ORIGINAL

TOWARD A SMOKE-FREE SOCIETY BY THE YEAR 2000

BY

C, EVERETT KOOP, M,D,
  SURGEON GENERAL
U,S, PUBLIC HEALTH SERVICE

         AND

DEPUTY ASSISTANT SECRETARY FOR HEALTH
U,S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

         PRESENTED TO THE
MINNESOTA COALITION FOR A SMOKE-FREE SOCIETY 2000
       MINNEAPOLIS, MINNESOTA
         MARCH 14, 1985


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(GREETINGS TO HOSTS, GUESTS, FRIENDS, ETCJ

   I'M HONORED TO BE YOUR SPEAKER THIS EVENING AT SUCH AN AUSPICIOUS

OCCASION,  IN PARTICULAR, I AM DELIGHTED TO BE SURROUNDED BY MEN AND

WOMEN WHO TRULY CARE ABOUT THE HEALTH OF THEIR FELLOW CITIZENS AND ARE
WILLING TO DO SOMETHING ABOUT IT,  I APPLAUD EACH AND EVERY ONE OF YOU

FOR YOUR EFFORTS IN FORMING THE MINNESOTA COLAITION FOR A SMOKE-FREE

SOCIETY 2000,

   I CAN ONLY SAY THAT, BY MERELY MAKING THE IDEA OF A COALITION
REALITY, YOU HAVE EARNED THE GRATITUDE NOT ONLY OF THE CITIZENS OF

MINNESOTA AND THE CITIZENS OF THE NATION, BUT ALSO THE GRATITUDE OF

THE REAL BENEFICIARIES OF THIS WEEK'S EVENTSmTHE CHILDREN WHO HAVE
YET TO BE BORN,

  THANKS TO YOU, THEIR WORLD WILL BE A LITTLE SAFER TO PLAY IN, A

LITTLE SWEETER TO BREATHE IN, AND MUCH HEALTHIER TO LIVE IN,


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  AND LET ME SAY THAT YOU ARE ACTING NOT A MOMENT TOO SOON, YES,
WE'VE ALL COME A GREAT DISTANCE OVER THE PAST QUARTER OF A CENTURY IN
THIS VITAL ISSUE OF SMOKING AND HEALTH, AND WE CAN SPEAK WITH SOME
CERTAINTY ABOUT THE PROGRESS WE'VE MADE, BUT WE OUGHT NOT TO GET
CARRIED AWAY, THE HARD COLD TRUTH OF THE MATTER IS THAT, 8.

OUR COUNTRY IS STILL BURDENED BY AN ESTIMATED 340,000 PREMATURE
SMOKING-RELATED DEATHS EACH YEAR,,,

WE'RE STILL BURDENED WITH THE TREMENDOUS AMOUNT OF SUFFERING AND
HARDSHIP THAT GOES ALONG WITH -- AND EXCEEDS -- THOSE DEATHS.,,

AND THIS YEAR -- ONCE AGAIN -- THE PEOPLE OF AMERICA ARE STILL
BURDENED WITH THE ECONOMICS OF SMOKING, WE STILL HAVE TO COME UP
WITH THE MONEY TO PAY THE ANNUAL SMOKING-AND-HEALTH BILL OF
$39 BILLION, THAT'S FOR PERSONNEL AND MEDICAL TECHNOLOGY AND
INSURANCE AND LOST WAGESmALL THE REAL, BASIC COSTS LEVELLED
AGAINST US ALL BY DISEASE AND DISABILITY.


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  SO THIS IS NOT EXACTLY THE TIME FOR A FULL-SCALE CELEBRATION,
NOT YET, ANYWAY, RATHER, IT IS A TIME TO REDEDICATE OUR EFFORTS,

   IS THERE ANY HOPE FOR VICTORY? YES, THERE IS, BUT TO UNDERSTAND
MY AFFIRMATIVE RESPONSE, I THINK YOU HAVE TO REMEMBER WHERE WE'VE COME
FROM OVER THE PAST QUARTER OF A CENTURY,  I CALL THIS PERIOD THE
"PHASE I" PERIOD IN THE LONG CAMPAIGN AGAINST TOBACCO,

