Famous Dead Smokers

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A big part of the decision to start smoking has to do with how the smoker looks: cool, rebellious, tough. Some very famous people have been smokers, many of whom have died due to smoking-related illnesses. See if you recognize any of the famous smokers below, or the diseases that killed them:

Claim Smoking-related

Smoker

to Fame

illness

Louis Armstrong

Jazz musician

Heart attack

Lucille Ball

Actress, I Love Lucy

Aortic aneurysm

Humphrey Bogart

Actor, Casablanca

Cancer of esophagus

John Candy

Actor, Planes, Trains, and Automobiles

Heart attack

Walt Disney

Animator, Disney World

Lung cancer

F. Scott Fitzgerald

Writer, The Great Gatsby

Heart attack

Ian Fleming

Writer, James Bond novels

Heart attack

Sigmund Freud

Psychologist

Cancer of the jaw

George Harrison

Musician, The Beatles

Throat cancer

Bob Marley

Reggae musician

Lung cancer

Jackie Kennedy -Onassis

First Lady

non-Hodgkins Lymphoma

Babe Ruth

Baseball player

Naso-pharyngeal cancer

MAKING WISE CHOICES

Tobacco products are widely available and legally sold in grocery stores, 24-hour convenience markets, gas stations, and many other shops to anyone over the age of 18. But it is important to remember that they contain a drug that is highly addictive—nicotine. Nicotine can affect the way your body works now and how well it may function in the future.

In this book, you will read about teens making decisions about smoking. You will learn more about how nicotine affects the body. You will learn about the legal issues surrounding nicotine and how these laws have changed over the years. You will find out some surprising statistics about nicotine and learn more about the people most likely to smoke or use other nicotine products. Finally, you will learn what to do about nicotine addiction—how to prevent problems, how to ask for help if you want to quit, and what to do if you want to encourage a friend or family member to stop smoking. This information will help you make wise choices when you are dealing with nicotine.

Perhaps you have already tried cigarettes. Maybe you have a friend or family member who is a heavy smoker and whom you would like to help quit smoking. Through the stories of the teens in this book and the facts contained in each chapter, you will learn more about nicotine and begin to understand how it can affect you.

The History of Tobacco

The plant known as tobacco played a vital role in the earliest days of the New World, and the development of tobacco as an industry mirrors the civilization and, ultimately, industrialization of much of the Americas. Before a single European explorer set foot on the soil of the famed New World, tobacco was there. The plant flourished across much of the Americas, and tobacco crops could be found from Brazil to the St. Lawrence River.

Native American tribes cultivated tobacco and used it both in ceremonies and for their personal enjoyment. The tobacco plant's leaves were dried and then crumbled. In northern climates, tobacco was chewed or smoked in pipes; for Native Americans in North America, the so-called "peace pipe" was a sacred object. In tropical climates, tobacco leaves were more commonly wrapped together or wrapped around corn husks and smoked as a kind of cigar.

When Christopher Columbus and his crew arrived in the New World in 1492, landing in the territory we know today as the Bahamas, they encountered a native tribe who presented the strangers with gifts: beads, fruit, and some dried leaves. The beads and fruit were appreciated, but the dried leaves were quickly tossed away. Europeans did not yet recognize the value of those dried leaves of tobacco—but they would quickly learn.

Traveling westward, Columbus sailed to the island now called Cuba. Another team of explorers was sent ashore, who returned with reports of the natives inhaling the smoke of a native plant. The

Dead Leaves Given

European explorers of the New World were given tobacco leaves as gifts from Native Americans, who smoked tobacco both in religious ceremonies and recreationally. Tobacco use became a worldwide phenomenon soon afterwards.

pipe they used to inhale the smoke was shaped like the letter Y, and the Native Americans called it toboca or tobaga. Soon the crew was joining the natives in their custom. Smoking was unknown in Europe. Up to this time, smoke was used to cover unpleasant odors or used as incense in religious ceremonies.

Smoking for the sake of inhaling the smoke for pleasure was an unfamiliar concept.

Smoking would not remain an unfamiliar concept for long. Within 125 years, tobacco would spread around the world, carried back by explorers as one of the wonders they discovered in the New World. Tobacco traveled to Spain, Italy, and Portugal. Dutch and Portuguese sailors carried it with them to China, Japan, and the East Indies. Sir Walter Raleigh carried it back to England.

