AMA and Smoking Policy (abbreviated version)
wer...@aecom.uucp
[Edited version]
Editorial JAMA May 24, 1985; 253:3001-3.
In the AMA, Policy Follows Science:
A Case History of Tobacco
[Pro-cigarette text] -- ADVERTISEMENT, JAMA, Nov. 4, 1939; 113:37.
[Summary of decision making theory]
[Summary of AMA decision making]
[Notes on Scientific Journals
[Notes on Tobacco Use]
Thus, decades elapsed from
the first explosion of tobacco cigarette use around the time of World
War I before data appeared calling clear attention to the correlation
between tobacco use and diseases. Not until 1950 did Wynder and Graham
publish in JAMA a major article from a study of 684 proved cases strongly
implicating tobacco smoking as a possible etiologic factor in lung
cancer.
Beginning in 1934, the AMA accepted tobacco advertising in its
journals. In 1952, Ochsner and colleagues drove the nail in the coffin
(so to speak) with their article on bronchogenic carcinoma. Shortly
thereafter, the Board of Trustees of the AMA voted to discontinue
advertisements for tobacco and its allied products and also not to accept
liquor advertising, both to be effective Jan. 1, 1954. In 1958, JAMA
published the pivotal article by Hammond and Horn tying tobacco smoking
with many additional diseases.
Additional evidence mounted and in a policy enacted in June 1963,
the AMA House of Delegates recognized the deleterious effect of tobacco
as well as other toxic substances on human health. It suggested that
further research by done, at the same time urging physicians "to engage
more actively in intensive educational programs regarding smoking and
health, directed to the public in general and to youth in particular."
In June 1964, the House of Delegates removed all doubt and went on record
as recognizing " a significant relationship between cigarette smoking and
the incidence of lung cancer and certain other diseases, and that
cigarette smoking is a serious health hazard."(8)
From that time until today, 21 years later, the Public Health
Service, the AMA, and many other other individuals and groups have
labored long and hard to get people who currently smoke to stop and have
tried to prevent people who don't smoke from starting.
Actions of the House of Delegates in those 21 years have been
many, culminating in the June 1983 Annual Meeting, when Minnesota
Delegation Resolution 121 was adopted:
"Resolved, That the American Medical Association urge the medical
community, related groups, educational institutions, and
government agencies more effectively to demonstrate the
health hazards inherent in the use of tobacco products and
work towards promoting a smoke free society by the year 2000."
You can't be much stronger than that.
[Summary]
[Notes on addiction]
Tobacco kills every day in virtually all major cities in our
society, almost always legally. The only serious challenger to tobacco
as a premier destructive substance in ethyl alcohol. Who then is
responsible for the epidemic of bronchial carcinoma, pulmonary emphysema,
coronary artery disease, etc, tied to tobacco cigarette smoking?
Answering this question is easy becuase so many people share the blame.
Everyone from tobacco farmers, cigarette company stockholders, and
ashtray manufacturers to the publishers of newspapers and magazines that
carry tobacco advertising, the tennis players who play under the tobacco
banner, and everyone in between is culpable.
[Conclusion]
[References]
-- George D. Lundberg, MD
--
Craig Werner (MD/PhD '91)
!philabs!aecom!werner
(1935-14E Eastchester Rd., Bronx NY 10461, 212-931-2517)
"If you've heard this story before, don't stop me. I want to hear it again."