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50 Years of Tobacco Control

Since the release of the first Surgeon General’s Report on smoking and health in 1964, smoking rates in the United States have dropped by more than half. Eight million lives have been saved by tobacco control efforts — yet up to 20 million more have been lost. Explore milestones in tobacco control, and find out what we can do together to make tobacco history.

Watch President's Video

Matthew L. Myers

President
Campaign for Tobacco-Free Kids

Tom Frieden

Director, CDC
Fmr. Health Commissioner, NYC

Nancy Brown

CEO
American Heart Association

John Seffrin, PhD

CEO
American Cancer Society

Cheryl Healton, PhD

Director
NYU Global Institute of Public Health

Ken Warner

Professor, Fmr. Dean
University of Michigan, School of Public Health

Steve Schroeder, MD

Fmr. President & CEO (1990-2002)
Robert Wood Johnson Foundation

1940s

Smoking prevalence climbs as it becomes an entrenched part of popular culture and norms.

1940

World War II: Smoking reaches a watershed mark. Rates of smoking increase among both men and women as army rations include cigarettes—often provided free by cigarette companies—and many women, now entering the workforce for the first time, begin smoking on the job.

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1946

Dr. Alton Ochsner and Michael DeBakey, who would become two of the most prominent U.S. physicians of the twentieth century, publish an article in the Archives of Surgery linking smoking to lung cancer, and citing research articles from several countries.

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1950s

Smoking continues to climb, as the evidence for tobacco’s negative health effects builds. Rigorous studies link tobacco use to death and disease.

1950

Three articles are published in the Journal of the American Medical Association and the British Medical Journal that cite evidence showing the link between smoking and lung cancer.

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1950

The Federal Trade Commission says cigarette ads that highlight health benefits are deceptive.

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1952

Good Housekeeping refuses ads for cigarettes for the first time

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1955

The American Cancer Society-commissioned Hammond-Horn study conducted from 1952 to 1955 includes 188,000 U.S. men recruited by 22,000 volunteers. This is the first large prospective study to examine the effect of cigarette smoking on death rates from cancer and other diseases.

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1957

First U.S. Surgeon General Leroy E. Burney issues a "Joint Report of Study Group on Smoking and Health." The report says, “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." This marks the first time the U.S. Public Health Service takes a position on smoking and health.

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1960s

Major health organizations join forces to bring attention to the mounting evidence of the harms of smoking. Cigarette consumption reaches its peak before the landmark Surgeon General's report in 1964 definitively links smoking and lung cancer.

1961

The presidents of the American Cancer Society, the American Heart Association, the National Tuberculosis Association, and the American Public Health Association submit a joint letter to President Kennedy, pointing out the increasing evidence of the health hazards of smoking and urge the President to establish a commission. The result will be the landmark 1964 Surgeon Generals’ Report.

1963

Yearly per capita consumption of cigarettes in the U.S. reaches its peak, at 4,336 cigarettes per person per year — more than a pack of cigarettes every two days. Cigarette consumption will begin a true downward trend in 1964 with the release of the first Surgeon General’s report on tobacco and health.

1964

The landmark Surgeon General's report linking smoking and lung cancer is released by Surgeon General Luther L. Terry. The report was developed by a committee of 10 experts from diverse disciplines, with no previous stance on tobacco. The committee reviewed more than 7,000 scientific articles with the help of more than 150 consultants.

Dr. Terry later said the report, "hit the country like a bombshell. It was front page news and a lead story on every radio and television station in the United States and many abroad."

A survey conducted in 1958 found that only 44 percent of Americans believed smoking caused cancer, while 78 percent believed so by 1968. The report marked a major shift in the tides of public opinion, and kicked off 50 years in the fight against death and disease from tobacco.

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1965

Congress passes the Federal Cigarette Labeling and Advertising Act requiring the following Surgeon General's Warning on the side of cigarette packs: "Caution: Cigarette Smoking May Be Hazardous to Your Health." Cigarette packages begin carrying the warnings, whose wording will evolve over the next five decades, on January 1, 1966.

