Table of Contents
The Surgeons General and Smoking: An Overview
John Parascandola is the director of the Office of Public Health History in the Department of Health and Human Services, a branch of the United States Public Health Service.
Summary: In the 1930s, the increased incidence of lung cancer compelled scientists and physicians to examine more closely the speculation that smoking caused cancer. Critics countered that other factors, such as pollution, could be responsible for the rise in lung cancer; however, in the 1950s, medical researchers from the United States and Britain defined smoking as a major cause of the rising rates of lung cancer. In the early 1960s, antitobacco activists and public health organizations urged the U.S. government to create an advisory group of experts to study the health effects of smoking. This group, known as the Surgeon General’s Advisory Committee on Smoking and Health, identified cigarette smoking as a significant health hazard. The Advisory Committee’s conclusions sparked a strong antismoking campaign that resulted in an overall decrease in cigarette consumption.
On January 11, 1964, a most unusual press conference was held behind closed doors in the State Department auditorium to release the report of the Surgeon General’s Committee on Smoking and Health. The press conference was held on a Saturday to minimize the effects of the report on the stock market and to ensure coverage in the Sunday newspapers. All of...
(The entire section is 2321 words.)
Smoking Is Harmful
William F. Harrison is an obstetrician and gynecologist who practices at the Fayetteville Women’s Clinic in Fayetteville, Arkansas.
Summary: Habitual cigarette smoking leads to serious health complications, including emphysema, cardiovascular disease, and various lifethreatening cancers. Much of this damage occurs because tobacco smoke slowly destroys the cleansing mechanism in the lungs, allowing toxins to remain in prolonged contact with lung tissue. Moreover, the damage caused by exposure to tobacco smoke progresses more rapidly after many years of smoking, eventually resulting in the illnesses that cause more than 400,000 annual deaths in the United States alone.
Most of us in medicine now accept that tobacco is associated with major health consequences and constitutes the No. 1 health problem in this country.
The consequences of smoking
What smokers have not yet come to terms with is that if they continue smoking, the probability of developing one or more of the major complications of smoking is 100%. It absolutely will happen. They will develop chronic bronchitis, laryngitis, pharyngitis, sinusitis and some degree of emphysema. It is also highly probable that they will develop serious disease in the arteries of all vital organs, including the brain and heart, markedly increasing their risk of heart attack and stroke. If they continue, they increase the probability...
(The entire section is 725 words.)
The Harmful Effects of Smoking Are Overstated
Rosalind B. Marimont is a retired mathematician and scientist living in Silver Spring, Maryland. She has been active in health policy issues for more than thirty years.
Summary: The health risks attributed to smoking have been grossly exaggerated. The Centers for Disease Control and Prevention (CDC) uses an erroneous computer application to estimate the number of deaths caused by smoking, leading the public to believe that 400,000 Americans die annually from smoking-related illnesses. In actuality, many of these deaths could be the result of other health problems, such as high cholesterol or obesity. The CDC’s distorted information on the hazards of tobacco use, coupled with the strong antismoking sentiment in the U.S. government, has misdirected the nation’s health priorities. The United States faces more dangers from violence, family breakdown, and drug abuse than it does from smoking.
In the War on Smoking, truth has been the first casualty. Junk science has replaced honest science, and propaganda parades as fact. By vastly overrating the dangers of tobacco, and neglecting those of alcohol and drugs, the Anti-Smoking Police (ASPs) have gravely distorted the proper priorities for our resources.
Faulty information about smoking
The “facts” now quoted as gospel by the ASPs are false. For example:
• It is false that smoking kills 400,000 Americans...
(The entire section is 1217 words.)
Nicotine Is an Addictive Substance
Alan I. Leshner is the director of the National Institute on Drug Abuse.
Summary: Nicotine, an active ingredient in tobacco, is extremely addictive. It operates by elevating levels of the neurotransmitter dopamine, a pleasure-inducing brain chemical. Although various nicotinereplacement therapies and some medications can successfully treat nicotine addiction, most smokers still have difficulty quitting. The public health community must continue to address the problem of cigarette smoking by combining pharmacological treatments with behavioral therapies, by identifying risk factors for drug addiction, and by increasing preventative efforts.