  YOU MAY RECALL THAT 25 YEARS AGO, THE AMERICAN HEART ASSOCIATION
RELEASED ITS FIRST REPORT ON SMOKING, WHICH CONCLUDED THAT MEN WHO
WERE HEAVY SMOKERS SUFFERED AN EXCESS NUMBER OF DEATHS FROM HEART
DISEASE, THAT REPORT JOGGED A LOT OF MINDS AND HELPED TO FOCUS THE
EFFORTS OF THE PUBLIC HEALTH SERVICE,


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  THEN, 21 YEARS AGO, ONE OF MY DISTINGUISHED PREDECESSORS0 Dk
LUTHER TERRY, RELEASED SMOKING AND HEALTH: THE REPORT OF THE ADVISORY
COMMITTEE TO THE SURGEON GENERAL AND GOT THIS HISTORIC ANTI-SMOKING
CAMPAIGN INTO GEAR, THERE HAVE BEEN 16 OTHER REPORTS SINCE THEN, ALL
PROVING, IN GREATER AND GREATER DETAIL, THAT SMOKING WAS -- AND STILL

IS -- A GRAVE THREAT TO INDIVIDUAL AND FAMILY HEALTH,

   I WAS A CALLOW YOUTH OF 47 WHEN THE FIRST SURGEON GENERAL'S
REPORT ON SMOKING AND HEALTH WAS RELEASED BACK IN 1964. I THOUGHT IT
WAS A TREMENDOUS BREAKTHROUGH,  I ALSO BELIEVED THAT THE REPORT WAS
THE DEATH-KNELL FOR CIGARETTES, ,,YOU OBVIOUSLY WOULDN'T SEE THEM

ANYMORE AFTER THE NEXT 5 YEARS,

OF COURSE, I WAS TERRIBLY WRONG,


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  NEXT, CONGRESS REQUIRED HEALTH WARNING LABELS ON CIGARETTES AND

ULTIMATELY BANNED THE ADVERTISING OF CIGARETTES FROM TELEVISION,

  THREE YEARS AGO, IN 1982, AS A MUCH WISER AND MORE WORDLY MAN, I
RELEASED MY FIRST "SURGEON GENERAL'S REPORT," SPECIFICALLY LINKING

CIGARETTE SMOKING AND CANCER, PARTICULARLY LUNG CANCER, THE DATA IN

THAT REPORT IMPLICATED SMOKING IN AS MANY AS 129,000 SMOKING-RELATED
CANCER DEATHS PER YEAR,

  OUR NEXT REPORT, IN 1983, REVEALED THE CLOSE RELATIONSHIP BETWEEN
SMOKING AND CARDIOVASCULAR DISEASE, AND THE NUMBERS WERE EVEN LARGER
THAN WHAT WE HAD FOUND FOR CANCER:

WE ESTIMATED THAT CIGARETTE SMOKING WAS DIRECTLY RELATED TO 170,000
CORONARY HEART DISEASE DEATHS EACH YEAR, AGAINmA SUBSTANTIAL

NUMBER,


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  AND JUST LAST YEAR THE 1984 SURGEON GENERAL'S REPORT ON SMOKING
AND HEALTH DOCUMENTED THE RELATIONSHIP BETWEEN CIGARETTE SMOKING AND
CHRONIC OBSTRUCTIVE LUNG DISEASE, ONCE AGAIN, WE HAD A GRIM PICTURE
OF HIGH MORBIDITY -- CHRONIC, LONG-TERM SUFFERING -- AMONG CIGARETTE
SMOKERS,

   I'VE BEEN READING MEDICAL AND HEALTH REPORTS FOR ALL OF MY 44
YEARS AS A PROFESSIONAL IN MEDICINE, AND I'VE ATTENDED HUNDREDS OF
SEMINARS AND SPECIAL STUDY SESSIONS, ALL OF IT HAS BEEN IMPORTANT,
BUT I VENTURE TO SAY THAT NOT A GREAT AMOUNT OF THAT READING OR A
GREAT NUMBER OF THOSE MEETINGS HAD AS SOLID A FOUNDATION OF DATA AS
THE PUBLIC HEALTH SERVICE HAS MANAGED TO PULL TOGETHER ON THIS ISSUE
OF SMOKING AND HEALTH,