1969

The U.S. Supreme Court applies the Fairness Doctrine to cigarettes, giving tobacco control groups "equal time" on the air to reply to tobacco commercials.

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1969

Congress passes the Public Health Cigarette Smoking Act, banning cigarette advertising on television and radio and requiring a stronger health warning on cigarette packages: "Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Your Health." Ads will actually come off the air in 1971.

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1970s

The first major actions are taken to curb death and disease from tobacco use: TV and radio ads are banned, cigarettes get a strong warning label, and a handful of states and communities restrict smoking in some public places.

1970

The first Great American Smokeout Day, February 18, takes place in Randolf, Mass. Arthur P. Mullaney, guidance counselor at Randolph High School works with students to set aside one day to not smoke and donate money they would have spent on cigarettes to a scholarship fund. (The Great American Smokeout Day will become a national event in 1977.)

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1971

The Surgeon General proposes a federal ban on smoking in public places.

1972

The sixth Surgeon General's Report, “The Health Consequences of Smoking,” addresses “public exposure to air pollution from tobacco smoke” and the danger of smoking to an unborn child.

Read the Report

1974

Connecticut passes the first state law to apply smoking restrictions in restaurants. California will come to establish itself as a pioneer on smoke-free laws and tobacco control, and in 1998 will implement the first law making all restaurants and bars smoke-free.

1978

A Lorillard sales seminar document reveals ways to target their menthol brand Newport cigarettes to the African American community, including “tie-in with any company who help black[s] – ‘we help them, they help us.’ Target group age 16+.” This continues a long history of the tobacco industry targeting young minorities with messages and ads about menthol cigarettes.

Read the Report

1980s

Tobacco control advocacy picks up momentum, and popular culture begins to acknowledge the dangers of smoking.

1980

First U.S. Surgeon General Report on the Health Consequences of Smoking for Women is released. While smoking rates remain lower among women than men, initiation of smoking among adolescent females continues to rise.

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1984

FDA approves nicotine gum as the first smoking cessation aid.

1985

Lung cancer surpasses breast cancer as the number one killer of women — a distinction that still holds today.

1986

Americans for Nonsmokers' Rights is created — an outgrowth of a number of small, local tobacco advocacy groups — to help increase education and legislation efforts to limit exposure to secondhand smoke.

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1988

The twentieth Surgeon General's Report — “The Health Consequences of Smoking: Nicotine Addiction” — released by C. Everett Koop calls nicotine "a powerfully addicting drug." In a 618 - page summary of more than 2,000 studies of nicotine and its effects on the body, Koop declares, "It is now clear that… cigarettes and other forms of tobacco are addicting and that actions of nicotine provide the pharmacologic basic of tobacco addiction.”

Read the Report

1988

President Ronald Reagan signs the Federal Aviation Act, with the Durbin Amendment, into law, making domestic flights of two hours of less smokefree. In an open letter, Representative Durbin attributes the smokefree victory to the “strong grassroots support” generated by groups like ANR and states that “hard work on the local level is what led to an unprecedented public health victory in Congress.

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1990s

Policy and systems changes, such as higher tobacco excise taxes, smoke-free indoor air laws, and access to cessation treatments, become more widespread as national and advocacy partners join forces in a nationwide initiative to significantly reduce death and disease from tobacco.

1991

In 1991 the Robert Wood Johnson Foundation begins to tackle one of the most intractable problems in the field of public health — tobacco addiction. Over the next two decades, it invested more than $500 million and joined forces with advocates and researchers, promoting coalitions and facilitating the work of collaborators.

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1992

The Synar Amendment to the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act requires states to enact laws prohibiting the sale and distribution of tobacco products to minors.

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1993

The National Institute for Occupational Safety and Health issues a bulletin recommending that secondhand smoke be reduced to the “lowest feasible concentration” in the workplace.

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1994

Tobacco executives testify before Congress that “nicotine is not addictive.”

Seven big tobacco company executives testified before a congressional subcommittee, swearing that nicotine was not addictive. The televised panel, led by Representative Henry Waxman, questioned the executives for six hours. One executive insisted that cigarettes were no more addictive than coffee, tea or Twinkies. "The difference between cigarettes and Twinkies," Waxman replied, "is death."

