Fifty years ago this month, Dr. Luther Terry, Surgeon General of the United States, issued the landmark 1964 Surgeon General’s Report providing the first definitive proof that cigarette smoking causes both lung and laryngeal cancer. This announcement came after a committee of experts had worked for 18 months, reviewing more than 7,000 published papers and engaging 150 consultants.
The importance of this report and its findings cannot be overstated. Fifty years ago, we did not know that smoking definitely causes lung cancer and other diseases, only that smoking was associated with a higher risk of these diseases. Recognizing that the impact of tobacco on our national and, indeed, the world’s health was the major public health issue of the day, Dr. Terry assembled an unimpeachable panel of distinguished physicians and scientists. He chose individuals for the panel who were not only among the giants of medicine and science, but were also objective and could ensure the integrity of the report.
The report was based on what ranked as the largest and most careful review of the medical literature yet undertaken. Most importantly, the report was clear, evidence based and unequivocal. It showed beyond a shadow of a doubt that smoking caused both lung cancer and larynx cancer. The report concluded that cigarette smoking is 1) a cause of lung cancer and laryngeal cancer in men; 2) a probable cause of lung cancer in women; and 3) the most important cause of chronic bronchitis.
The impact of the report on public perception was astonishing. In 1958, only 44% of Americans believed that smoking seriously impacted health, according to a Gallup Poll. Ten years later, and four years after the report’s release, that number had climbed to 78%. The report also galvanized the anti-tobacco movement. Its findings have lent enormous credence to smoking cessation efforts over the last 50 years. In 1964, 52% of adult men and 35% of adult women smoked cigarettes. This had fallen to 21.6% of adult men and 16.5% of adult women by 2011.
Today, we are certain that tobacco causes some of the most widespread and devastating diseases in the world, including cancers of the lung, larynx (voice box), esophagus, mouth, throat and bladder, which together account for about 30% of the world’s cancer-related deaths. Tobacco is also a major cause of heart disease, emphysema and other diseases of the lungs and heart.
There have been several subsequent reports issued by the Surgeons General, the latest an eye-opening look at smoking behavior among the younger generation. This, like all prior reports, builds on that first landmark report from a great physician leader and his matchless panel of experts. The impact of their efforts on smoking in the US and the world is unquestionable. The debt that the world owes these 12 brave scientists has never been greater.
Author: Fadlo R. Khuri, MD, deputy director, Winship Cancer Institute
Want to learn more about the impact of the 1964 Surgeon General’s Report on smoking? View this video as Dr. Khuri further discusses the effect the report has had on the medical community.
About Dr. Fadlo Khuri
Fadlo R. Khuri, MD, deputy director of the Winship Cancer Institute of Emory University and Professor and Chairman of the Department of Hematology & Medical Oncology, Emory University School of Medicine, is a leading researcher and physician in the treatment of lung and head and neck cancers. He is Editor-in-Chief of the American Cancer Society’s peer-reviewed journal, Cancer.
Dr. Khuri’s contributions have been recognized by a number of national awards, including the prestigious 2013 Richard and Hinda Rosenthal Memorial Award, given to an outstanding cancer researcher by the American Association for Cancer Research.
An accomplished molecular oncologist and translational thought leader, Dr. Khuri has conducted seminal research on oncolytic viral therapy, developed molecular-targeted therapeutic approaches for lung and head and neck tumors combining signal transduction inhibitors with chemotherapy, and has led major chemoprevention efforts in lung and head and neck cancers. Dr. Khuri’s clinical interests include thoracic and head and neck oncology. His research interests include development of molecular, prognostic, therapeutic, and chemopreventive approaches to improve the standard of care for patients with tobacco related cancers. His laboratory is investigating the mechanism of action of signal transduction inhibitors in lung and aerodigestive track cancers.