Tobacco spread to France in the mid 1500s, courtesy of the French ambassador to Portugal, a man named Jean Nicot. Nicot was impressed by Portuguese doctors who claimed that the tobacco plant had medicinal purposes, including the power to cure ulcers. He swiftly sent some seeds of the plant back to France, accompanied by his own letters proclaiming the wonder of this new "drug" that would soon bear his name— nicotine.

Tobacco soon became widely credited for all sorts of miraculous healing and curative powers, perhaps in part owing to the writings of Nicot and also to the traditions of the Native Americans. The natives had claimed that chewing or smoking tobacco protected them from the many illnesses that struck the European explorers who arrived on their shores. Tobacco was declared to be a useful disinfectant, a cure for the plague (an epidemic of infectious disease), a laxative, and a powerful gargle. It was even suggested that tobacco ashes had use as a teeth whitener! Tobacco smoke was declared to be a helpful mood elevator, as well as a memory improver.

PRIZED CROP OF THE COLONIES

The rapid spread of tobacco and the wildly exaggerated claims of its miraculous healing powers concerned many, among them King James I of England. He criticized the claims of tobacco's medicinal purposes and worried about its impact on his kingdom's health. He eventually wrote down his concerns in an essay published in 1604 under a pseudonym, a popularly circulated pamphlet titled A Counterblaste to Tobacco. The king soon took a further step to stop the spread of tobacco. He levied a heavy tax on imports of tobacco, intending to put an end to the smelly habit. But his tax had an unexpected result. Tobacco quickly became one of England's richest sources of income, both from the taxes he imposed and from the wealth pouring in from the English colony of Virginia's tobacco crop.

Initially, Virginia's tobacco crop was considered weaker and more bitter than the superior plants grown in the Spanish colonies of Mexico, Cuba, and the West Indies. Early in the seventeenth century, the Jamestown settlement was determined to convert the tobacco grown by the local Powhatan tribe into something that could challenge the successful Spanish product. One of the settlement's leaders, John Rolfe, earned his place in history by marrying the Powhatan princess Pocahontas, but he also played a critical role in transforming Virginia into one of the New World's wealthiest colonies. Rolfe obtained some tobacco seeds from one of the Spanish colonies (probably Trinidad) and blended them with the Powhatan seeds at Jamestown. The result was a darker, stronger tobacco leaf— one that soon proved to be as popular back in Europe as the Spanish export.

King James and the English rulers who followed quickly recognized that the tobacco crop growing in Virginia could provide almost unlimited wealth. The mission of the Virginia colony soon became narrowed to almost a single purpose: grow as much tobacco as possible. More and more Englishmen were encouraged to set sail for Virginia, to plant their own crops and ship them home. Soon, the American colonies were granted a monopoly on all tobacco shipped to England.

As the habit spread throughout England, the colonies ratcheted up their tobacco production. Tobacco became more than a crop and an export in the colonies — it became an alternate form of money. Workers were paid in tobacco, and goods could be bought with tobacco. Lacking enough workers to help tend the expanding tobacco fields, a new trade soon grew in the colonies—a trade in slaves from Africa.

It is interesting to see how tobacco shaped the history of America in these pre-Revolution days. Particularly in the southern colonies, where the climate was especially favorable to growing tobacco, farmers planted the leaf almost exclusively. Rules were passed dictating that tobacco could be shipped only to Britain, and only on British ships. The colonists were dependent on Britain and its merchants for revenue for their crop, as well as for other goods they needed. Soon their discontent began to spread, as they recognized that they were being forced to sell their crops at favorable prices to British traders, when they might obtain better prices at better terms from other sources.

The differences among settlements in the northern and southern American colonies were also affected by tobacco— differences that would spark a civil war in the nineteenth century. Tobacco plantations and farms required greater stretches of land, and so the settlements in the south were widely spread, with few heavily clustered groups of people. There were fewer large towns. Instead, the large privately held plantations, generally worked by slaves, resulted in a different mentality beginning to develop—a mentality that divided wealthy landowners from those who worked the soil for them. Democratic ideals were harder to find in a region where a handful of aristocratic landowners decided the fate of many who worked for them.

