"My advice to the smoker would be to stop cigarette smoking. My advice to the person who has not started smoking would be – don't start."
Fifty years after U.S Surgeon General made this statement while launching a landmark report which definitively linked smoking with cancer and death for the first time, the advice to smokers from health authorities hasn't changed.
But back in 1964, the news that smoking was deadly came as a bombshell to the community at a time when smoking was a way of life.
The report's bottom-line message was hardly new. For more than a decade, studies had found higher rates of lung cancer in heavy smokers and a Reader's Digest article entitled "Cancer by the Carton" contributed to the largest drop in cigarette consumption in the USA since the Depression.
But, in a pattern which would repeat itself over and over in the following decades, the tobacco industry fought back fiercely.
They introduced cigarettes with filters which they claimed would trap toxins before they settled into smokers' lungs and went on an advertising blitz to create the impression that the evidence was inconclusive when in fact it was very clear.
Cigarette sales rebounded and in 1962 U.S Surgeon General Dr Luther Terry announced he was convening an expert panel to examine the evidence and settle the debate once and for all.
To give you an idea of how much smoking was a way of life back then, half of the expert panel, including the U.S Surgeon General, were smokers.
But the U.S Surgeon General quit just a few months before issuing his damning report, which found cigarette smoking clearly caused lung cancer and was responsible for the country's escalating male cancer death rate.
It also found there was no evidence that filters reduced the risk.
Within a year, the report prompted governments all over the world to take the first steps towards modern tobacco control.
Since the U.S Surgeon General's report was released in 1964, smoking rates in Australia have almost halved.
Governments have acted to protect the community from the harms of smoking in many ways including a total ban on tobacco advertising and on smoking in workplaces, pubs and clubs and a range of other outdoor areas as well as point-of-sale bans and plain packaging.
But with smoking still the leading cause of preventable death and disease in Australia and responsible for killing 15,000 Australians each year, we need to continue to look at new ways of reducing smoking rates as well as continuing to do the things we know work – keeping the price of cigarettes high, continuing to screen anti-smoking advertising campaigns and expanding smokefree areas.
Some smokers still in denial
Despite 50 years passing since it was definitively proved that smoking caused cancer and death, some smokers are still in denial about the devastating effects of smoking.
New Cancer Council Victoria research found one in four smokers still believe the effects of smoking have been exaggerated while one in 10 smokers don't believe smoking causes illness at all.
When asked what illnesses could be caused by smoking, only half of all smokers could name lung cancer and even fewer could name stroke or heart attack.
The next 50 years
With smoking rates in many parts of Australia on track to drop below 10% by 2020, the question is what else should we be doing to put an end to smoking once and for all?
Quit Victoria and Cancer Council Victoria believe the availability of tobacco should be the next frontier for governments.
You can buy tobacco in more places in Australia than a loaf of bread and when you consider it is a product that kills one in two long-term users and is only meant to be sold to adults, we have to start to question whether it is appropriate that tobacco is so widely available.
What do you think government should do to further reduce smoking rates?
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