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Ending the Tobacco Problem: A Blueprint for the Nation (2007)
Board on Population Health and Public Health Practice (BPH)

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. "3 Containing the Tobacco Problem." Ending the Tobacco Problem: A Blueprint for the Nation. Washington, DC: The National Academies Press, 2007.

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Ending the Tobacco Problem: A Blueprint for the Nation

tobacco problem. A notable early development came in 1966 when John F. Banzhaf successfully petitioned the Federal Communications Commission (FCC) to invoke the Fairness Doctrine and mandate reply time on television and radio for the cigarette commercials glamorizing smoking. This action ultimately led to an FCC requirement, beginning in 1967, that stations run one free counter advertisement from health groups for every three cigarette commercials that they aired. The American Cancer Society, working with top advertising agencies that donated their time, took the lead in producing graphic and compelling counter advertisements. Banzhaf went on to form Action on Smoking and Health, a national antismoking consumer organization that was reported to have 60,000 members by 1979 (Kluger 1996).

Congressional initiatives gave some support to the public education efforts, giving what seemed to be at least a symbolic win to the nascent tobacco control movement. Within a year of the publication of the Surgeon General’s report, the U.S. Congress passed the Cigarette Labeling and Advertising Act of 1965, which required cigarettes packages to contain the message “Warning: Cigarette Smoking May Be Hazardous To Your Health” (CDC 2005).

As additional scientific evidence documenting the dangers of smoking continued to emerge, the 1969 Public Health Cigarette Smoking Act upgraded the warning to read “Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous To Your Health” (CDC 2005). The law also banned all cigarette advertising on television and radio, effective January 1, 1971 (Borio 1993).

By 1981 a Federal Trade Commission (FTC) staff report had concluded that the health warning on packages was “worn out” and was having little impact on public knowledge and attitudes about smoking. The warning was too abstract and difficult to remember, and it was not seen as personally relevant (Hinds 1982). Congress responded with the Comprehensive Smoking Education Act of 1984, which required the use of four, more specific, labels on cigarette packages and cigarette advertisements that would be rotated on a regular basis (CDC 2005).

The new warnings reflected the steady flow of research findings tying smoking to increasing numbers of serious conditions. By the time that the 1989 Surgeon General’s report was released, the list of conditions that scientific studies had linked to smoking included various cancers—including lung, laryngeal, oral, and esophageal cancers—as well as pulmonary disease, heart disease, and fetal growth retardation. This growing body of research helped power the tobacco control movement.

The Tobacco Industry’s Response

Even as public health forces were coalescing and making policy inroads, the tobacco industry was fully engaged as a formidable opponent. Tobacco

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110
Front Matter (R1-R16)
Summary (1-28)
Introduction (29-38)
PART I BACKGROUND, 1 Epidemiology of Tobacco Use: History and Current Trends (39-76)
2 Factors Perpetuating the Tobacco Problem (77-106)
3 Containing the Tobacco Problem (107-142)
PART II A BLUEPRINT FOR REDUCING TOBACCO USE, 4 Reducing Tobacco Use: A Policy Framework (143-156)
5 Strengthening Traditional Tobacco Control Measures (157-270)
6 Changing the Regulatory Landscape (271-340)
7 New Frontiers of Tobacco Control (341-354)
Index (355-372)
Appendix A Comprehensive Smoking Cessation Policy for All Smokers: Systems Integration to Save Lives and Money (373-422)
Appendix B Clean Air Laws (423-434)
Appendix C Warning Labels and Packaging (435-448)
Appendix D The Long-Term Promise of Effective School-Based Smoking Prevention Programs (449-477)
Appendix E Adolescents' and Young Adults' Perceptions of Tobacco Use: A Review and Critique of the Current Literature (478-494)
Appendix F Interventions for Children and Youth in the Health Care Setting (495-502)
Appendix G Reducing and Preventing Tobacco Use Among Pregnant Women, Parents, and Families (503-515)
Appendix H Smoking in the Movies: Its Impact on Youth and Youth Smoking (516-551)
Appendix I State Statutes Governing Direct Shipment of Alcoholic Beverages to Consumers: Precedents for Regulating Tobacco Retail Shipments (552-577)
Appendix J The Role of Public Policies in Reducing Smoking Prevalence: Results from the SimSmoke Tobacco Policy Simulation Model (578-598)
Appendix K Commissioned Simulation Modeling of Smoking Prevalence as an Outcome of Selected Tobacco Control Measures (599-640)
Appendix L Controlling the Retail Sales Environment: Access, Advertising, and Promotional Activities (641-652)
Appendix M Sales and Marketing of Cigarettes on the Internet: Emerging Threats to Tobacco Control and Promising Policy Solutions (653-678)
Appendix N Media Campaigns and Tobacco Control (679-689)
Appendix O Advocacy as a Tobacco Control Strategy (690-703)
Appendix P Special Populations with Higher Rates of Cigarette Smoking: Identification and Implications for Tobacco Control (704-716)