The War on Smoking at 30

January 11, 1994

Thirty years ago this week, the U.S. Surgeon General declared war on the most insidious destroyer of human health, tobacco smoke.

In his landmark report "Smoking and Health", Dr. Luther Terry launched an aggressive campaign against this formidable yet preventable cause of disability and death. Despite the enormous controversy over rebuffing a widely accepted social custom, the one-time Baltimore physician challenged political forces to change that acceptance.

Over the past 30 years, cigarette smoking has shown a steady decline; one in four persons admits to being a smoker, and many of them light up less frequently than in the past. Tobacco ads are banished from TV and radio, replaced by anti-smoking ads; mandatory health warnings appear on cigarette packages and ads; the once ubiquitous ashtray has become an oddity or antique. More businesses, shopping centers and public places prohibit smoking as a general rule, as well as many government bodies and the nation's post offices. The stop-smoking industry has mushroomed.

Accumulating evidence has solidly linked smoking to lung cancer, as well as heart and respiratory diseases. Well over 400,000 U.S. deaths a year result from smoking. The public distaste for smoking has widened, becoming institutionalized, even as tobacco continues to be a legal, governmentally encouraged commodity, easily purchased anyplace.

Now the battle is actively engaged over the health effects of second-hand smoke that could lead to an effective end to public smoking.

The Environmental Protection Agency unequivocally declared a year ago that passive smoke causes cancer in nonsmokers and that there is no safe, acceptable level for tobacco smoke. Researchers estimate that perhaps 50,000 deaths annually can be tied to second-hand smoke. Those findings have emboldened more businesses and local jurisdictions to expand smoking restrictions.

Maryland is trying to become the first state to ban smoking in the workplace as a health hazard. The state Occupational Safety and Health Advisory Board concluded public hearings on the regulation, which should go before the General Assembly for approval this year. The rule faces strong political opposition, but has the support of a majority of citizens whose health is directly affected.

The process of removing tobacco from public use has been slow -- certainly slower than for any other demonstrated lethal substance in our society. Sadly, the decline of cigarette smoking has leveled off recently, despite stronger evidence of harmful health effects. Further restrictions, in price and availability, will be needed to maintain the momentum against this addictive, lethal health menace.

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