December 2000
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18 Reads
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8 Citations
The Journal of Primary Prevention
Several decades ago just before publication of the Surgeon General’s landmark report on the hazards of cigarette smoking, I was part of an ad-hoc group of public health specialists and applied behavioral scientists whom the Public Health Service called to Washington to consult on what the government might do to address the hazard of cigarette smoking in the United States. Out of these meetings the U.S. Government developed a very broad, multi-faceted, and not altogether coherent strategy for reducing the number of smokers in this country. At the time of those meetings, cigarette smoking was not only highly prevalent; it was also an accepted part of individual behavior in restaurants, bars, many forms of public transportation, work places, and public buildings. Cigarette smoking was ubiquitous in movies. Lighting and smoking cigarettes was part of every actor’s everyday stage craft. Today the United States is, by comparison with almost every other country in the world, an amazingly smoke-free environment. The vast majority of restaurants have sections reserved for nonsmokers; in some states smoking is altogether prohibited in restaurants, office buildings, and other public places. Cigarette manufacturers face law suits for damages brought by state governments. Smoking is banned in all domestic airlines. In many places, during their breaks, hard core smokers stand furtively outside the entrances of buildings to grab a puff and thus satisfy their insistent addiction. Yes, altogether too many American adults remain hooked on cigarettes and, although rates rise and fall year by year, an alarming percentage of young people persist in flirting with nicotine addiction. Nevertheless, the combination of public education, judicious warnings, limitations of advertising, efforts of citizen action groups, targeted legal restrictions, and law suits have resulted in a remarkable transformation of our society’s stance towards this major agent of disease.