  ALL THIS ACTIVITY OF THE PAST 20 TO 25 YEARS HAS HAD AN EFFECT,
WE MIGHT WISH FOR SOMETHING MORE DRAMATIC, BUT THE EFFECT IS REAL
ENOUGH,


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  IN 1983, FOR EXAMPLE, THERE WAS A 7 PERCENT DROP IN THE ANNUAL
PER CAPITA CIGARETTE CONSUMPTION, BRINGING THE FIGURE DOWN TO LESS
THAN 3,500 CIGARETTES CONSUMED PER PERSON PER YEAR, THAT'S THE LOWEST
THIS FIGURE HAS BEEN SINCE 1949, AND THAT'S VERY GOOD NEWS,

  ALSO, ACCORDING TO PROVISIONAL FIGURES FROM OUR NATIONAL CENTER
FOR HEALTH STATISTICS, THE NUMBER OF MEN WHO SMOKE CIGARETTES -- AS A

PERCENTAGE OF ALL MEN -- DECLINED FROM 37,9 PERCENT TO 33 PERCENT
BETWEEN 1980 AND 1983, AMONG WOMEN, THE DECLINE WAS FROM 29,8 PERCENT
TO 29 PERCENTmA SLIGHT CHANGE, THAT'S TRUE, BUT A DECLINE
NEVERTHELESS, IN ADDITION, WE ESTIMATE THAT LAST YEAR 21 PERCENT OF
ALL HIGH SCHOOL SENIORS SMOKED CIGARETTES; 6 YEARS AGO NEARLY 30
PERCENT DID, THAT'S A SIZEABLE DROP,

  THESE AND OTHER DEVELOPMENTS WERE EFFECTIVELY COMBINED IN WHAT I
REFER TO AS "PHASE I" OF THE NATIONAL CAMPAIGN AGAINST SMOKING,


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  IN "PHASE II" THE NONSMOKER ARRIVED ON THE SCENE, THE NONSMOKER
WAS MERELY IRRITATED AT FIRST,, #THEN BECAME ANNOYED,, ,AND THEN TURNED
MILITANT. THE MORE MILITANT HE OR SHE HAS BEEN, THE GREATER THE
CHANGE THAT HAS OCCURRED IN SOCIAL CUSTOMS AND IN LOCAL AND STATE
LAW,

  YOU WILL RECALL THAT, BACK IN 1973, ARIZONA TOOK THE PLUNGE AND
BECAME THE FIRST STATE TO PROHIBIT SMOKING IN PUBLIC PLACES, ON
COMMERCIAL AIRLINERS IN ARIZONA AIRSPACE, AND ON BUSES,

  IN 1975 MARYLAND AND MINNESOTA PASSED LAWS THAT SPECIFICALLY
PROTECTS NON-SMOKERS FROM HAVING TO BREATHE ANY INDOOR AIR THAT HAS
BEEN POISONED BY SMOKERS, IN THAT YEAR, PASSIVE SMOKING ENTERED THE
LAW,


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  SINCE THEN, MORE THAN 30 STATES AND HUNDREDS OF LOCAL COMMUNITIES
HAVE FOLLOWED SUIT, ENACTING ORDINANCES TO PROHIBIT OR SEVERELY
RESTRICT SMOKING IN PLACES LIKE RESTAURANTS, GOVERNMENT OFFICES,
THEATERS, INDOOR SPORTS ARENAS, BUS STATION WAITING-ROOMS, CLINICS,
RETAIL STORES, AND SO ON,

  A YEAR AGO, THE VOTERS OF SAN FRANCISCO PASSED "PROPOSITION P" IN
AN ELECTION WATCHED BY THE WHOLE COUNTRY, "PROPOSITION P" IS A TOUGH
LAW VERY MUCH ON THE SIDE OF THE NON-SMOKER, THE LAW SAYS, AMONG
OTHER THINGS, THAT EVERY WORKPLACE AND PUBLIC GATHERING PLACE MUST
SEPARATE SMOKERS FROM NON-SMOKERS. A COMPLAINT BY A SINGLE NON-SMOKER
IS ENOUGH TO REQUIRE THIS SEPARATION IN ORDER TO PROTECT THE HEALTH
AND WELL-BEING OF THAT NON-SMOKER,