The goals that would shape the American Revolution were shaped by tobacco, too. Although we remember the democratic ideals and principles, economic concerns were what helped to motivate the colonists of Virginia and elsewhere to fight for freedom. Tobacco growers were tired of the heavy taxes England was imposing, and they worried about the debts many of them had incurred from the exploitation of English merchants. They knew they had a valuable crop; they wanted to be able to market it throughout the world.

Tobacco plants were a major cash crop in colonial America, where farmers, especially in the southern colonies, devoted a majority of their land to its cultivation. King James I passed laws and taxes that made American colonists dependent upon English merchants to make profits from their tobacco, which helped fuel the American Revolution.

A REVOLUTIONARY HABIT

The tobacco plant that played a critical role in the early colonization of America was for use in pipes and, later, inhaled by French aristocrats as snuff. Snuff was a kind of powdered tobacco that was pushed into the nose. Its use quickly spread in popularity until nearly every wealthy gentleman in the first half of the eighteenth century owned an elaborately crafted snuffbox. A ritual or ceremony evolved around the habit of taking snuff, but it was very much a symbol of the wealthiest aristocrats. In

France, snuff's association with the hated aristocrats meant that the habit would come to a swift end in the wake of the French Revolution.

Eventually, the snuff habit faded, but the use of tobacco did not. In the Spanish colonies of the Americas, a new way of smoking tobacco had quickly spread back to Spain and, by the early part of the nineteenth century, to France and then to Russia. The cured tobacco leaf was mixed with the sweepings of rolled cigars and then wrapped in a kind of miniature form with paper. The result was something the Spanish called the cigarito.

The cigarito was viewed as a kind of poor man's tobacco, made as it was from the leftovers of pipe tobacco and snuff. It was viewed as weaker than the cigar or pipe. Its popularity remained limited, and it wasn't until British soldiers who had fought in the Crimean War (1854-1856) returned from battle that the habit of smoking cigarettes began to spread throughout England. Theses soldiers had been exposed to cigarette smoking by French and Turkish soldiers. The quicker smoke and greater portability (capability of being carried) of cigarettes was much better suited to wartime than the more time-consuming preparation required by pipes or cigars.

A British tobacco merchant named Philip Morris was quick to capitalize on the new habit. His shop had built a trade on selling Cuban cigars and pipe tobacco from Virginia. But when soldiers returning from the Crimean War began to ask for cigarettes, he quickly recognized the new market and the new opportunity. His shop, located on fashionable Bond Street in London, marketed its cigarettes with the assurance that his cigarettes were made in clean factories using only the finest tobacco and paper, as well as a superior brand of cork tipping designed to keep the cigarette from sticking to the smoker's lips. He called his brands of cigarettes Oxford Blues and Cambridge Blues, later also adding the Oxford Oval brand.

Morris carried out an astute bit of marketing, designed to link his cigarettes to England's finest universities and target an exclusive, upper-class clientele. The ploy was extraordinarily successful. Suddenly cigarette smoking, which had previously been viewed as a dirty habit for the lower-class masses, was targeting the elite university students—the very group that would go on to assume positions of power in England's political and economic circles.

A DUKE'S TOBACCO

While Philip Morris was cultivating the cigarette market in England, tobacco was playing an important role on the other side of the Atlantic. The habit of smoking cigars spread in the mid-1800s, after the U.S. war with Mexico and the subsequent introduction of the stronger form of tobacco to American smokers. Tobacco actually helped to fund the Civil War; tobacco revenues helped to support the South, and tobacco taxes helped to fund the North's war efforts. But for most of the nineteenth century it was cigar smoking or pipe smoking that most Americans associated with tobacco. New York and Philadelphia manufactured large quantities of cigars, and millions of cigars were imported from Cuba.

As pioneers traveled westward, they took cigars with them. Huge cigars, some up to a foot long, moved across the frontier with settlers in their Conestoga wagons, earning them the label "stogies."

The cigarette remained a novelty in the United States, with its growth limited in part by the manufacturing challenges posed by rolling cigarettes. The industry still depended on hand laborers. Workers who were fast at rolling cigarettes could easily find employment, but even the fastest could manage little more than four cigarettes a minute.