Editor’s Note: This viewpoint was originally a prepared statement presented to a Senate committee during its hearings on tobacco control legislation on February 10, 1998.
Mr. Chairman and Members of the Committee, I am pleased to be here with my distinguished colleagues to discuss current research findings and future research directions on one of the Nation’s deadliest and most costly health problems—use of tobacco products. It is addiction to nicotine that is at the root of this enormous burden.
An addictive drug
Scientific research has determined that nicotine is in fact a highly addictive drug. Nicotine addiction, like other drug addictions, is characterized by compulsive drug seeking and use, even in the face...
(The entire section is 1479 words.)
Smokers Are Not Necessarily Addicted to Nicotine
Richard J. DeGrandpre, an independent scholar of drugs and culture, is coeditor of Drug Policy and Human Nature and coauthor of The Changeable Self.
Summary: Nicotine dependency is not necessarily the reason that some people acquire a cigarette smoking habit. The fact that only a minority of smokers who attempt to quit have success with nicotinereplacement therapy suggests that nonchemical or environmental factors may trigger the desire to smoke. Public health advocates who insist that nicotine is the addictive agent in cigarettes only exacerbate the problem by leading smokers to believe that they are enslaved by a drug. A fuller understanding of the varieties of addiction is needed to help curb cigarette addiction.
During the 1996 presidential election campaign, Bill Clinton successfully cast Big Tobacco as a national enemy, with Bob Dole playing the role of collaborator by downplaying the addictiveness of nicotine. Meanwhile, the Food and Drug Administration has been asserting jurisdiction over cigarettes as “nicotine delivery devices,” arguing that tobacco companies intend to hook their customers, just like schoolyard drug pushers. Hundreds of pending lawsuits, including class actions and cases filed by state governments, similarly allege a conspiracy to addict smokers. These developments represent important changes in our attitudes toward cigarettes. Though justified in the name of...
(The entire section is 2007 words.)
Secondhand Smoke Endangers Human Health
The Environmental Protection Agency (EPA), created in 1970, is the federal agency in charge of controlling and preventing air and water pollution caused by contaminants and toxins. EPA headquarters are in Washington, D.C.
Summary: Secondhand smoke, also known as environmental tobacco smoke or ETS, is harmful to human health. Considerable evidence drawn from scientific investigations and epidemiology studies proves that secondhand smoke can cause respiratory illnesses and lung cancer in nonsmokers. Critics of these findings contend that the Environmental Protection Agency has manipulated data to arrive at a predetermined conclusion, and that no studies have definitively confirmed a causal relationship between secondhand smoke and cancer. However, all of the epidemiology studies reveal that people who have longer-term exposure to secondhand smoke face an increased risk of developing lung cancer.
In early 1993, the United States Environmental Protection Agency (EPA) released a report (Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders; EPA/600/6-90/006 F) that evaluated the respiratory health effects from breathing secondhand smoke (also called environmental tobacco smoke). In that report, EPA concluded that secondhand smoke causes lung cancer in adult nonsmokers and impairs the respiratory health of children. These findings are very similar to ones made previously...
(The entire section is 3267 words.)
The Dangers of Secondhand Smoke Are Negligible
Sarah Mahler-Vossler has a doctorate in business from the City University of New York and has been an associate professor of management at Hartwick College in Oneonta, New York.
Summary: No conclusive evidence proves that secondhand smoke (also known as environmental tobacco smoke or ETS) significantly increases the risk for respiratory illnesses and heart disease among nonsmokers. The highly publicized reports on the alleged dangers of secondhand smoke are based on faulty studies and mishandled statistics. Policy makers, government agencies, and public health officials—motivated by the current smoking prohibitionist fervor— cite the few studies that back up their own foregone conclusions about ETS and ignore those revealing that the dangers of secondhand smoke are negligible.
It’s a lot easier to scare people than it is to unscare them. When guilt is added to fear, the task is even tougher. Americans have been convinced that environmental tobacco smoke, or ETS, is dangerous. Of course they’re frightened, and smokers have been made to feel guilty. They fear they are hurting, maybe killing others—maybe even their own children. Media-mediated and neighbor-reinforced, this scary message about ETS gets an even wetter Pavlovian slaver when the alarm-bell ringers are top government officials or those with names followed by lots of letters and fancy affiliations. But these highly...