   IN ADDITION, IF THE PEOPLE RESPONSIBLE FOR A PUBLIC SPACE DO NOT
SEPARATE THE SMOKERS AFTER A COMPLAINT HAS BEEN LODGED, THEY ARE
SUBJECT TO HEAVY DAILY FINES,


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  NOT TO BE OUT-DONE, LOS ANGELES AND SAN DIEGO ENACTED SIMILAR
LAWS,

  ONE OF THE MOST INTERESTING OF THESE RECENT ANTI-SMOKING LAWS IS
BASED ON A WORKMEN'S COMPENSATION STATUTE ENACTED BY VIRGINIA IN
1975, ACCORDING TO THAT LAW, IF A PUBLICLY EMPLOYED FIRE-FIGHTER,
POLICE OFFICER, OR DEPUTY SHERIFF IS DISABLED OR DIES BECAUSE OF HEART
DISEASE, RESPIRATORY ILLNESS, OR HIGH BLOOD PRESSURE, VIRGINIA WILL
ASSUME THAT THE DISEASE WAS THE RESULT OF THE STRESSFUL CONDITIONS OF
EMPLOYMENT,

  BUT FAIRFAX, ALEXANDRIA, AND ARLINGTON COUNTIES SAY THAT'S NOT
ENOUGH, THEY HAVE ENACTED THEIR OWN ORDNANCES THAT SAY THOSE SAME
CARDIOVASCULAR AND RESPIRATORY DISEASES ARE ALSO LINKED TO SMOKING,
THEREFORE, THOSE COUNTY GOVERNMENTS WILL DENY COMPENSATION OR PENSION
CLAIMS MADE BY ANY CURRENT EMPLOYEES WHO PREMATURELY BRING THOSE
CONDITIONS UPON THEMSELVES BY SMOKING,


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  AND FURTHERMORE THE COUNTIES DEMAND THAT ALL NEW EMPLOYEES IN
PUBLIC SAFETY JOBS SIGN THE FOLLOWING PLEDGE:

(QUOTE) "I AGREE NOT TO SMOKE AT ANY TIME, SO LONG AS I AM
EMPLOYED BY THE ABOVE-MENTIONED AGENCIES (THAT IS, POLICE, FIRE,
AND SHERIFF'S OFFICE), WHETHER ON OR OFF DUTY, AND THAT MY FAILURE
TO COMPLY WITH THE ABOVE-MENTIONED CONDITIONS OF EMPLOYMENT SHALL
CONSTITUTE GOOD CAUSE FOR MY EMPLOYER TO TERMINATE MY EMPLOYMENT,"
(UNQUOTE)

  SMOKING IS BECOMING SOCIALLY UNACCEPTABLE,, ,EVEN AMONG YOUNG
PEOPLE, WHO SOMETIMES STRIKE US AS BEING UNCLEAR ABOUT THE SOCIAL
GRACES IN GENERAL, IN ANY CASE, COUNTLESS SCHOOL AND SCHOOL BUS
AUTHORITIES HAVE INITIATED "NO SMOKING" RULES -- A RESULT MANY TIMES
OF MILITANCY AMONG YOUNG PEOPLE WHO ARE IRRITATED, ANGRY NON-SMOKERS,


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  INCIDENTALLY, A BOOKLET BY CHARLOTTE FORD ON ETIQUETTE FOR
SMOKERS JUST CAME OUT LAST MONTH, I COMMEND IT TO YOU,

  THAT'S A ROUGH SKETCH OF WHAT I'D CALL "PHASE 2" OF THIS CAMPAIGN
AGAINST CIGARETTES, WHAT OF "PHASE 3"?

  DURING "PHASE 30" WE BEGIN TO UNDERSTAND WITH MORE SCIENTIFIC
PRECISION JUST WHY THE NON-SMOKER IS SO UPSET, DURING THIS PHASE WE
ARE GENERATING HARD DATA THAT SPECIFICALLY MEASURE THE DETRIMENTAL
HEALTH EFFECTS OF "PASSIVE" OR "SIDE-STREAM" SMOKING,

