Toward a Medical Consensus
With growing sentiment, in and beyond the
medical community, that there were serious risks to
tobacco use, government agencies became more concerned about tobacco advertising that stated or implied
health benefits to the cigarette. Several times during
the 1950s, the Federal Trade Commission (FTC) issued
orders against cigarette advertising that made health
claims. Congress also took an interest in tobacco
advertising; in 1957, Representative John A. Blatnik
(D-MN) held hearings on deceptive filter-tip cigarette
advertising (Neuberger 1963). The Surgeon General
first brought the Public Health Service into the scene
by establishing a scientific study group in 1956 to appraise the effects of smoking on health. The study
group determined that there was a causal relationship
between excessive smoking of cigarettes and lung
cancer. Surgeon General Leroy E. Burney issued a
statement in 1957 that “the weight of the evidence is
increasingly pointing in one direction: that excessive
smoking is one of the causative factors in lung cancer” (Burney 1958, p. 44). In an article he subsequently
published in the Journal of the American Medical Association, Burney reiterated this view and went even
further:
“The weight of evidence at present implicates
smoking as the principal etiological factor in the
increased incidence of lung cancer” (Burney 1959,
p. 1835).
Much of the medical profession, however,
remained ambivalent on the issue. In an editorial several weeks after Burney’s article, the journal itself argued against taking the Surgeon General too seriously:
“Neither the proponents nor the opponents of the
smoking theory [that cigarette smoking causes cancer]
have sufficient evidence to warrant the assumption of
an all-or-none authoritative position” (Talbott 1959,
p. 2104).
In June 1961, the presidents of the ACS, the
American Public Health Association, the American
Heart Association (AHA), and the National Tuberculosis Association (later the American Lung Association
[ALA]) urged President John F. Kennedy to establish
a commission to study the health consequences of
smoking (U.S. Department of Health, Education, and
Welfare [USDHEW] 1964).
Early in 1962, representatives of these organizations met with Surgeon General
Luther L. Terry, who then proposed establishing an
advisory committee to assess available knowledge and
make recommendations concerning smoking and
health. In April, Terry provided the Secretary of
Health, Education, and Welfare a fuller proposal asking to reevaluate the Public Health Service’s position
on smoking. Among the factors prompting his call for
action, Terry cited new studies on the adverse consequences of smoking, the 1962 Royal College of Physicians report (which had been summarized that year in
Reader’s Digest [Miller 1962]), and other evidence of a
shift in medical opinion against smoking as well as
similar views among the national voluntary organizations. Terry also pointed to efforts to reduce tobacco
use in Britain, Denmark, and Italy; to Senator Maurine
(Brown) Neuberger’s (D-OR) proposal that Congress
create a commission on smoking; and to a request from
the FTC for guidance on the labeling and advertising
of tobacco products.
In the summer, Terry announced the appointment of a committee to review all of the data on the
medical effects of smoking. The committee was established after consultation with representatives of
relevant government agencies, the voluntary health organizations, the American Medical Association (AMA),
the American College of Chest Physicians, and the
Tobacco Institute. Each organization was empowered
to veto any names proposed for the committee; people
who had taken public positions on the questions at
issue were eliminated from consideration.
Historical Review 39
Surgeon General's Report
While the committee reviewed the data, actions
were being urged or taken in response to the evidence
that had emerged. Leroy Collins, former governor of
Florida and president of the National Association of
Broadcasters, urged broadcasters in 1962 to “make
corrective moves” on their own to limit or regulate
tobacco advertising to which children might be exposed. “We cannot ignore the mounting evidence that
tobacco provides a serious hazard to health,” he asserted (New York Times 1962, p. 71). Also in 1962—a
busy year for efforts to reduce smoking—Air Force
Surgeon General Major General Oliver K. Niess
ordered an end to the distribution of free cigarettes in
Air Force hospitals and flight lunches (Neuberger
1963). Smoking education was a growing phenomenon in public schools, where materials were provided
by the ACS and other voluntary organizations. Church
groups (particularly the Seventh-day Adventists) and
temperance organizations continued their campaign
against smoking. And although the AMA remained
silent on the issue, at least eight state medical societies
had adopted resolutions on smoking and health
