American Journal of Public Health, Vol 91, Issue 2 196-205, Copyright © 2001 by American Public Health Association
Cigarettes and the US Public Health Service in the 1950s
M Parascandola
Museum of Medical Research, National Institutes of Health, Bethesda, Md., USA. mparas@erols.com
The conclusion of the United States Surgeon General's Advisory Committee on
Smoking and Health in 1964 that excessive cigarette smoking causes lung
cancer is cited as the major turning point for public health action against
cigarettes. But the surgeon general and US Public Health Service (PHS)
scientists had concluded as early as 1957 that smoking was a cause of lung
cancer, indeed, "the principal etiologic factor in the increased incidence
of lung cancer." Throughout the 1950s, however, the PHS rejected further
tobacco-related public health actions, such as placing warning labels on
cigarettes or creating educational programs for schools. Instead, the
agency continued to gather information and provided occasional assessments
of the evidence as it came available. It was not until pressure mounted
from outside the PHS in the early 1960s that more substantive action was
taken. Earlier action was not taken because of the way in which PHS
scientists (particularly those within the National Institutes of Health)
and administrators viewed their roles in relation to science and public
health.