Surgeon General’s Report on Smoking

1964 - Institutional Event

In 1964, 46 percent of all Americans smoked. They did it in offices, airplanes, elevators and hospitals. Cigarette commercials filled TV airwaves. Even cartoon programs were sponsored by cigarette brands.

So when Surgeon General Luther L. Terry issued the report of his special commission on smoking in January 1964, it was front page news. For the first time, Smoking and Health: Report of the Advisory Committee to the Surgeon General  emphatically linked smoking to lung cancer and other diseases.

To many people, the findings were not entirely surprising. Evidence of smoking as a cause of lung cancer had surfaced much earlier. For that reason, a national commission was requested in 1961 by an alliance of the American Cancer Society, the American Heart Association, the National Tuberculosis Association and the American Public Health Association.

Terry’s 10-man commission met in late 1962. After 14 months of studying 7,000 articles with more than 150 consultants, the commission reported that average smokers had a nine- to tenfold risk of developing lung cancer compared to nonsmokers. Heavy smokers had at least a twenty-fold risk. The report also implicated smoking as a cause of chronic bronchitis, emphysema and heart disease.

Following the release of the report, Congress required all cigarette packages to carry health warnings. They also banned all broadcast cigarette advertising, beginning in 1970.

Information provided by BCBSNC.

The Surgeon General first warned that smoking may lead to cancer and other diseases in 1964. Photo by Rex Miller, courtesy of the Duke Homestead and Tobacco Museum.

Contrary to advertising messages by tobacco companies, research studies had linked smoking to lung cancer as early as 1950.

Lung Cancer, Tobacco and North Carolina

Lung cancer is the number one cause of cancer deaths in the United States today, just as it was in 1964. It kills about 160,000 Americans each year—30 percent of all the men and women who die of cancer. While five-year survival rates of most major cancers have increased over the past few decades, lung cancer survival rates remain low at around 15 percent.

What makes lung cancer deaths even more tragic is that they’re preventable: smoking causes an estimated 87 percent of all cases. When you consider smoking-related deaths from other cancers, heart disease, emphysema and other diseases, tobacco’s toll on American lives reaches 400,000 a year.

Smoking rates have dropped since the first Surgeon General’s report, especially in the last 20 years. But 45 million Americans 18 and older—about 21 percent of adults—still smoke. The rate for high school students is slightly higher.

In North Carolina, smoking rates remain above the national average. However, the state’s tobacco legacy has definitely faded. In Durham, long known as the Bull City because it was the source of world-famous Bull Durham Tobacco, Duke University Medical Center consistently ranks among the country’s top hospitals for cancer treatment and research. In 1982, when health care overtook tobacco as the city’s leading industry, Durham declared its new identity as the City of Medicine.

Information provided by BCBSNC.

North Carolina smoking rates have surpassed national averages year after year, according to a Blue Cross and Blue Shield of NC 2003 report.

A Life Flight helicopter lands at Duke Hospital in Durham, once “Bull Durham,” now “City of Medicine.”