Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Path: utzoo!decvax!decwrl!pyramid!prls!philabs!aecom!werner From: werner@aecom.UUCP Newsgroups: net.med,sci.med Subject: AMA and Smoking Policy (abbreviated version) Message-ID: <537@aecom.UUCP> Date: Sun, 26-Oct-86 22:45:39 EST Article-I.D.: aecom.537 Posted: Sun Oct 26 22:45:39 1986 Date-Received: Mon, 27-Oct-86 20:13:27 EST Distribution: na Organization: Albert Einstein Coll. of Med., NY Lines: 70 Keywords: abbreviated version Xref: decwrl net.med:5299 sci.med:91 <> [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."