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Remarks of Dr. Howard K. Koh, Assistant Secretary for Health at the U.S. Department of Health and Human Services, on the 50th anniversary of the 1964 Surgeon General’s Report on Smoking and Health

January 17, 2014

Welcome everyone to this very special occasion at the White House.

This day is a historic moment for reflection, recognition and resolve. First, we recognize the national leaders, many who are here in this room, who have passionately advanced tobacco control to make our country healthier. We have so many examples of your dedication: academic experts who have propelled the science, heads of voluntary organizations and community coalitions who have served as crucial leaders for change, and legal experts who have challenged the tobacco industry in the courts. Today, we begin by recognizing these visionaries. Because of you, tremendous progress has been made. Thank you.

But 50 years after the landmark Surgeon General’s Report, the tobacco epidemic still rages on—in every community and in every corner of our country. Far too many are still becoming hooked and dying well before their time. Millions continue to suffer preventable suffering and die preventable death. Lung cancer should be an uncommon illness, yet still remains the leading cause of cancer death. And projections are that the typical smoker loses at least a decade of precious life.

So 50 years later, tobacco addiction remains a public health catastrophe. To summarize, our good health is a precious and fragile gift—and tobacco takes that gift away.

This is not an accident. These deaths do not occur just by chance. Each year, the tobacco industry spends $8 billion—nearly a million dollars an hour—to advertise and market cigarettes and smokeless tobacco, thereby outspending current state tobacco control programs by a factor of 18 to 1. Each year, the tobacco industry recruits customers to consume over 14 billion packs of cigarettes, with each cigarette now understood to be a finely engineered—and exquisitely designed—nicotine delivery device. And each year the tobacco industry adds to an ever-growing array of novel products, like flavored small cigars, that have special appeal to young people.

For too long, these efforts have succeeded in creating a society where tobacco use is the social norm, thereby leading to devastating consequences. As a result, for each adult dying from tobacco, two younger replacement smokers have been recruited to take their place.  And in this tragic way, the cycle of dependence and despair continues for yet another generation. This is unacceptable and intolerable, especially since the burden of tobacco now falls disproportionately on some of our most vulnerable, such as persons of lower socioeconomic status, sexual minorities, and those living with mental illness and substance use disorders.

As a nation, we should not be forced to accept the unacceptable and tolerate the intolerable. Today our nation is at a crossroads. How will we address the tobacco epidemic for the future? Our collective answer must be that we renew our resolve and redouble our efforts for prevention. One of our biggest societal challenges now is the misperception that somehow this epidemic has already been solved, when nothing could be further from the truth. We cannot somehow assume that this battle has been won, when our toughest challenges still lay ahead.  

It is time to commit to ending the tobacco epidemic once and for all. And it shouldn’t take another 50 years. We have, at our fingertips, many tools to solve this epidemic. We know what works. In 2010, the U.S. Department of Health and Human Services released its first-ever strategic plan for tobacco control. This Action Plan provides the critical framework to rejuvenate and reinvigorate national efforts to end the epidemic. Now, today’s Surgeon General’s Report underscores the essential commitments initially outlined in that Action Plan. They include:

    • High-impact mass media campaigns and increased efforts to prevent kids from being bombarded by images of smoking in the movies
    • Fully-funded comprehensive statewide tobacco control programs at CDC-recommended levels
    • Higher prices on cigarettes and other tobacco products that will drive down consumption
    • Complete protection of our entire country—not just half the population—through smoke-free indoor air policies
    • Effective implementation of FDA’s tobacco product regulation authorities  
    • Full access to cessation counseling and FDA-approved medication for smokers

And this list is just a start. Most important of all, we need committed leadership through every sector of society—leadership that will reject the status quo as acceptable and move our nation to a healthier future. It is time to reclaim the social norm as one that is tobacco-free and bring health, not disease, to future generations. We will only be successful if everyone commits to ending the suffering and making this epidemic a thing of the past.

It our hope that with a renewed sense of urgency—starting today—we can someday relegate the tobacco epidemic to the history books, just as we have done with smallpox. Let’s commit to ending this epidemic once and for all, and give our kids a fighting chance for a healthy future. Thank you very much.