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1996

The Campaign for Tobacco-Free Kids is founded by the Robert Wood Johnson Foundation, American Cancer Society, American Heart Association, American Medical Association and others to advocate at the national, state and local levels for the proven policies that reduce tobacco use and save lives.

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1998

“Tobacco Use Among U.S. Racial/Ethnic Minority Groups: A Report of the Surgeon General” is the first to address the diverse tobacco control needs of four major U.S. racial/ethnic minority groups—African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics. The report notes that African Americans suffer the greatest burden of tobacco-related mortality of any ethnic or racial group in the United States, and that complex relationships and robust outreach from tobacco companies to these communities could hamper progress in reducing that burden.

Read the Report

1998

The Attorneys General of 46 states signed the Master Settlement Agreement with the four largest tobacco companies in the United States to settle state suits to recover billions of dollars in costs associated with treating smoking-related illnesses.

The Agreement also imposed restrictions on the advertising, marketing and promotion of cigarettes — for example, prohibiting youth-targeted ads including the use of cartoons such as Joe Camel.

In FY2014, states will collect $25 billion in revenue from the tobacco settlement and tobacco taxes, but will spend only 1.9 percent of it – $481.2 million – on programs to prevent kids from smoking and help smokers quit.

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2000s

Reductions in smoking saved millions of lives, but tobacco use remains the number one cause of preventable death in the United States.

2000

U.S. law bans smoking on all international flights departing from or arriving in the United States (smoking was prohibited on almost all domestic flights in the U.S. in 1990).

2000

Legacy®, a national public health organization created as a result of the Master Settlement Agreement between state Attorneys General and tobacco companies, launches the truth campaign, the largest national youth smoking prevention campaign and the only national campaign not directed by the tobacco industry. truth directly counters messages from the tobacco industry, which spent $8.8 billion in 2011 marketing its products in the United States alone. As a result:

  • truth was responsible for keeping about 450,000 teens from starting to smoke during its first four years, from 2000 to 2004.
  • The campaign not only paid for itself in its first three years, but also saved nearly $1.9 billion and as much as $5.4 billion in medical care costs to society.
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2003

New York City passes the Smoke-Free Air Act. Sixteen U.S. states raise cigarette taxes, including Delaware and Georgia. 30 states have raised cigarette taxes since Jan. 1, 2002. On June 30, New Jersey raises its tax by 55 cents to $2.05 per pack, the highest in the nation at that time.

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2004

Kool brand cigarettes release an ad campaign (“Kool Mixx”) clearly aimed at African American youth, featuring images of young rappers, disc jockeys and dancers on cigarette packs and in advertising. The campaign also promotes a new line of cigarette flavors like Caribbean Chill, Mocha Taboo, and Midnight Berry using images of African Americans. Print advertising for tobacco products is still very prevalent in Black magazines.

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2005

The first international public health treaty — the World Health Organization’s Framework Convention on Tobacco Control — goes into effect. It calls on participating countries to enact proven measures to reduce tobacco use and exposure to secondhand smoke, including comprehensive smoke-free laws, higher tobacco taxes, strong health warnings and bans on tobacco marketing. 177 countries are parties to the treaty.

2006

“The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General” details the harmful effects of secondhand smoke and concludes there is no risk-free second hand smoke exposure. The report recommends that regulating smoking through smoke-free laws and policies is the most effective way to protect individuals from exposure.

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2006

On August 17, 2006 Judge Kessler issued a 1,683 page opinion holding the tobacco companies liable for fraudulently covering up the health risks associated with smoking and their marketing to children. The judge concluded, “From the 1950s to the present, different defendants, at different times and using different methods, have intentionally marketed to young people under the age of twenty-one in order to recruit ‘replacement smokers’ to ensure the economic future of the tobacco industry.”

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2007

Studies emerge documenting the disproportionate amount of tobacco advertising in low-income, minority communities. A 2007 study found that there were 2.6 times more tobacco advertisements per person in areas with an African American majority compared to white-majority areas.