It would take a former Confederate soldier named Washington Duke to propel cigarette smoking to a new level. After the war, Duke had returned to his family's farm in North Carolina and discovered that little of it remained, apart from a few tobacco plants. He shaped the family farm into a modest business supplying pipe tobacco and then took a look around for new opportunities. But others seemed to have cornered the market on the kind of "plug" tobacco used for chewing. Washington Duke's oldest son, James Buchanan Duke, had an idea. In England and in New York, a small number of people were smoking tobacco as cigarettes, and there was less competition for this tiny market. In 1881, a new brand of cigarette was introduced: the Duke of Durham brand.

Then, James Buchanan Duke took the family business one step farther. He had heard of a new machine being patented in Virginia—a machine that could make and roll cigarettes. There was little interest in the machine, called the Bonsack after its inventor, James Bonsack. Most tobacco manufacturers believed that their clientele preferred what they perceived as the higher quality of a hand-rolled cigarette.

Three years after the Duke of Durham cigarette was introduced into the market, James Buchanan Duke had transformed his factory into one using the new Bonsack machines to produce cigarettes. It was a gamble, but one that paid off. The machine sliced cigarettes from a massive tube of wrapped tobacco. It could produce an astounding 200 cigarettes a minute and make as many cigarettes in a day as 40 laborers rolling the cigarettes by hand. And it cost only 20 cents to make a cigarette, compared with the 80 cents it cost to produce a hand-rolled cigarette. The savings in production costs enabled the Duke company (known as W. Duke & Sons) to offer cigarettes at a significantly lower price.

W. Duke & Sons also had another revolutionary impact on the tobacco industry—they were the first American company to professionally market and promote their brands of cigarettes. Included in their packs of cigarettes were collectible items—photos of popular athletes and actors, for instance— and coupons that offered discounts or other rewards for bulk purchases of cigarettes.

Many women worked in cigarette factories like this one in Richmond, Virginia at the end of the 19th century, rolling cigarettes by hand. W. Duke & Sons revolutionized the tobacco industry when they started using the Bonsack, a machine that could do the work of 40 laborers.

By 1890, W. Duke & Sons had grown so profitable that it was able to buy out most American competitors, including the R.J. Reynolds Tobacco Company, and consolidate its empire under the impressive American Tobacco Company name. Some 13 British tobacco companies (not including Philip Morris, which instead formed its own American division), concerned that Duke would next begin to buy up their European market, united to form Imperial Tobacco. The two groups competed for several years, cutting prices and offering bonuses to retailers, until they ultimately united in 1902 to form the British American Tobacco Company.

This alliance would dominate the tobacco industry at the beginning of the twentieth century, but a new climate was growing in America under the leadership of President Theodore Roosevelt. As part of Roosevelt's antitrust campaign, dominating monopolies like Duke's tobacco empire were forced to reexamine their practices. (Antitrust laws protected businesses by placing restraints on large dominating businesses, called monopolies.) By 1911, Duke had been ordered by the U.S. Supreme Court to divest its empire, and divisions such as R.J. Reynolds, Ligett & Myers, and others were separated from the parent company.

BRANDING A CAMEL

Although the Duke family shaped the cigarette business, it was Richard Joshua (R.J.) Reynolds who would create the modern cigarette. Once R.J. Reynolds had been separated from the American Tobacco Company, its founder decided to ensure its continued success by focusing on the cigarette market in a new way. Reynolds did not like the kind of tobacco that was being used in cigarette manufacture, and he was concerned that tobacco smoking might be unhealthy. He decided to create a new mix—one based on a combination of pipe tobacco and a mix of American and Turkish tobacco leaves, with additional flavorings added. The result was a cigarette smoke that was noticeably different from other brands on the market, one that was richer than most American blends and lighter than those from Turkey.

With his new tobacco mix, Reynolds faced a market dominated by roughly 50 brands of cigarettes. Rather than use the tobacco in several different brands, Reynolds decided to do something truly revolutionary—his company would focus its efforts on only one brand of cigarette and push that one brand into market dominance.