(The entire section is 1855 words.)
The Tobacco Industry Markets Its Product to Youths
David Tannenbaum is an intern at Multinational Monitor, a monthly journal that focuses on the issues of labor, globalization, and corporate corruption.
Summary: As a result of various lawsuits, several cigarette companies were required to release records documenting their intentional marketing of tobacco products to minors. These documents reveal that tobacco companies tracked their brands’ popularity among teens, designed cigarette labels specifically for youths, and planned advertising campaigns to increase their market share among minors. In an attempt to deny allegations that they were targeting youths, the tobacco industry designed public relations programs and educational publications that emphasized the need for adults to help youths make responsible decisions about smoking. The intent of these programs was not to reduce teen smoking but to boost the public image of cigarette companies and to create the perception that the tobacco industry was addressing the problem of underage smoking.
For years, tobacco companies have claimed that they neither market to teenagers nor depend on them for decades of future profits. The tobacco documents used in the Minnesota State Attorney General’s lawsuit against the companies and other documents that were released as a result of that suit disprove both of those claims.
Cigarette companies have long known which brands attract...
(The entire section is 1856 words.)
Tobacco Advertising Encourages People to Smoke
William Everett Bailey is a longtime tobacco control advocate and the author of The Invisible Drug, from which this viewpoint is excerpted.
Summary: Cigarette advertising encourages people to smoke. Tobacco companies use images in their advertising that connote sophistication, independence, attractiveness, and rebelliousness, and these images persuade people to buy cigarettes. Moreover, cigarettes are prominently featured in movies, and tobacco company sponsorship ensures that cigarette brand names and poster ads pervade sporting events such as tennis tournaments and auto racing. To counter antismoking advocates’ attempts to ban or restrict cigarette advertising, tobacco companies downplay the deadly effects of tobacco use and emphasize smoking as a legal individual choice and right. Tobacco promotional efforts have been so effective that even nonsmokers often view smoking as innocuous and socially acceptable.
Advertising affects everyone. We just do not like to admit it. —Professor Edward Popper, North Eastern University
What made cigarettes the most successful product in American history? Advertising. No one likes to admit that advertising has an effect on them. Most people will agree that they do not like to be “sold.” Despite this, advertising works. It makes people buy brand name products, and products on sale.
(The entire section is 4396 words.)
Tobacco Advertising Should Not Be Banned
Jacob Sullum is a senior editor of Reason, a monthly libertarian magazine. He is also the author of For Your Own Good: The Anti-Smoking Crusade and the Tyranny of Public Health, from which this viewpoint is adapted.
Summary: Many researchers, antismoking activists, and public health advocates contend that tobacco advertising should be restricted or banned because it encourages people—particularly teenagers—to take up smoking. Yet there is no conclusive proof that people smoke because of exposure to cigarette ads and tobacco promotional items. Although ads may have an effect on an individual’s cigarette brand preference, advertising does not necessarily convince people to start smoking. Banning tobacco advertising in an effort to reduce teen smoking would be nothing more than censorship. Curbing underage smoking is ultimately the responsibility of concerned individuals, families, and law enforcement.
On January 1, 1971, the Marlboro Man rode across the television screen one last time. At midnight a congressional ban on broadcast advertising of cigarettes went into effect, and the smoking cowboy was banished to the frozen land of billboards and print ads. With the deadline looming, bleary-eyed, hung-over viewers across the country woke to a final burst of cigarette celebration. “Philip Morris went on a $1.25-million ad binge New Year’s Day on the Dick Cavett, Johnny Carson and Merv...
(The entire section is 5870 words.)
The United States Needs a Comprehensive Tobacco Control Policy
William Novelli is president and Matthew Myers is vice president and general counsel of the National Center for Tobacco-Free Kids in Washington, D.C.
Summary: In June 1998, a congressional bill that would have enacted a comprehensive national tobacco control policy failed in the U.S. Senate. This bill would have required tobacco industry funding of antismoking campaigns, restrictions on the advertising and marketing of tobacco products, the granting of authority over tobacco products to the Food and Drug Administration, increased cigarette prices, and promises from the tobacco industry to reduce youth smoking. Moreover, the tobacco industry agreed to pay billions of dollars to states that had sued the industry in the 1990s to recover the health care costs of treating smoking-related illnesses; in turn, cigarette manufacturers would be granted some immunity from future lawsuits. Although opportunities for future legislation still exist, the failure of the McCain bill is a setback for the United States. Civil lawsuits and settlements are unlikely to lead to tobacco control policies that will reduce youth smoking rates and promote public health. The nation is still in need of extensive federal controls on the tobacco industry.
