK THE

TOBACCO INDUSTRY CONCERNS CIGARETTE VENDING MACHINES.

HERE IS ANOTHER EXAMPLE OF THE CODDLED CIGARETTE

COMPANIES.

IT IS ILLEGAL TO SELL BOTH ALCOHOL AND CIGARETTES TO

MINORS. THAT IS BECAUSE ALCOHOL AND NICOTINE ARE THE

TWO MAJOR LEGAL ADDICTING DRUGS IN OUR SOCIETY.

66
WE WOULD NEVER TOLERATE SELLING ALCOHOLIC BEVERAGES
IN VENDING MACHINES, BUT SOMEHOW WE TOLERATE

CIGARETTE VENDING MACHINES.

IT IS SAD EVIDENCE OF OUR FAILURE TO TAKE SERIOUSLY THE
DANGERS OF SELLING THIS ADDICTING DRUG NICOTINE TO
MINORS.

AND MANY MINORS ARE BUYING THEIR CIGARETTES THROUGH

VENDING MACHINES.

67
IN SPITE OF ALL OUR EDUCATIONAL EFFORTS, 3,000 TEENS A DAY
TAKE UP SMOKING. AND THEY START YOUNG. OF HIGH SCHOOL

SENIORS WHO SMOKE, 75 PERCENT STARTED IN 9TH GRADE.

THE CIGARETTE VENDING MACHINES SHOULD BE THE NEXT

TARGET IN THE CRUSADE AGAINST SMOKING.

68
WE NEED TO FOCUS OUR ENERGY ON SPECIFIC ISSUES, TO

CHOOSE OUR BATTLES, AND WIN THEM ONE BY ONE.

I'M SURE YOUR SESSIONS HAVE STRESSED THE NEED TO
DEVELOPE DIFFERENT STRATEGIES AND TACTICS TO ADDRESS
THE VARIATIONS IN TOBACCO USE ACCORDING TO GEOGRAPHY

AND GENDER.

69
FINALLY, I WANT TO STRESS THE POWER OF OUR GREATEST
WEAPON: THE POPULAR RESOURCES THAT CAN BE TAPPED BY

MORAL SUASION.

WHEN I WAS YOUR SURGEON GENERAL, I FREQUENTLY SAID
THAT I HAD NEITHER POWER NOR BUDGET.

THAT WAS CERTAINLY TRUE, FOR I HAD ONLY A TINY STAFF AND -
-IN WASHINGTON TERMS-- A TINY BUDGET, ENOUGH TO KEEP US

IN PAPER CLIPS AND PHOTOCOPIES.

70
BUT I THINK I WAS ABLE TO ACCOMPLISH A LARGE AGENDA

SOLELY THROUGH THE POWER OF MORAL SUASION.

IN THE RIGHT HANDS, AND IN ENOUGH HANDS, MORAL SUASION
CAN OVERCOME OBDURATE BUREAUCRACIES, ENTRENCHED
ECONOMIC POWER, AND THE INCREASINGLY DESPERATE

TOBACCO COMPANIES.

71
I MAY HAVE HUNG UP THE UNIFORM OF THE SURGEON GENERAL,

BUT I HAVEN'T RETIRED FROM THE FIGHT AGAINST SMOKING.

TOGETHER, WE CAN WIN IT.

LET'S GET GOING.

THANK YOU.

HHEELFEF

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