Reynolds wanted a name for this brand that suggested something vaguely exotic. Turkish blends were considered to be the market leaders at the time, so Reynolds considered and discarded several different names that vaguely suggested the Middle East—names like Kismet and Nabob—before ultimately settling on the name Camel. His marketing campaign built excitement with advertisements announcing "The Camels are Coming." Within one year, Camels alone held 13 percent of the cigarette market, and by 1918—the year Reynolds died— the company he had founded controlled nearly 40 percent of the American cigarette business.

It was the efforts of Reynolds and Duke that ultimately transformed the cigarette business into the dominant, powerful tobacco industry that we know today.

THE SMOKE OF WAR

Cigarette smoking became a national habit as a result of World War I (the United States entered the war in 1917). Soldiers fighting in western Europe quickly became dependent on cigarettes. In fact, during the war the American general John Pershing sent a cable to the American War Department stating: "You ask me what we need to win this war. I answer tobacco as much as bullets."

In the aftermath of the war, a new market had been added for cigarettes: women. Suddenly, cigarette manufacturers began to target women with their marketing campaigns, and women were gradually seen smoking in public, giving cigarette smoking a new kind of social acceptability.

As the first half of the twentieth century unfolded, cigarette smoking was suddenly a national habit. Glamorous movie actors and actresses smoked in the most popular movies; advertisements featured singers and even doctors praising the "smoothness" of one particular brand of cigarette or another.

Still, a few voices critical of tobacco were beginning to be heard. In 1943, the Federal Trade Commission filed a complaint against the four largest cigarette makers, charging them with falsely claiming in their advertisements that their products were harmless. In 1950, a report was published in the Journal of the American Medical Association, indicating that in a study of 600 lung cancer patients, more than 96 percent of them had been smokers.

By 1953, doctors were beginning to suspect that there was

Lung Cancer Risk Increases

Non-smoker

Cigarettes Smoked Per Day

By the middle of the 20th century, doctors began to establish the link between smoking and an increased risk of developing cancer. According to this graph from the National Cancer Institute, a person who smokes 20 cigarettes per day is 10 times more likely to develop lung cancer than a nonsmoker.

an ingredient in cigarette smoke that could produce cancer. Links were beginning to be established between smoking and an increase in the death rate from cancer. There were also new data, published in 1954, which showed that more women were being diagnosed with lung cancer, most of whom had begun to smoke in the 1920s and 1930s.

These studies had an effect on the cigarette market. Sales began to decrease. In 1952,416 billion cigarettes were consumed;

less than two years later the number had fallen to 388 billion, and surveys showed that 40 percent of the public believed that smoking caused lung cancer.

TOBACCO INDUSTRY RESEARCH COMMITTEE

To combat the public perception that cigarette smoking was dangerous and to avoid a collapse of their businesses, a group of executives from the leading tobacco companies—Philip Morris, American Tobacco, Benson & Hedges, and the U.S. Tobacco Company—held a secret meeting in December 1953 at the Plaza Hotel in New York. They enlisted the services of a public relations firm and agreed to undertake their own campaign, this one attacking the findings of scientists and researchers who were publishing results suggesting a link between cancer and smoking.

This meeting would mark the beginning of what later legal findings would suggest was a conspiracy among executives of the tobacco industry. Their plan was to embark on a public relations campaign that would encourage smokers to continue to smoke, despite key research that was suggesting that smoking posed a significant health hazard. Their decisions centered around four key points:

• To produce brands with filters and brands with lower tar delivery (even though most studies had shown that there was no evidence that any brand of cigarette was less harmful than any other, the idea was to convince consumers that certain brands were "milder")

• To support scientific research that would either deny the earlier research linking cigarettes to cancer or that would, at the least, raise questions about such findings

• To produce a campaign designed to counter the claims of those opposed to smoking

• To diversify tobacco corporations to protect their assets against potential financial losses

New brands appeared on the market—brands with filters and king-sized cigarettes whose advertisements suggested that the longer cigarette length provided "natural filtration." By 1957, nearly 50 percent of all cigarettes sold in the United States were tipped with filters. One of the most popular was Kent, which proudly advertised its "micronite" filter—a filter made from a form of asbestos.

Congress called for hearings on cigarette advertising, and the findings revealed that cigarette advertisements suggesting that cigarettes containing less tar and nicotine were somehow "healthier" were clearly deceptive. By 1959, the Federal Trade Commission (FTC) issued a ruling that tobacco manufacturers could no longer include in their advertisements any statements about low or reduced tar or nicotine. This ruling was designed to eliminate any kind of health claims from cigarette advertising.