  ONE OF THE LATEST PIECES OF INFORMATION OF THIS KIND WAS
PUBLISHED IN THE SEPTEMBER 27TH, 1984, ISSUE OF THE NEW ENGLAND
JOURNAL OF MEDICINE,  IT'S A JAPANESE STUDY THAT MEASURED THE PRESENCE
OF COTININE, A METABOLIC PRODUCT OF NICOTINE THAT IS FOUND IN THE
URINE OF SMOKERS,


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  THE JAPANESE RESEARCH TEAM TOOK URINE SAMPLES FROM 472 NON-
SMOKERS WHO LIVE AND WORK WITH SMOKERS, THEY DISCOVERED, FOR EXAMPLE,
THAT IF YOU ARE A NON-SMOKER AND LIVE WITH SOMEONE WHO SMOKES 2 PACKS
A DAY, YOU WILL BE UNWITTINGLY "SMOKING" 3 CIGARETTES A DAY, ACCORDING

TO THE PRESENCE OF COTININE IN THE URINE,

  THE JAPANESE SPECIFICALLY MEASURED A NICOTINE DERIVATIVE, WHICH
MEANS THAT NO CRITIC CAN DISMISS THE STUDY BY CLAIMING THE POLLUTION
COULD HAVE ALSO COME FROM DIESEL EXHAUST OR FIREPLACE ASHES,

   THIS KIND OF DATA CONCERNING THE DANGER THAT SMOKERS PRESENT TO
NON-SMOKERS IS BEGINNING TO BUILD UP, BUT IF HISTORY IS A RELIABLE
TEACHER, THEN I'M AFRAID WE'RE GOING TO NEED MOUNTAINS OF SUCH DATA

BEFORE THE PUBLIC WILL GENERALLY ACCEPT THE CONCLUSION,

AND THAT IS A CRUEL IRONY,


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  I WOULD ASK YOU TO THINK FOR A MOMENT ABOUT THE OTHER CANCER
THREATS THAT HAVE BEEN POSED TO OUR SOCIETY AND WHAT OUR RESPONSES
HAVE BEEN, TAKE "AGENT ORANGE," FOR EXAMPLE,

  VETERANS OF THE VIETNAM WAR CLAIMED THE HERBICIDE BROUGHT ON A
VARIETY OF DISEASE CONDITIONS -- INCLUDING CANCER, THE CASE IS NOW
VIRTUALLY SETTLED, WITH 7 CHEMICAL COMPANIES AGREEING TO PAY $190
MILLION TO 160000 VETERANS,

  I HAVE TO TELL YOU THAT THE EVIDENCE GATHERED AGAINST "AGENT
ORANGE" FOR NEARLY 10 YEARS IS LESS SUBSTANTIAL THAN THE EVIDENCE
WE'VE BEEN COLLECTING AGAINST CIGARETTES FOR MORE THAN TWO DECADES,
NEVERTHELESS, THE AMERICAN PUBLIC, A NUMBER OF MAJOR CHEMICAL
CORPORATIONS, THE UNITED STATES CONGRESS, CERTAIN AGENCIES OF THE
EXECUTIVE BRANCH, THE COURTS, AND MOST OF THE COUNTRY'S LAWYERS SEEM
TO AGREE THAT THERE'S ENOUGH EVIDENCE TO SERIOUSLY IMPLICATE -- OR TO
"CONVICT," AS IT WERE -- THE HERBICIDE "AGENT ORANGE,"


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   INCIDENTALLY, IF YOU ADD UP ALL THE POSSIBLE NUMBERS OF VICTIMS
OF "AGENT ORANGE" DURING THE YEARS IT WAS USED IN THE VIETNAM WAR, AND
IF YOU ADD UP ALL THE POSSIBLE COSTS ASSOCIATED WITH THE ALLEGED

ILLNESSES -- YOU WILL STILL ARRIVE AT A TOTAL FAR SHORT OF THE

DEVASTATION PRODUCED BY CIGARETTE SMOKING IN THIS COUNTRY IN JUST,,,
ONEmYEAR,

  THE "AGENT ORANGE" E PERIENCE IS NOT UNIQUE, EITHER, WE REACTED
IN EXACTLY THE SAME WAY TOWARD "EmDnBw" OR ETHYLENE DIBROMIDE,
E,D,B, IS A PESTICIDE THAT HAD BEEN USED FOR 35 YEARS TO PROTECT
STORED GRAIN, GRAIN MILLING MACHINERY, AND CITRUS AND TROPICAL FRUITS
FROM INSECT INFESTATION,

