History of Tobacco Regulation - The Impetus for Federal Regulation

The effect of smoking on health has been the subject of discussion for hundreds of years. Early participants in the tobacco controversy, beginning in the late 16th century, did not associate the use of tobacco with the production of cancers although they credited it with causing or curing nearly every other known disease.

Dr. John Hill, of London, a physician, botanist and prolific writer, first suggested the relation in 1761. In Cautions Against the Immoderate Use ol Snuff, he reported six cases of "polypusses" related to excessive indulgence in tobacco in the form of snuff. One such "polypus" was described as a swelling in one nostril that was hard, black and adherent on a broad base. Painless at first, it later developed "all the frightful symptoms of an open cancer." Dr. Hill believed that this lesion could be fatal and placed the blame for its origin on tobacco. Dr. Hill has been noted as the first to report an association of tobacco with cancer (Redmond, 1970: 21).

In 1939, the first scientific study linking lung cancer with smoking was published. Between 1950 and 1954, 14 studies associating cigarettes and serious diseases were completed (Fritschler, 1969: 145).

At the present time, there is no government agency with clear jurisdiction over the health aspects of cigarettes. The Federal Trade Commission can act on matters of advertising and package information. The Food and Drug Administration concerns itself only with foods, drugs, solids, or liquids that are eaten or drunk. Tobacco is neither a food nor a drug under current legal definitions. Nor are cigarettes eaten or drunk; they are inhaled.

The 1890 edition of the U.S. Pharmacopoeia, an official listing of drugs published by the government, included tobacco. In later editions, tobacco was dropped. Former Senator Maurine Neuberger has claimed that the removal of tobacco from the Pharmacopoeia was the price paid to get support of tobacco-state legislators for the Food and Drug Act of 1906. The leaf was thereby removed from the jurisdiction of the FDA (Wagner, 1971: 74).

The first statement from the Public Health Service on the subject was made by its Surgeon General, Leroy F. Burney, M.D., in the Journal of the American Medical Association in November, 1959. The heart of this statement was that "the weight of evidence at present implicates smoking as the principal etiological factor in the increased incidence of lung cancer" (Diehl, 1969: 154).

In June, 1961 the American Cancer Society, the American Heart Association and the National Tuberculosis and Respiratory Disease Association jointly requested that a commission be appointed "to consider the responsibilities of government, of business and of voluntary agencies relative to the health hazards of cigarette smoking and to recommend a solution of this health problem that would protect the public and would interfere least with the freedom of industry and the happiness of individuals" (Diehl, 1969: 155).

On June 7, 1962, the then Surgeon General, Dr. Luther Terry, announced, with the approval of the President, that he was establishing an "expert committee to undertake a comprehensive review of all data on smoking and health."

The members of this committee were respected scientists who had previously expressed no opinion about the relationship of tobacco to health. All members were approved for appointment by the tobacco industry as well as by the American Medical Association and several national health agencies. Half of the committee members were cigarette smokers.

On January 11, 1964, after some 15 months of intensive study, this Advisory Committee- to the Surgeon General issued its monumental unanimous report stating that "cigarette smoking is a health hazard of sufficient importance in the United States to warrant, appropriate remedial action."

The committee stated unequivocally that "cigarette smoking is causally related to lung cancer in men; the magnitude of the effect of cigarette smoking far outweighs other factors. The data for women, though less extensive, point in the same direction." Air pollution was found to be a very minor factor in the cause of the disease, far outweighed by cigarette smoking.

The death rate from heart disease, the report noted, was 70 percent higher in cigarette smokers than in nonsmokers, and although there was not enough evidence to say positively that smoking causes heart disease, there was enough to assume that it is a cause and to take action against it.

Another conclusion of great importance was that "cigarette smoking is the most important of the causes of chronic bronchitis in the United States and increases the risk of dying from chronic bronchitis and emphysema."

The report analyzed the statistical, pathological, clinical, and experimental evidence in relation to smoking and other diseases. A total of more than 4,000 published reports were studied and more than 150 investigators were personally interviewed. "The result was the most comprehensive and authoritative report on this subject ever made" (Diehl, 1969: 156).