NEW WARNINGS

On January 11, 1964, the Surgeon General of the United States, Luther Terry, held a press conference. The 200 journalists in attendance were provided with copies of a 387-page report: Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. The report contained the results of a study of thousands of articles and years of research, concluding with the finding that cigarette smoking was clearly a cause of lung cancer in men, was probably a cause of lung cancer in women, and was the leading cause of chronic bronchitis.

At the time that the report was issued, 46 percent of all Americans smoked. More than half of all American men smoked, and one-third of American women smoked. And while the findings of the Surgeon General's report would prompt some people to give up smoking, the number of smokers soon bounced back.

The FTC was quick to act on the Surgeon General's report. Two potential labels were drafted for use on packs of cigarettes.

One read: "CAUTION —CIGARETTE SMOKING IS A HEALTH HAZARD. The Surgeon General's Advisory Committee has found that 'cigarette smoking contributes to mortality from specific diseases and to the overall death rate.'" The other was an abbreviated version: "CAUTION: Cigarette smoking is dangerous to health. It may cause death from cancer and other diseases."

Intensive lobbying by tobacco manufacturers followed the news of these preliminary plans for mandatory labeling. By the time Congress passed the Federal Cigarette Labeling and Advertising Act of 1965, the wording had been changed to the milder "Caution: Cigarette Smoking May Be Hazardous to Your Health."

The question of labeling was raised by Congress again in 1969, and this time a new focus was placed on advertising as well. The sleek cigarette ads were beginning to attract younger and younger smokers, and despite intensive lobbying by the industry, a new law was passed, this one requiring a slightly more strongly worded label: "Warning: The Surgeon General Has Determined That Cigarette Smoking is Dangerous to Your Health." And there was an even more significant ruling as part of this new legislation: as of January 1,1971, all cigarette advertising would be banned from radio and television.

Another 15 years would pass before Congress would again pass smoking legislation, but the balance was beginning to tilt toward those members of the public supporting an antismoking position. In 1969, Ralph Nader petitioned the Federal Aviation Administration (FAA) to ban the use of cigarettes, cigars, and pipes on all passenger flights, arguing that the smoke posed a health and fire hazard to all on board. By 1974, public sentiment was beginning to build for a modified version of Nader's plan: separate sections on planes for smokers and nonsmokers and a ban on smoking of pipes and cigars.

Only a few weeks after his petition to the FAA, Nader turned to the Interstate Commerce Commission with a

The "No Smoking" symbol and the antismoking legislation it accompanies are familiar to most citizens of the United States. However, antismoking laws are relatively new: the first warning labels were placed on cigarette packs in 1966; cigarette advertisments were banned from radio and television in 1971; and smoking on airplane flights of fewer than two hours was banned in 1987.

complaint about smoking on buses. Within two years, smokers had been confined to the rear 20 percent of interstate buses. Next came interstate rail routes. By 1973, there were separate smoking and nonsmoking rail cars, with approximately half of the train space being designated for smoking cars.

A POWERFUL INDUSTRY

Despite the success of antismoking advocates like Nader, the tobacco industry continued to successfully promote its products. States such as Minnesota, Utah, Nebraska, and Montana all passed laws in the 1970s regulating smoking in confined public places, but no similar federal legislation was passed, in part because no compelling scientific evidence had been published about the effects of secondhand smoke.

In fact, during the first three years after the ban on broadcast advertising went into effect, per capita sales of cigarettes to Americans actually increased. Money that would previously have been spent on broadcast advertising instead went into print media (magazines and newspapers) and outdoor advertising, as well as into increased merchandising and sponsorship of sporting events.

By 1978, a member of President Jimmy Carter's cabinet— Joseph Califano, the Secretary of Health, Education and Welfare—took a bold stand. On January 11, 1978, he announced

Keith last saw his grandfather at Thanksgiving dinner. His grandfather had been battling cancer for several months, and when the family gathered for the holiday meal, Keith was shocked at how thin and frail he had become. The older man didn't say much, and he ate very little. He seemed like a shadow. Keith's grandfather had been a heavy smoker, and his mother said that it was the smoking that had caused the cancer. Later that weekend when he and some friends met at the mall, Keith thought about how sick his grandfather had looked. As they lit up their cigarettes, Keith decided that he would stop smoking before he became too old. He didn't want to end up like his grandfather.

