50 Years After a Public Health Victory, Can We Do It Again?

January 11, 2014 marks 50 years since the release of the Surgeon General’s Report on smoking and health. In a just published commentary, Otis W. Brawley says the report’s conclusions “are arguably the most important and far-reaching in the history of public health and are, perhaps, the classic example of science driving public policy.”

Otis Brawley

Otis W. Brawley, MD, Chief Medical Officer, American Cancer Society

The report led to rapid, dramatic drops in smoking, whose impact can be seen today. In fact, less smoking may be the most important factor in drops in cancer mortality since the early 90’s. Decreases in lung cancer deaths attributed to smoking are credited with 40 percent of the overall drop in cancer mortality in men.

Public health experts today look back with envy at the remarkable impact of this single report. As Brawley writes, “Given the numerous medical controversies today, it is of value to explore why this process was so successful and why so many were willing to accept this pronouncement as truth.”

Brawley then tells the winding tale of how methodology developed to study infectious disease was first applied to chronic disease; how the creation of case control studies and cohorts came along just in time to cut off a widening epidemic caused by tobacco use; and how public health groups, scientists, and a single question at a press conference converged to bring public attention to “the tobacco problem,” and led directly to Surgeon General Luther L. Terry’s efforts to put together a panel of “outstanding experts who would assess the available knowledge in the area of smoking and health and make appropriate recommendations.”

It is a fascinating retelling of the history that led to that momentous January day 50 years ago, when Dr. Luther Terry and others released a report that “forever changed the course of public health.” And it may prompt us to ask ourselves: what would it take to be that successful again, and is it achievable in our lifetimes?

About David Sampson

I am the director of medical and scientific communications for the American Cancer Society national home office.
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