1964 Report of the Advisory Committee to the Surgeon General of the Public Health Service.

On January 11, 1964, Surgeon General Luther Terry released a historic report to the press implicating cigarette smoking as a cause of lung cancer, heart disease, and chronic bronchitis. A longtime smoker himself, Dr. Terry, along with his Advisory Committee, unveiled Smoking and Health: Report of the Advisory Committee of the Surgeon General of the Public Health Service.

The Public Health Service, scheduled the press conference for a Saturday to help minimize the report’s effect on the stock market. On the basis of more than 7,000 articles relating to smoking and disease already available at that time in the biomedical literature, the Advisory Committee concluded that cigarette smoking is—

• • • • A cause of lung cancer and laryngeal cancer in men
      • A probable cause of lung cancer in women
      • The most important cause of chronic bronchitis

1975 -The Health Consequences of Smoking

Updated information on health effects of involuntary (passive) smoking. Noted evidence linking parental smoking to bronchitis and pneumonia in children during the first year of life.

1976 -The Health Consequences of Smoking: Selected Chapters from 1971 through 1975

Compiled selected chapters from 1971–1975 reports.

1979 -The Health Consequences of Smoking, 1977-1978

Combined 2-year report focused on smoking-related health problems unique to women. Cited studies showing that the use of oral contraceptives potentiates harmful effects of smoking on the cardiovascular system.

1979 -Smoking and Health

Fifteenth-anniversary report. Presented most comprehensive review of health effects of smoking ever published, and first Surgeon General’s report to carefully examine behavioral, pharmacologic, and social factors influencing smoking; to consider the role of adult and youth education in promoting nonsmoking, and to review health consequences of smokeless tobacco. Many new sections, including one identifying smoking as “one of the primary sources of drug interactions in man.” The evidence suggests that mothers who smoke during pregnancy face the possibility of creating long-term, irreversible effects on their babies. As smoking levels among women go up, disease and death rates go up also: lung cancer has increased five-fold among women since 1955. Women who smoke like men die like men who smoke. Sheds new light on dramatically increased risks to smokers exposed to certain occupational hazards. Workers in the asbestos, rubber, coal, textile, uranium, and chemical industries, among others, face these risks. The subject of smoking among children is addressed. The percentage of girls aged 12 to 14 who smoke has increased eight-fold since 1968. Among the age group 13 to 19, there are now 6 million regular smokers. One hundred thousand children under 13 are regular smokers.

1980 – The Health Consequences of Smoking for Women

Devoted to health consequences of smoking for women. Reviewed evidence that strengthened previous findings and permitted new ones. Noted projections that lung cancer would surpass breast cancer as the leading cause of cancer mortality in women. The identified trend toward increased smoking by adolescent females.

1981 – The Health Consequences of Smoking–The Changing Cigarette

Examined health consequences of “the changing cigarette” (i.e., lower tar and nicotine cigarettes). Concluded that lower yield cigarettes reduced risk of lung cancer, but found no conclusive evidence that they reduced risk of cardiovascular disease, COPD, and fetal damage. Noted possible risks from additives and their products of combustion. Discussed compensatory smoking behaviors that might reduce the potential risk of lower-yield cigarettes. Emphasized that there is no safe cigarette and that any risk reduction associated with lower-yield cigarettes would be small compared with the benefits of quitting smoking.

1982 – The Health Consequences of Smoking – Cancer

Cigarette smoking is the major single cause of cancer mortality in the United States. Tobacco’s contribution to all cancer deaths is estimated to be 30 percent. Cigarette smokers have total cancer death rates two times greater than do nonsmokers. Heavy smokers have a three to four times greater excess risk of cancer mortality. There is no single action an individual can take to reduce the risk of cancer more effectively than quitting smoking, particularly cigarettes. Cigarette smoking is a major cause of cancers of the lung, larynx, oral cavity, and esophagus, and is a contributory factor for the development of cancers of the bladder, pancreas, and kidney. The term contributory factor by no means excludes the possibility of a causal role for smoking in cancer of these sites.

1983 The Health Consequences of Smoking–Cardiovascular Disease

Examined health consequences of smoking for cardiovascular disease. Concluded that cigarette smoking is 1 of 3 major independent causes of CHD and, given its prevalence, “should be considered the most important of the known modifiable risk factors for CHD” (p. 6). Discussed relationships between smoking and other forms of cardiovascular disease.

