It’s been 50 years since the Surgeon General warned of the health effects of tobacco use, essentially beginning an experiment in behavior modification on a massive scale — one that has had a remarkable impact but is still short of its ultimate objective.
A half-century of anti-smoking efforts has put the nation on track toward the only logical and desirable outcome — the eventual eradication of the practice. When the warning was issued, 44 percent of Americans smoked. Today, the number is around 18 percent. It is an impressive rate of reduction, and one that will continue because, from a public health standpoint, it’s hard to see how a percentage other than zero could be considered acceptable.
In 1964, smoking was viewed as having some redeeming qualities. It was fashionable, a statement of self-expression, and there were notions — mainly promoted by tobacco companies — that it provided some beneficial effects on mood, stamina and other things.
Today, the world knows better, and people no longer view the practice as something “cool.” Sure, there are those who light up as an act of defiance, a roguish expression of rugged individualism. But most people who smoke admit they do it simply because they are addicted. They do it furtively, alone or in small groups and outside of public gathering places where, with fewer and fewer exceptions, the practice is shunned.
In short, since the Surgeon General’s warning, smoking has been thoroughly stigmatized. Today, 70 percent of smokers say they would like to quit. Were they to, the overall percentage of use would drop below 10 percent, to a level that puts it close to a category of obsolescence.
That won’t happen soon, but it is likely to eventually. The war on tobacco is a war of attrition. Addictions are hard to break, and the tobacco industry spends more than $8 billion a year on promotion and positive messaging. There are those who would lament the loss of jobs and other impacts of a diminishing tobacco industry. But untold amounts of money and lives have been saved in the past five decades as fewer people have suffered the health detriments from a habit they either abandoned or never acquired.
And as we go forward, public health agencies are aiming their messages at kids who may be tempted to give smoking a try. That is precisely where money should be spent, at the point of prevention. As the nation has learned over the last 50 years, it’s easy to avoid starting a habit, while breaking one can take lots of time.
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