The Surgeon General's 'Smoking and Health': a continuing challenge

Abstract

In the USA, the Surgeon General occupies a position equivalent to director of public health or chief medical officer in countries such as Australia. They are the head of the USA Public Health Service, a branch of the uniformed services in the USA. They are allowed more latitude in expressing their professional goals than other public servants and it has become customary for Surgeon Generals to issue reports on significant public health issues, ranging from osteoporosis to sexual abuse and HIV/AIDS. Probably the best known report has been the first, issued by Rear Admiral Luther Terry in January 1964, ‘Smoking and Health, Report of the Advisory Committee to the Surgeon General of the Public Health Service, US Department of Health, Education, and Welfare, Public Health Service’ to give its full title.1 Like most of his advisory committee Dr Terry was a heavy smoker. In 1964 it was estimated that 42% of American adults smoked and in Australia in the same year 58% of men and 28% of women smoked. ‘Smoking and Health’ was not the first report on the effects of smoking as it brought together a synthesis of the results of 7000 published studies. It was not until some years later the irony in the title was noted and it was realised that a title such as ‘Smoking or Health’ would have been far more appropriate.