1984 – The Health Consequences of Smoking–Chronic Obstructive Lung Disease

Reviewed evidence on smoking and COLD. Concluded that smoking is the major cause of COLD, accounting for 80–90% of COLD deaths in the United States. Noted that COLD morbidity has greater social impact than COLD mortality because of extended disability periods of COLD victim.

1985 – The Health Consequences of Smoking–Cancer and Chronic Lung Disease in the Workplace

Examined relationship between smoking and hazardous substances in the workplace. Found that for the majority of smokers, smoking is a greater cause of death and disability than their workplace environment. Risk of lung cancer from asbestos exposure characterized as multiplicative with smoking exposure. Observed special importance of smoking prevention among blue-collar workers because of their greater exposure to workplace hazards and their higher prevalence of smoking.

1986 – The Health Consequences of Involuntary Smoking

Focused on involuntary smoking, concluding that “Involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers” (p. 7). Also found that, compared with children of nonsmokers, children of smokers have higher incidence of respiratory symptoms and infections and reduced rates of increase in lung function. Presented detailed examination of growth in restrictions on smoking in public places and workplaces. Concluded that simple separation of smokers and nonsmokers within same airspace reduces but does not eliminate exposure to environmental tobacco smoke.

1988 – The Health Consequences of Smoking–Nicotine Addiction

Established nicotine as a highly addictive substance, comparable in its physiological and psychological properties to other addictive substances of abuse. After carefully examining the available evidence, this Report concludes that:
• Cigarettes and other forms of tobacco are addicting.
• Nicotine is the drug in tobacco that causes addiction.
• The pharmacologic and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine.

1990 – The Health Benefits of Smoking Cessation

Examined how an individual’s risk of smoking-related diseases declines after quitting smoking.

1994 -Preventing Tobacco Use Among Young People

Addressed the crucial problems of adolescent tobacco use by providing a detailed look at adolescence, the time of life when most tobacco users begin, develop, and establish their smoking behavior.

1998 – Tobacco use among U.S. racial/ethnic minority groups – African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, Hispanics. A Report of the Surgeon General, 1998*

Described the 4 major U.S. racial/ethnic minority groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics—patterns of tobacco use, adverse health effects, and the effectiveness of interventions in terms of tobacco’s cultural and socioeconomic effects on the members of these groups. This report described the complex factors that play a part in the growing epidemic of diseases caused by tobacco use in these 4 groups.

2000 – Reducing Tobacco Use: a Report of the Surgeon General

The first report to offer a composite review of the various methods used to reduce and prevent tobacco use. This report evaluated each of the 5 major approaches to reducing tobacco use: educational, clinical, regulatory, economic, and comprehensive.

2001 – Women and Smoking, A Report of the Surgeon General

This report shines a light on the devastating impact of smoking on women and the need for the Nation to come together and address this problem. Just look at a sample of the statistics summarized in this report.
• An estimated 27,000 more women died of lung cancer than of breast cancer in 2000.
• Three million women have died prematurely because of smoking since 1980, and on average, these women died 14 years prematurely.
• Twenty-two percent of women smoked cigarettes in 1998.
• And 30 percent of high school senior girls reported smoking in the past month, according to recent information.

This report found that women who smoke have a lower bone density and experience a premature decline of lung function. These women also are at increased risk of conception delay and both primary and secondary infertility. For pregnant women who smoke, the risk is increased for low birth weight, perinatal mortality—both stillbirth and neonatal deaths—and sudden infant death syndrome after the child is born.Concluded that the increased likelihood of lung cancer, cardiovascular disease, and reproductive health problems among female smokers make tobacco use a serious women’s health issue.

2004 – The Health Consequences of Smoking

Concluded that smoking causes diseases in nearly every organ of the body. Also concluded that cigarette smoking is causally linked to leukemia, cataracts, pneumonia, and cancers of the cervix, kidney, pancreas, and stomach.

2010 – How Tobacco Smoke Causes Disease—The Biologic and Behavioral Basis for Smoking-Attributable Disease

Describes in detail the specific pathways by which tobacco smoke damages the human body.