Fifty Years Ago: I have a dream

Fifty years ago, Dr. Martin Luther King's 'I have a dream' speech was beginning to precipitate a major culture change in the US. However, ashtrays littered everywhere and seemed to be on every table and desk. Athletes and even Fred Flintstone endorsed cigarettes in TV commercials. Smoke hung in the air in restaurants, offices and airplane cabins as more than 42 per cent of adults in the US smoked, with a good chance your doctor was among them. 

The turning point came on Jan. 11, 1964. It was on that Saturday morning that U.S. Surgeon General Luther Terry released an emphatic and authoritative report that said smoking causes illness and death — and the government should do something about it.

In the decades that followed, warning labels were put on cigarette packs, cigarette commercials were banned, taxes were raised and new restrictions were placed on where people could light up. “It was the beginning,” said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.

It was not the end though as while the U.S. smoking rate has fallen by more than half to 18 per cent, that still translates to more than 43 million smokers. Smoking is still far and away the leading preventable cause of death in the U.S and in other countries like Nigeria, the story is not different.

Nevertheless, the Terry report has been called one of the most important documents in U.S. public health history, and on its 50th anniversary, officials are not only rolling out new anti-smoking campaigns but reflecting on what the nation did right that day.

It is noteworthy to state that although cigarette consumption dropped a whopping 15 per cent over the next three months after the 1964 report was published but then, it began to rebound as health officials realized it would take more than one report.

Thus, from 1965 to 1971, a number of policy changes came in place including the requirement for cigarette packs to carry warning labels, free air time for anti-smoking public service announcements on tv & radio stations and banning of cigarette commercials.

Still, progress was slow as smoking was the norm and many found it difficult to quit despite the known hazards. In the 70s, a movement was born to protect nonsmokers from cigarette fumes, with no-smoking sections on airplanes, in restaurants and in other places introduced. Those would give way to complete smoking bans as cigarette machines disappeared, cigarette taxes rose, and restrictions on the sale of cigarettes to minors got tougher.

With tobacco companies also coming under increasing legal attack, the biggest case of them all saw more than 40 states bring lawsuits demanding compensation for the costs of treating smoking-related illnesses. Big Tobacco settled in 1998 by agreeing to pay about $200 billion and curtail marketing of cigarettes to youths. In 1998, while the settlement was being completed, tobacco executives appeared before Congress and publicly acknowledged for the first time that their products can cause lung cancer and be addictive.

KEY EVENTS
Some key events in the US on the fight over tobacco during the last 50 years:

1964: U.S. surgeon general report concludes smoking causes lung cancer.
1965: Warning labels required on cigarette packs.
1971: TV and radio commercials for cigarettes banned.
1972: Airlines told to provide no-smoking sections.
1987: Aspen, Colo., becomes first U.S. city to ban smoking in restaurants.
1988: Smoking banned on short domestic airline flights.
1998: Forty-six states reach $206 billion settlement with cigarette makers.
2000: Smoking prohibited on international flights.
2009: Food and Drug Administration authorized to regulate tobacco products.
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The above snapshot tells us the journey of combating tobacco use in the US. Fifty years ago, Nigeria was four years into her independence and one year old as a republic. Black & White TV was few & far between as most homes relied on radio for receiving information and news. The Internet was non-existent. Telephones were a major luxury. There were no states only sub-regions and agric products was our main source of income as a nation.

As a country, we cannot afford to talk about another 50yrs before we begin to see significant changes made to how tobacco products are used. Infact, with our public health indices not good, the URGENCY to ACT and do so QUICKLY is right before us.

Examining examples from the US and a few other countries too, it is clear that until relevant laws and policies are put in place which is STRONGLY enforced across federal and state lines, little traction on making Nigeria smoke-free might be made.

The mantra 'Prevention is better than cure' remain the bedrock of all public health interventions and the onus is now on us as a nation to define in clear terms how our tobacco use story will evolve. 

As the national assembly resumes next week, there is need to support, advocate and bring more focus to its members in the senate and house of representatives what steps they MUST take by placing comprehensive tobacco use legislation for us to begin to see the emergence of a smoke-free country NOW!

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