1957 First Statement by a Surgeon General regarding smoking and health

In 1957 Surgeon General, Dr. Leroy Burney  issues the first official statement regarding smoking and health.

On July 12, 1957, after organizing a group of scientists to appraise 18 studies on smoking and health, Dr. Burney, himself a smoker, issued a report saying,

‘‘It is clear that there is an increasing and consistent body of evidence that excessive cigarette smoking is one of the causative factors in lung cancer. ”

The release of the report was the first in a series of steps, still being taken more than 40 years later, to diminish the impact of tobacco use on the health of the American people.

Soon after, the U.S. Congress adopted the Federal Cigarette Labeling and Advertising Act of 1965 and the Public Health Cigarette Smoking Act of 1969. These laws—

• Required a health warning on cigarette packages
• Banned cigarette advertising in the broadcasting media
• Called for an annual report on the health consequences of smoking.

In September 1965, the Public Health Service established a small unit called the National Clearinghouse for Smoking and Health. The Clearinghouse and its successor organization, the Centers for Disease Control and Prevention’s Office on Smoking and Health, have been responsible for 29 reports on the health consequences of smoking.

Reports of the Surgeon General from 1967 – Current

1967 – The Health Consequences of Smoking: A Public Health Service Review

Confirmed and strengthened conclusions of the 1964 report. Stated that “the case for cigarette smoking as the principal cause of lung cancer is overwhelming.” Found that evidence “strongly suggests that cigarette smoking can cause death from coronary heart disease,” which was upgraded from the 1964 conclusion of an “association.” Also concluded that “Cigarette smoking is the most important of the causes of chronic non-neoplastic bronchopulmonary diseases in the United States.”

1968 – The Health Consequences of Smoking: 1968 Supplement to the 1967 Public Health Service Review

Updated information that was presented in the 1967 report. Estimated that smoking-related loss of life expectancy among young men as 8 years for “heavy” smokers (more than 2 packs/day) and 4 years for “light” smokers (less than ½ pack/day)

1969 – The Health Consequences of Smoking: 1969 Supplement to the 1967 Public Health Service Review

Also supplemented 1967 report. Confirmed association between maternal smoking and infant low birthweight. Identified evidence of increased incidence of prematurity, spontaneous abortion, stillbirth, and neonatal death (USDHEW 1969).

1971 -The Health Consequences of Smoking

Examined evidence on immunologic effects of tobacco and tobacco smoke, harmful constituents of tobacco smoke, and “public exposure to air pollution from tobacco smoke” (p. 121). Found tobacco and tobacco smoke antigenic in humans and animals; tobacco may impair protective mechanisms of immune system; nonsmokers’ exposure to tobacco smoke may exacerbate allergic symptoms; carbon monoxide in smoke-filled rooms may harm health of persons with chronic lung or heart disease; tobacco smoke contains hundreds of compounds, several of which have been shown to act as carcinogens, tumor initiators, and tumor promoters. Identified carbon monoxide, nicotine, and tar as smoke constituents most likely to produce health hazards of smoking.

1972 – The Health Consequences of Smoking

The relationships between cigarette smoking and cancer, cardiovascular disease, and
non-neoplastic bronchopulmonary disease are reviewed and evidence is presented which helps develop our understanding of the mechanisms which are involved in these relationships. In the final three chapters, information is presented on public exposure to air pollution from t.obacco, on the relationship between tobacco and allergy, and on the harmful constituents which are found in cigarette smoke.

1973 -The Health Consequences of Smoking

Presented evidence on the health effects of smoking pipes, cigars, and “little cigars.” Found mortality rates of pipe and cigar smokers higher than those of nonsmokers but lower than those of cigarette smokers. Found that cigarette smoking impairs exercise performance in healthy young men. Presented additional evidence on smoking as a risk factor in peripheral vascular disease and problems of pregnancy

1974 -The Health Consequences of Smoking

Tenth-anniversary report.Reviewed and strengthened evidence on major hazards of smoking. Reviewed evidence on the association between smoking and atherosclerotic brain infarction and on the synergistic effect of smoking and asbestos exposure in causing lung cancer.

The Legacy of Julius B. Richmond, M.D.

Over his long and splendid career, Dr. Julius B. Richmond did as much as anyone to protect and improve the health of his fellow citizens, especially children, and adolescents.

From 1953 to 1965, Dr. Richmond was Chairman and Professor of the Department of Pediatrics in the College of Medicine at the State University of New York (SUNY). He became Dean in 1965 and served in that capacity until 1970.

In 1965, Dr. Richmond was appointed by President Lyndon Johnson as the first National Director of Project Head Start in the Office of Economic Opportunity. Head Start became a successful year-round comprehensive child development program, with about 1,500 centers nationwide. Approximately 750,000 children continue to be enrolled in Project Head Start each year.

In 1971, Dr. Richmond was recruited by the Harvard Medical School, where he became a Professor of Psychiatry and Human Development and Chairman and Professor of the Department of Social and Preventative Medicine. Simultaneously, Harvard appointed him Professor of Public Health in the School of Public Health.

While at Harvard, Dr. Richmond was honored to receive a dual Presidential appointment by President Jimmy Carter as Surgeon General of the United States and Assistant Secretary for Health; the first person ever selected to occupy both positions, which required Senate confirmation. As a result of these appointments in the Federal public health sector, he oversaw some 50,000 employees.

In his 1979 Surgeon General’s Report, Dr. Richmond focused on tobacco control efforts and presented overwhelming scientific evidence for the multiple harms caused by smoking.

Dr. Richmond received several honorary degrees from Yale and Harvard Universities, among others. Dr. Richmond continued his professional and academic activities as the John D. MacArthur Professor of Health Policy Emeritus at Harvard. He continued to teach and write, always striving to shape health policies for the promotion of disease prevention, with emphasis on low-income children and families, all the while mentoring students and colleagues. He continued this until his last few months of life.

Throughout his nearly 70-year career, Dr. Richmond was a brilliant, caring, hands-on pediatrician. In later years, he took on the arduous task of educating the public about the dangers of tobacco and the decades-long manipulation of scientific data by the tobacco industry by testifying in open court. In doing so, Dr. Richmond voluntarily subjected himself to many days of grueling cross-examination while refusing compensation as a skilled expert witness.

Dr. Richmond served as the first Chairman of FAMRI’s Medical Advisory Board; his guidance was vital to the Board of Trustees in directing the allocation of over $300,000,000 resulting from the settlement of the class-action lawsuit. The money was used (and continues to be used) to fund grants to researchers from some of the finest biomedical institutions worldwide. In addition, FAMRI also funded five Centers of Excellence.

These grants work toward fulfilling the aim of FAMRI’s scientific research, which is to eradicate the diseases and medical conditions caused by exposure to secondhand tobacco smoke.  

Dr. Richmond had one of American history’s most extraordinary and productive careers. He carefully monitored science and public education, an effort recognized by the Heinz Foundation in 2003 when he received the 10th Heinz Award for Public Policy for transforming Americans’ attitudes toward their health and improving the collective quality of life across generations.

His sterling character traits mirrored his professional accomplishments. His sense of humor was legendary, as was his humility in refusing to acknowledge his importance. In addition, he was endlessly patient, civil, tolerant, and incredibly well-informed.

FAMRI is eternally grateful for Dr. Richmond’s leadership, insights, and the pure pleasure of his company.