  EIGHT YEARS AGO THE NATIONAL CANCER INSTITUTE RELEASED SOME
RESEARCH FINDINGS THAT IMPLICATED EmDnB, AS THE CAUSE OF CANCER IN
LABORATORY ANIMALS. SINCE THAT FIRST ANNOUNCEMENT, MORE TESTS WERE
CONDUCTED WITH SIMILAR RESULTS,


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  THEN, E,D,B, RESIDUE WAS FOUND IN GROUND WATER, AND A NUMBER OF

OTHER EVENTS COINCIDED SO THAT WE'VE ALL BECOME CONVINCED THAT WE
DON'T WANT ETHYLENE DIBROMIDE AROUND ANY MORE,

THE VERDICT IS CLEAR ENOUGH: E,D,B, IS NOT SAFE,

  AND WE ARE SAYING THAT, AS A SOCIETY, WITHOUT HAVING ANY RECORD
OF EVEN ONE INDIVIDUAL DEVELOPING CANCER AS A DIRECT RESULT OF
INGESTING E,D,B, BUT SUCH CLEAR, EXPLICIT PROOF IS NOT NECESSARY
UNDER THE LAW GOVERNING THE TOXICITY OF AGRICULTURAL CHEMICALS,

   THEREFORE, LAST MARCH, 1984, JUST 9 YEARS AFTER THAT FIRST,

SOMEWHAT TENTATIVE REPORT OF THE NATIONAL CANCER INSTITUTE, THE
ENVIRONMENTAL PROTECTION AGENCY ORDERED THE ELIMINATION OF E,D,B, FROM

THE AMERICAN FOOD MARKETPLACE,


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  PLEASE REMEMBER THAT THE ACT OF SMOKING IS NOT MANDATED BY LAW
NOR IS IT PART OF SOME GRAND STRATEGY TO WIN A WAR,  IT'S A PERSONAL,
VOLUNTARY ACT: YOU MAY CHOOSE TO SMOKE OR YOU MAY CHOOSE NOT TO,  THE
DECISION IS STRICTLY UP TO YOU,

  BUT 53 MILLION AMERICANS WANT TO, THEY MAKE THAT CHOICE EVERY
DAY, AND IN DOING SO, THESE 53 MILLION PEOPLE BECOME VICTIMS OF ONE
OF THE MOST DESTRUCTIVE SUBSTANCES IN OUR ENVIRONMENTmMUCH MORE
DESTRUCTIVE THAN "AGENT ORANGE" OR "E,D,B/'

  BUT JUST SAYING THAT IS NOT ENOUGH TO CONVINCE SMOKERS TO QUIT.
WE NEED TO PRODUCE MORE HARD, SCIENTIFIC EVIDENCE, THAT'S A JOB FOR
THE USa PUBLIC HEALTH SERVICE AND WE INTEND TO KEEP AT IT, BUT WE
ALSO NEED TO TRANSMIT THAT INFORMATION CLEARLY AND STEADILY TO ALL OUR
CITIZENS, THE PUBLIC HAS TO REALLY BELIEVE THAT WHAT WE SAY IS
TRUE,


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  THAT JOB OF PUBLIC EDUCATION IS ONE THAT THE MINNESOTA COALITION
IS COMMITTED TO, I WAS HAPPY TO LEARN, IT'S PRETTY CLEARLY SPELLED
OUT IN YOUR STATE-WIDE PLAN FOR NONSMOKING AND HEALTH,  I CAN TELL YOU
THAT IT'S A MAJOR ASSIGNMENT, BUT ONE THAT SIMPLY HAS TO BE DONE AND
DONE WELL,

   IF WE ARE SUCCESSFUL IN THIS "PHASE III," THEN I THINK WE'LL SOON
BE ENTERING WHAT I WOULD CALL "PHASE IV," THE ERA OF THE EDUCATED

CONSUMER,

  TO KNOW THE SCIENCE AND TO KNOW THE ETIQUETTE AND TO KNOW THE LAW
IS ALL VERY WELL AND ALL VERY NECESSARY, BUT THE CONSUMER CAN NEVER
BE REALLY EDUCATED ABOUT THE RISKS OF SMOKING, UNTIL HE OR SHE BECOMES
FAMILIAR WITH THE POWER, THE INFLUENCE, AND THE ECONOMICS OF THE
CIGARETTE INDUSTRY ITSELF,


