IT IS TIME to demolish two commonly held myths about cigarette smoking.
Both have clouded this issue vital to Americans' health for too many years. And both continue to pollute the debate set off by publication of the surgeon general's latest devastating anti-smoking report.
One myth is that crusades of mere words -- like Joseph Califano's, to take the current example -- can't change smoking habits.
The other is that ending federal tobacco-growing supports, the bete noire of the anti-smokers, would help talt smoking.
In fact, words have had a mighty effect over the last 25 years. And ending aid to tobacco growers would probably increase, not decrease, smoking.
First, the matter of words or, if you will, anti-smoking propaganda.
After the recent anti-smoking report was issued, a Chicago Tribune headline, one typical of many commentaries, read: "Califano's Cigaret War Just a Puff." "Most political observers," explained a Tribune Washington correspondent, "believe that as long as the tobacco industry has friends in Congress and the White House, Califano's war will be as potent as a candy cane."
In the same vein, John Banzhaf, director of Action on Smoking and Health, spoke of "Califano's stillborn war on smoking," and Dr. Sidney Wolfe, Ralph Nader's health man, said, "The war against smoking is a sham."
Wolfe's main point, well taken as far as it goes, was that the war on smoking gets but a fraction of the money spent on wars on less harmful drugs. Other critics said: "If the government were serious, it would stop aiding tobacco farmers." "A third of all adults smoke, despite the so-called war against smoking." And "you just can't change human nature."
A Profound Change
BUT IF THERE has ever been a success for a sparely funded public policy -- a policy of mere words -- the anti-smoking campaign is it.
The first major compaign against smoking was started, actually, not by the government but by the American Cancer Society in 1954, after if found a strong link between cigarettes and disease in a nationwide survey of smokers and non-smokers. In 1957 Surgeon General Leroy Burney announced that the "weight of evidence" indicated that smoking caused lung cancer.
In 1964 Surgeon General Luther Terry, further pushed by the cancer society to examine all available facts, issued the historic surgeon general's report that led to a warning on every cigarette pack. In the early 1970s TV screens were alive with anti-smoking spots. Two years ago the zealous new secretary of health, education and welfare, Califano, relit the federal anti-smoking war.
What happened over these years? There have been some gains and some losses. In simple numbers, there are more smokers aged 17 and over today (54.1 million) than there were in 1965 (53.3 million). But in fact there has been a truly profound change in American cigarette habits.
In 1955 37 percent of all adults smoked. By 1965 the figure had become 42 percent, but the increase now was entirely among women. Some men had started to quit, and by 1978 the figure for all adults was only 33 percent, down more than a quarter from the 1965 high.
Among men, cigarette use peaked at 51 percent in 1955-57. In 1978 the figure was 37.5 percent. In 1955 fully 62 to 63 percent of all men aged 25 to 44 smoked; by 1975, only 44 to 47 percent of men 25 to 44 were still puffing away.
In 1955, only one woman in four smoked. But smoking among females, a product of the Jazz Age, World War II and continued postwar emancipation, was still rising -- to a peak of 33.3 percent by 1965 by federal survey (or 38 percent in 1972, according to Gallup).
Smoking then began to dip slightly smong adult women to a current 29.6 percent by federal survey (and 34 percent by Gallup's count).
At the same time, however, smoking among the young, and particularly among girls, has increased. Smoking among older boys may in fact have begun leveling off.
But among girls it has continued to rise. A survey of adolescents who smoke at least weekly found 2.9 percent of boys 12 to 14 in this class in 1968, 5.7 percent in 1970 but 4.2 percent in 1974. Among boys 15 to 16, 17 percent smoked in 1968, 19.5 percent in 1970 and 18 percent in 1974; among boys 17 to 18, 30 percent in 1968, 37 percent in 1970, 31 percent in 1974. Among girls 12 to 14, 0.6 percent smoked in 1968 but 4.9 percent by 1974; at 15 to 16, the percentage doubled, from 9.6 in 1968 to 20.2 in 1974; at 17 to 18, it rose from 18.6 in 1968 to 26 in 1974.
Among 12 to 18s who smoke, the number of heavy smokers also has increased sharply. In 1968, 45 percent of boy smokers and 39 percent of girl smokers used 10 or more cigarettes daily; by 1974, this had become 66 percent of boys and 56 percent of girls.
"Well!" say some of the critics, "if anit-smoking propaganda has been so successful among men, why has it had less effect among women and none among teen-age girls?"
