Economic and Social Impedance
General economic conditions also supported the
continuation of smoking. The 1960s and early 1970s
was a time of general prosperity. Real cigarette prices
rose in the 1960s but declined in the 1970s (USDHHS
1994). The affordability of cigarettes increased from
1965 to 1980 and served as an economic counterweight
to the growing awareness of tobacco’s ill effects (Lynch
and Bonnie 1994) (see also “Effect of Price on Demand
for Tobacco Products” and “Taxation of Tobacco Products” in Chapter 6).
Another compelling social condition may have
further limited the initial impact of the Surgeon
General’s report. From the early 1960s to 1973, American military personnel were engaged in Vietnam.
During this period, 8.7 million Americans served in
the military, including 2.7 million in Vietnam (Moss
1990).
Whether the Vietnam War encouraged smoking has not been a topic of speculation, probably
because of that war’s more publicized role in supposedly encouraging the use of marijuana and other drugs
(Klein 1993). But the norm of smoking would only
have been strengthened by the mobilization of a large
military force bringing several million young men and
women into a setting where smoking was traditionally held to offer relief from both stress and boredom,
and where it was part of a lingering cultural image of
the heroic soldier. Moreover, the prevalence of cigarette smoking was and has remained higher in the
military than in the population at large (in 1992, 35 vs.
26 percent) (Lynch and Bonnie 1994).
Delayed Effects and Delayed Actions
A significant biologic explanation for the delayed
effect of the 1964 report can be found in the delayed
progression of smoking-related diseases, which
generally take substantial time to fully manifest
themselves in chronic illness and death. The cigarette’s
tremendous growth in popularity during the decades
preceding the Surgeon General’s report would thus
Historical Review 41
Surgeon General's Report
have only begun to show its vast health consequences.
In 1965, an estimated 180,000 persons died from
smoking-related diseases (USDHHS 1989); over the
next two decades, that yearly estimate increased to
337,000, even though smoking prevalence had been
steadily declining since the early 1970s (USDHHS
1989). First-time or long-time smokers in the mid-1960s
to mid-1970s thus had far less opportunity than the
next generation to personally witness the tragic but
convincing demonstration of the health consequences
of smoking. It might be hypothesized that this somber proof of the Surgeon General’s report at last evoked
a meaningful response among relatives and friends