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  LET ME MENTION IN PASSING TWO BOOKS THAT ARE HELPING TO SPEED
THIS EDUCATION PROCESS ALONG, A SMOKING GUN, BY ELIZABETH M, WHELAN,
WAS PUBLISHED JUST RECENTLY HERE IN THE UNITED STATES,

  A BOOK VERY MUCH LIKE MS, WHELAN'S WAS PUBLISHED IN GREAT
BRITAIN, IT'S CALLED SMOKE RING, BY PETER TAYLOR, I UNDERSTAND THAT
AN UPDATED PAPERBACK VERSION OF MR, TAYLOR'S BOOK WILL APPEAR IN THIS
COUNTRY LATER THIS YEAR, PETER TAYLOR, BY THE WAY, WAS RESPONSIBLE
FOR THAT MOMENTOUS DOCUMENTARY, "DEATH IN THE WEST,"

  BUT FOR A QUICK LESSON IN THE POWER OF THE CIGARETTE INDUSTRY IN
RELATION TO THE PRESS, LET ME RECOMMEND THAT YOU READ DRn KENNETH
WARNER'S "SPECIAL REPORT" IN THE FEBRUARY 7 ISSUE OF THE NEW ENGLAND
JOURNAL OF MEDICINE,


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  DR, WARNER SAYS THAT "AS A RESULT OF THE MEDIA'S FAILURE TO COVER
SMOKING AND HEALTH MORE THOROUGHLY, PEOPLE ARE SMOKING TODAY WHO WOULD
NOT HAVE BEEN,"  AND HE IS ABSOLUTELY RIGHT,

  WHY IS THIS SO? DR, WARNER SAYS, "CIGARETTES ARE THE MOST WIDELY
ADVERTISED CONSUMER PRODUCT IN AMERICA," AND THEY ARE, HE GOES ON TO
SAY THAT "THE THREAT OF LOSING ESSENTIAL ADVERTISING REVENUEmHAS
ENCOURAGED EDITORS AND PUBLISHERS TO AVOID COVERAGE OF SMOKING AND
HEALTH WHEN POSSIBLE AND TO 'TONE IT DOWN' WHEN NOT,"

  THE KIND OF REPORT THAT DR, WARNER HAS WRITTENmTHE KIND OF BOOK
THAT PETER TAYLOR HAS WRITTENmTHESE ARE THE TOOLS WITH WHICH THE
CONSUMER WILL BECOME MORE KNOWLEDGEABLE ABOUT THE POWER OF THE
CIGARETTE INDUSTRY AND WILL UNDERSTAND MUCH BETTER WHY THE CAMPAIGN
AGAINST CIGARETTE SMOKING IS LONG AND COSTLY AND FRUSTRATING -- EVEN
THOUGH THE PUBLIC IS WINNING,


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  ANYWAYwTHAT'S WHAT I SEE AS "PHASE IV" IN THIS LONG HISTORY OF
THE ANTI-SMOKING CAMPAIGN IN THIS COUNTRY,

BUT NOW I WANT TO PAUSE AND ASK YOU THE SAME QUESTION I ASKED

MYSELF A COUPLE OF YEARS AGO: WHAT DOES THIS STRING
HISTORY ADD UP TO?

OF ACTIVITY AND

TOWARD WHAT GOAL ARE WE MOVING?

  IS THE PUBLICATION OF EACH ANNUAL REPORT A CELEBRATION ALL TO
ITSELF?

  ARE THOSE ANTI-SMOKING LAWS ONLY THERE TO MAKE THE WORKPLACE A
LITTLE SAFER AND THE AIR A LITTLE SWEETER?