The experts cannot reply with any scientific sureness. But it is obvious that the past few decades have seen two social movements that have dwarfed the modest anti-smoking effort: the rise of the youth culture and the emergence of male-like female behavior. We still see emergent, often rebellious teen-agers searching for rites of passage and defiance. And we see emergent, yet often highly insecure women. Both groups have reached for the cigarette as a sign of independence -- and the source of soothing chemical compounds that make tobacco so pertent a drug.
EVEN AMONG these groups, however, there has been one important change for the better. This is the change in the cigarette itself, a change again triggered by "mure" words, very much including the federal publication of tar and nicotine figures.
In 1954 less than 1 percent of all cigarettes were filter types; by 1964, filters had 64 percent of the market. In 1954 the average cigarette delivered 36 miligrams of tar and over 2 of nicotine. By 1977, the average tar per cigarette sold had dropped to around 17 miligrams, and nicotine to 1.1.
This trend was offset to an extent by the fact that those smokers who consumed more than one pack a day rose from 20 percent in 1955 to 25 percent in 1976. Though the percentage of smokers in the population has dropped, the number of cigarettes smoked per year rose 16 percent (from 529 billion to 615 billion) between 1965 and 1978. In short, cigarette smokers who smoke today are smoking more often.
Still, fewer men and women are inhaling deeply today, according to a recent survey. Fewer men, though more women, are smoking cigarettes as far down as possible.
Some of the flaver-adding ingredients of the "new," milder cigarette may be carcinogens that as yet remain unidentified. Still, the lung tissues of current smokers look strikingly cleaner to pathologists -- and contain far fewer abnormal and probably precancerous cells -- than smokers' lungs of the 1950s. Also -- by the latest figures, still not solid enough to put in the bank -- lung cancer incidence seems to be declining in younger men.
Finally, Americans' cigarette consumption last year dropped to 3,965 cigarettes per person 18 and older, compared with 4,336 cigarettes -- nearly 10 percent more -- in 1963. And the greatest declines have taken place during the periods of most intense anti-smoking publicity, including the recent HEW crusade.
The Support Paradox
WHAT OF the alleged role of federal price supports in spurring cigarette use? The facts argue otherwise.
The federal program, first of all, is actually not a "subsidy" but a loan program. Tobacco farmers, mainly small operators doing much hand labor, are given either acreage or poundage allotments -- in fact, limitations.If a farmer accepts his allotment, a federally supervised stabilization corporation guarantees him a fixed, and high, support price. If he cannot sell his crop at that price, the corporation buys his tobacco with funds borrowed from the government, and sells it later when the price is better.
In fiscal 1979 the government has lent out $277 million for these programs, and spent another $9 million on tobacco research, grading, market news and administration, according to Ron Henderson, the secretary of agriculture's marketing assistant.
"We have already received back $174 million on our fiscal 1979 loans," he says. "Except for one period -- 1955-56, when a decision was made to sell tobacco at a loss of $47 million -- the government has always made a profit on this program in recent years. It has also collected $180 million in interest since 1946."
The low interest rate, 7 1/2 percent, is subsidized to an extent by the taxpayer. But the effect of ending the federal program, says Henderson -- who is backed by federal and other economists -- "would without doubt be elimination of small farmers, because the price they get would drop. They would be replaced by large producers, producing just as much tobacco as they wanted. The net cost of raw material to cigarette manufacturers might drop in half. I have no doubt that the end result would be cheaper cigarettes."
The cigarette pack might be only a nickel or so cheaper. But cigarettes would be easier, not harder, to buy. Even Dr. Wolfe agrees: "Ending price supports wouldn't stop smoking."
Wolfe does believe price supports should be ended -- "because they are a symbol of the government's attitude" -- and that "farmers now growing a deadly crop should be aided to get into other lines of work."
Politically, the chance of that happening is zero today, and it probably should be zero in a free society where some people want to smoke.
The wisdom of some federal anti-smoking tactics may certainly be questioned. Califano, for all his ardor and effectiveness, has done more than any previous HEW secretary to make the battle a personal one. Other administrations left the job to the surgeon general, as a non-partisan spokesman for health alone, not for party or president.
Califano has almost forcibly kept the soft-spoken and reticent, yet medically solid Surgeon General Julius Richmond in the background. This has made headlines in the short run but may be tying the program's ultimate fate too much to Califano's own. The result may be a poor New Foundation for this cause.
The importance of the cause, however -- and the power of simple words to convey undeniable facts -- both seem plain.