Editor’s Note: Although federal tobacco legislation failed in June 1998, the four largest tobacco companies agreed in November 1998 to pay forty-six states $206 billion...
(The entire section is 1844 words.)
Compromise Between the Government and the Tobacco Industry Would Benefit Public Health
Steven F. Goldstone is the chairman and chief executive officer of R.J. Reynolds Nabisco, Incorporated.
Summary: In the 1990s, dozens of states filed lawsuits against cigarette manufacturers in an effort to recoup the health care costs of treating smoking-related illnesses. In June 1997, the tobacco industry proposed a global settlement in which they agreed to accept regulation by the Food and Drug Administration, submit to marketing restrictions, fund youth antismoking programs, and pay compensatory damages to states. The tobacco industry is willing to sacrifice capital and marketing freedoms if doing so will resolve the state lawsuits, promote public health, and ensure a measure of future stability for cigarette manufacturers. In the end, tobacco companies should be able to work with public health officials while retaining the right to sell their product to adults.
Editor’s Note: This viewpoint was originally presented as a statement before a congressional committee during the January 1998 hearings on the global tobacco settlement that had been proposed in June 1997. Congressional tobacco control legislation failed in June 1998. However, in November 1998, forty-six states and four tobacco companies agreed on a civil settlement based on the June 1997 agreement.
My name is Steven Goldstone. I am the Chairman and Chief Executive Officer of RJR Nabisco, Inc., which owns the...
(The entire section is 1980 words.)
The Tobacco Settlement Is Commendable
Hubert H. Humphrey III is the attorney general of Minnesota.
Summary: On November 23, 1998, the tobacco industry agreed to pay fortysix states $206 billion and submit to advertising and marketing restrictions in a large civil settlement—the result of lawsuits on the part of states attempting to recover the costs of treating smokingrelated illnesses. Although this agreement is not a perfect way to address the problems caused by tobacco use, it is somewhat of a victory for the states because they will receive partial compensation for the health care costs of smoking. However, more actions must be taken to reduce youth smoking, including granting the Food and Drug Administration regulatory control over nicotine, increasing cigarette taxes, and developing effective antismoking public health programs.
The tobacco agreement signed on November 23, 1998, by the nation’s attorneys general does not drive a stake through the heart of the big tobacco companies. It does not even change the status quo dramatically. Still, it is a victory for the states and their attorneys general.
A victory for the states
The states win because the settlement will compensate them, at least in part, for the costs of providing medical treatment to residents harmed by tobacco. The attorneys general come out ahead, too. Until now, if they tried difficult cases and won, they had to pay huge fees to the...
(The entire section is 759 words.)
The Tobacco Settlement Is Not Commendable
Robert J. Samuelson is a nationally syndicated columnist.
Summary: The 1998 tobacco settlement, in which tobacco companies have agreed to pay partial compensation to states for the health care costs of treating smoking-related illnesses, is counterproductive. For one thing, the resulting increase in cigarette prices will unfairly tax smokers, many of whom are poor. Furthermore, the agreement will further confuse the public about who should bear the ultimate responsibility for the consequences of smoking: the individual, the government, or the tobacco industry. Unfortunately, moreover, the success of the antismoking campaign of the 1990s is likely to encourage misguided attacks on the manufacturers of other legal but risky products such as alcohol and high-fat food.
We may have closure—at least temporarily—to the anti-smoking crusade of the 1990s. The agreement between state attorneys general and the tobacco companies for the industry to pay the states roughly $200 billion over 25 years may quiet the controversy.
If so, this will be the agreement’s main benefit, because otherwise it is a parody of good government policy. It imposes a steep tax on a heavily poor part of the population; it offers only modest health benefits; and it deepens popular confusion about the public consequences of smoking.
Let’s concede the small possible health gains. The agreement will raise...
(The entire section is 931 words.)