Washington, DC 17 January – At a White House event today, public health officials and advocates recognized the 50th anniversary of the 1964 Surgeon General’s Report on Smoking and Health. The original report, so groundbreaking that its release was held on a Saturday to minimize the impact on the stock market, revealed to the world the scientific fact that smoking causes disease and death. A new public health initiative was born, both in the U.S. and abroad, culminating in the world’s first health treaty, the World Health Organization Framework Convention on Tobacco Control (FCTC).

While the 1964 report examined the impact of tobacco on Americans, the rest of the world was listening. The U.S. public health service was and is highly respected globally, and much of the scientific data analyzed by the expert committee came from foreign scientists, particularly in the United Kingdom. The new Surgeon General’s report, released this morning, also includes data from around the world.

“Enough is enough,” repeated Acting Surgeon General Boris D. Lushniak at the White House this morning, calling for a renewed effort to end tobacco use in our lifetime. The rest of the world agrees. When asked for her priorities in improving global health in 2011, World Health Organization Director Margaret Chan responded “Tobacco, tobacco, tobacco. We must fight it.”

Tobacco remains the number one cause of preventable death in the U.S. and the world, causing one in five deaths here at home and killing over 6 million per year worldwide. The epidemic has shifted dramatically in the 50 years since the 1964 report. At the time, it was a disease of the rich world. Today it is a particular burden for the poor, especially in developing countries. By 2030, 80% of global deaths from tobacco will be in the poorest countries in Asia, Africa and South America.

While we have seen great progress in addressing the tobacco epidemic, global statistics are sobering:

  • 100 million people died from tobacco-related disease in the 20th century. Unless we take action, 1 billion will die in the 21st century.
  • There are 1.3 billion smokers today. The number is rising.
  • The vector of the disease, the multinational tobacco industry, is richer than ever. If their annual revenue is compared to national gross domestic product figures, they would be among the richest countries in the world, in the G20.
  • In the poorest countries, some families spend 30% of their income on their nicotine addiction, taking money away from food, housing, education, and healthcare.

Fortunately, many countries are taking action, largely under the rubric of the Framework Convention on Tobacco Control. Coming into law in 2005, the FCTC is a blueprint for ending the tobacco epidemic, if fully implemented. The U.S. has signed but not ratified the treaty, and over the past 15 years has lost its primacy in regulations designed to combat tobacco use. Others have forged ahead with proven tactics such as:

  • National smoke-free laws
  • High tax rates
  • Public education campaigns
  • Comprehensive help for smokers who want to quit
  • Complete marketing bans, including advertising, promotion and sponsorship
  • Large, graphic warning labels (Australia has instituted plain packaging for cigarettes)
  • Banning flavorings that make tobacco more attractive, especially to children

Two countries – New Zealand and Finland – have drafted national plans aimed at ending tobacco use by 2025. Others are sure to follow their lead.

For fifty years, we have been working to reduce the death and disease caused by tobacco. There has been much progress, but it would surely be disappointing to 1964 Surgeon General Luther Terry that we have not stopped the epidemic. Leaders in the U.S. and around the world must take action now to ensure that we don’t meet again in 2164 with tobacco still a part of society.