What Keith may not know is that warning labels on cigarette packs have only been around since 1966. The same information about the harmful effects of smoking that is readily available to Keith may not have been available to people in his grandfather's generation. Keith may also not realize how addictive nicotine can be—it may be much more difficult than he thinks to stop smoking.

the start of a major antismoking campaign, one that labeled cigarettes "Public Health Enemy No. 1." He called on schools to teach students about the health hazards of smoking; he called on the Civil Aeronautics Board to ban smoking on all commercial flights; he called on Congress to increase the federal excise tax on cigarettes; and he announced that smoking would be prohibited in his own agency except in specially designated areas. Moreover, he called on other federal offices to do the same.

The FTC next stepped up its own investigation of cigarette advertising, particularly focusing on the targeting of younger smokers. Documents obtained from the tobacco company Brown & Williamson contained the revelation that the company was actively targeting underage smokers by attempting to subtly link cigarettes to marijuana, beer, wine, and sex.

In 1979, Secretary Califano oversaw the release of a new Surgeon General's report, this one reinforcing the health hazards of smoking. The data showed that while the number of smokers had declined, the number of young people smoking had not, and that the number of women dying from lung cancer was steadily increasing. President Carter did little to support the findings of Secretary Califano. Ultimately, Califano was forced out of office.

In 1981, the FTC released the results of a new study showing that the warning label on cigarette packs was having little effect. Congress was ultimately persuaded to act, and the Comprehensive Smoking Education Act of 1984 was passed, requiring rotating warnings on cigarette packs — different messages that would periodically be replaced to inform the public more fully. The warnings stated that cigarette smoke contained carbon monoxide; that "Smoking by Pregnant Women May Result in Fetal Injury, Premature Birth and Low Birth Weight"; that "Smoking Causes Lung Cancer, Heart Disease, Emphysema and May Complicate Pregnancy"; and that "Quitting Smoking Now Greatly Reduces Serious Risks to Your Health."

The Comprehensive Smoking Education Act of 1984 was passed in response to results from studies that showed warning labels on cigarette packs were largely ignored. New, more specific messages were created, and would be rotated periodically to ensure that the public was fully informed of the risks related to smoking.

In the 1980s, new research was published, much of it supporting the claims that spouses of heavy smokers had a significantly elevated risk of contracting lung cancer than spouses of nonsmokers. A new Surgeon General—C. Everett Koop — issued a report in 1986 that outlined the health consequences of what was termed "involuntary smoking."

The next step came with the decision in late 1981 to form the Coalition on Smoking or Health—a Washington-based group funded by the nonprofit groups the American Cancer Society, the American Lung Association, and the American Heart Association—to move away from merely educating the public on the health hazards of smoking toward a more active approach of lobbying for antismoking legislation. The Coalition's aims were clear, including plans to implement the FTC proposal for larger warning labels with rotating messages on cigarettes and in advertising and to raise the federal excise tax on cigarettes (the tax had remained at 8 cents per pack for nearly 30 years).

The increased federal tax went into effect in 1983, but tobacco manufacturers were prepared. Loudly denouncing the planned tax increase as discriminating against the poor, the manufacturers quietly began to increase prices in August 1982, raising prices four times over a six-month period. When sales of cigarettes dropped approximately 4 percent in 1983, tobacco manufacturers were quick to blame the federal tax. But they were in fact enjoying high profits, thanks to their price increases (the price of a pack of cigarettes rose from 62 cents in 1980 to 96 cents four years later).

In 1984, legislation passed requiring tobacco manufacturers to provide the Office on Smoking and Health with a complete list of the additives they used in manufacturing cigarettes. The results were to be kept secret, to be used only by government researchers to determine whether or not the additives posed a danger. For 10 years, those ingredients would be quietly studied and the results kept locked away. And then, in 1994, under the administration of President Bill Clinton, the Food and Drug Administration (FDA) issued a report stating what researchers had known for some time: cigarette manufacturers appeared to be manipulating the nicotine level in their cigarettes, using additives to keep smokers addicted.