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  WE NEED A HIGHER PURPOSE THAN THAT, WE NEED TO ASK OURSELVES
WHAT OUR TRUE OBJECTIVE IS DOWN THE ROAD, TO THAT VERY IMPORTANT
QUESTION I'VE PROPOSED AN ANSWER, I BELIEVE OUR ULTIMATE GOAL SHOULD

BE I I 8

A SMOKE-FREE SOCIETY BY THE YEAR 2000,

WE HAVE THE SCIENTIFIC BASIS FOR SUCH A GOAL AND WE HAVE MORE THAN
ENOUGH PUBLIC UNDERSTANDING TO ACHIEVE IT,

  IN ADDITION, I SUSPECT THAT MANY OF OUR SOCIAL, POLITICAL, AND
ECONOMIC INSTITUTIONS ARE ALREADY MOVING TOWARD SUCH A GOAL, EVEN
THOUGH THEY MAY NOT YET HAVE EXPRESSED IT QUITE THAT WAY,  IT`S ALMOST
AS IF SOCIETY HAS SUSPECTED ALL ALONG THAT THE NUMBER ONE HEALTH GOAL
FOR THIS COUNTRY WAS TO BE SMOKE-FREE BY THE END OF THE CENTURY,


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  THEREFORE, ON MAY 20, 1984, I MADE THAT CALL FOR A SMOKE-FREE
SOCIETY BY THE YEAR 2000,  I DID IT IN MIAMI AT A JOINT MEETING OF THE
AMERICAN LUNG ASSOCIATION AND THE AMERICAN THORACIC SOCIETY,

  I SAID VERY CLEARLY AT THE TIME THAT I WASN'T PROPOSING A PUBLIC
HEALTH SERVICE INITIATIVE,mmTHIS WAS NOT GOING TO BE ANOTHER PET
PROJECT OF THE US, SURGEON GENERAL,

  INSTEAD, I RAISED THE IDEA AS A CALLwA CALL FROM THE SURGEON
GENERAL Tj THE PEOPLE OF THIS COUNTRY,

  SINCE THE 20TH OF MAY, THE IDEA HAS BEEN ECHOING ALL AROUND THE
COUNTRY, HOSPITAL STAFFS ARE DEMANDING THAT THEIR FACILITIES BE MADE
SMOKE-FREE, WORKING PEOPLE ARE ASKING FOR SMOKE-FREE ENVIRONMENTS
WHERE THEY WORK, PROFESSIONAL PEOPLE ARE HANGING THOSE "THANK YOU FOR
NOT SMOKING SIGNS" IN THEIR WAITING ROOMS, AND HOUSEHOLDERS ARE
TACKING UP THE SAME SIGN OVER THEIR FRONT DOORBELLS,


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  IT'S DEFINITELY AN IDEA WHOSE TIME HAS COME, AND I WOULD ADD
THAT SUCH IS THE CASE NOT ONLY HERE IN THE UNITED STATES, BUT
ELSEWHERE AS WELL, THE IDEA OF A SMOKE-FREE SOCIETY IS GETTING
SERIOUS CONSIDERATION IN ISRAEL AND GREAT BRITAIN, FOR EXAMPLE, I'VE
SINCE TRAVELED TO BOTH COUNTRIES TO HELP THEM LAUNCH THEIR OWN ANTI-
SMOKING CAMPAIGNS.

  THE SMOKE-FREE SOCIETY WILL COME CLOSER,,,IT WILL BECOME A
REALITY,

IT IS POSSIBLE TO DO,

I KNOW THIS COUNTRY CAN DO IT,

  AND I KNOW THAT YOU ARE THE PEOPLE WHO CAN AND WILL BRING IT
ABOUT,


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  IN CLOSING, LET ME REMIND YOU THAT, IF YOU SHOULD GET DISCOURAGED
ALONG THE WAY,, #PLEASE, amJUST REMEMBER WHAT THE STAKES ARE: 340,000
LIVES PREMATURELY LOST EACH YEARwA MEDICAL COST BURDEN OF $39
BILLION,,,AND THE INTEGRITY OF THE VERY AIR WE BREATHE,

  I APPRECIATE THE EFFORT THAT EACH OF YOU IS MAKING, PERSONALLY,
PROFESSIONALLY, AND AS A MEMBER OF THE MINNESOTA COALITION, I
APPRECIATE IT, YOUR COUNTRY APPRECIATES IT, AND EVERY SUCCEEDING
GENERATION OF AMERICANS GROWING UP IN A SMOKE-FREE SOCIETY WILL
APPRECIATE IT, TOO,

THANK YOU,

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