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2009

The largest federal cigarette excise tax increase in history goes into effect, bringing the combined federal and average state excise tax for cigarettes to $2.21 per pack.

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2009

The Family Smoking Prevention and Tobacco Control Act gives the Food and Drug Administration (FDA) the authority to regulate the manufacture, marketing and sale of tobacco products to protect public health. Later that year, the FDA Center for Tobacco Products was formed and subsequently banned most flavored cigarettes and misleading cigarette labels such as light and low-tar.

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2014

Numbers are released showing that from 1964 to 2012, at least 8 million premature, smoking-related deaths were prevented, and each of those eight million people gained, on average, 20 years of life.

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2014

CVS Caremark announces that it will stop selling cigarettes and other tobacco products at its more than 7,600 CVS pharmacy stores across the United States by October 1, 2014. In eliminating the sale of tobacco products, CVS recognizes that pharmacies and pharmacists are responsible for far more than filling prescriptions and selling sundries; they have become a key partner for better health in neighborhoods across the nation.

Cigarette Use and Mortality Tobacco Control Saved 8M Lives Since 1964...17M Lives Still Taken

Great Depression

Consumption dips

World War II

Smoking reaches watershed moment as army rations include cigarettes; women entering the workforce begin smoking

Research

Major study links cigarette smoking to death rates from cancer and other diseases

Turning the Tide

First Surgeon General's report on tobacco and health

Turning the Tide

First Surgeon General's report on tobacco and health

Turning the Tide

First Surgeon General's report on tobacco and health

Fairness Doctrine

Public health messages begin to appear on TV and radio to counter the effect of tobacco advertising

Fairness Doctrine

Public health messages begin to appear on TV and radio to counter the effect of tobacco advertising

Fairness Doctrine

Public health messages begin to appear on TV and radio to counter the effect of tobacco advertising

Public Health Cigarette Smoking Act

Cigarette advertising on TV and radio is banned; cigarette packages get a stronger health warning label

Public Health Cigarette Smoking Act

Cigarette advertising on TV and radio is banned; cigarette packages get a stronger health warning label

Public Health Cigarette Smoking Act

Cigarette advertising on TV and radio is banned; cigarette packages get a stronger health warning label

Nonsmoker's Rights Movement

A movement begins to protect nonsmokers from secondhand smoke in public places

Nonsmoker's Rights Movement

A movement begins to protect nonsmokers from secondhand smoke in public places

Nonsmoker's Rights Movement

A movement begins to protect nonsmokers from secondhand smoke in public places

RWJF Investment

Robert Wood Johnson Foundation joins partners working to reduce tobacco death and disease; begins two decades of investment that will reach $500 million

RWJF Investment

Robert Wood Johnson Foundation joins partners working to reduce tobacco death and disease; begins two decades of investment that will reach $500 million

RWJF Investment

Robert Wood Johnson Foundation joins partners working to reduce tobacco death and disease; begins two decades of investment that will reach $500 million

Master Settlement Agreement

Four largest U.S. tobacco companies settle state suits to recover billions of dollars in costs associated with treating smoking-related illnesses

Master Settlement Agreement

Four largest U.S. tobacco companies settle state suits to recover billions of dollars in costs associated with treating smoking-related illnesses

Master Settlement Agreement

Four largest U.S. tobacco companies settle state suits to recover billions of dollars in costs associated with treating smoking-related illnesses

Federal Cigarette Tax More Than Doubles

FDA granted authority over tobacco products

Federal Cigarette Tax More Than Doubles

FDA granted authority over tobacco products

Federal Cigarette Tax More Than Doubles

FDA granted authority over tobacco products
Goals Include:
  • Reduce smoking rates to less than 10 percent within ten years
  • Protect all Americans from secondhand smoke within five years
  • Ultimately eliminate the death and disease caused by tobacco smoke

The timeline continues to evolve as we all work together to make tobacco history. What's missing? What would you like to see added to this timeline? Let us know at tobaccocontrol@rwjf.org

Contact Us: Route 1 and College Road East, P.O. Box 2316, Princeton, NJ 08543  |  (877) 843-RWJF (7953)  |