In the late 1980s, antismoking campaigns began to spread throughout the United States. States were soon restricting smoking on public transportation, in elevators, in schools, and in public office buildings.

LAWSUITS AGAINST TOBACCO COMPANIES

Tobacco companies found themselves being sued beginning in the 1950s, as research reporting the hazards of smoking began to be published. Most were single lawsuits, brought on behalf of a single client by a single lawyer. The tobacco industry was able to drag out the legal process and in nearly every instance outspend any other clients, forcing the lawsuits to be dropped in the face of outrageously expensive legal costs.

In the 1980s, the perception of smoking was quite different than it had been in the past decades. Laws had been passed restricting tobacco advertising on broadcast media, warning labels had been added, and some states and offices were restricting smoking. It was in this climate, in August of 1983, that a woman named Rose Cipollone filed a suit against the Ligett Group, Philip Morris, and Loews (the owner of Lorillard), claiming that the tobacco companies had failed to adequately warn her of the risks associated with smoking cigarettes and their addictiveness. Mrs. Cipollone died little more than a year later, and the suit was continued by her husband on her behalf. Ligett was held liable for negligence because it had failed to warn smokers of potential health hazards before 1966 (when warning labels were required on cigarette packs) and because its ads were misleading. The charges against Philip Morris and Loews were dismissed because Mrs. Cipollone had begun smoking their brands after 1966. The ruling required Ligett to pay Mr. Cipollone $400,000 but was overturned on appeal. The law firm representing the Cipollones, having spent some $5 million on the case, was ultimately forced to give up.

In October 1991, another case was brought, this one on behalf of Norma Broin, a flight attendant for American Airlines, and thousands of other nonsmoking flight attendants. The $5 billion class-action lawsuit charged that Brown & Williamson, Philip Morris, R.J. Reynolds, and Lorillard were guilty of fraud for withholding information about environmental tobacco smoke, resulting in many flight attendants contracting heart and lung diseases from their exposure to smoke in plane cabins. (A class-action lawsuit is brought by one or more plaintiffs on behalf of all people in the same

TOBACCO: A TIMELINE

1492

Christopher Columbus first encounters tobacco during his voyage to the New World.

1561

French ambassador Jean Nicot sends tobacco seeds to the French court.

1565

Sir Walter Raleigh persuades Queen Elizabeth I to try a pipe of tobacco.

1604

King James I of England writes A Counterblaste to Tobacco, criticizing claims of tobacco's medicinal uses.

1612

John Rolfe produces first successful commercial tobacco crop in Jamestown.

1619

Tobacco becomes the Virginia colony's chief export.

1665

In England, smoking is used as a protection against the plague.

1776

American Revolution is partially financed by the use of tobacco as collateral for loans.

1856

Soldiers returning from Crimean War introduce cigarettes in England.

1890

American Tobacco Company created by J.B. Duke.

1911

Duke forced to dismantle cigarette empire.

1913

R.J. Reynolds creates modern blended cigarette.

1917

Rations to World War I soldiers include cigarettes.

1964

First U.S. Surgeon General's report on smoking.

1966

First labels containing warnings placed on cigarette packs.

1971

Cigarette advertising banned from U.S. radio and television.

1973

Arizona passes first state law restricting smoking in public places.

1987

Congress bans smoking on flights of less than two hours.

1994

FDA announces plans to regulate nicotine as a drug.

1998

Tobacco industry reaches settlement worth $246 billion.

2000

Supreme Court rules FDA does not have authority to regulate tobacco.

predicament.) The tobacco companies ultimately agreed to a $349 million settlement.

In 1995, another class-action lawsuit was filed, this one was Castano et al. v. the American Tobacco Co. et al. The suit charged the tobacco industry with deceiving the public about nicotine's addictiveness. The Ligett Group agreed in March 1996 to a settlement, but the suit ended only two months later, when a federal appeals panel dismissed the case, agreeing that the potential number of plaintiffs (persons bringing suit, thought to be more than 90 million current and future smokers) to the suit made it impossible to manage.

In 1995, yet another tobacco case, Carter v. Brown & Williamson Tobacco Corp., used the company's own internal documents to clearly demonstrate that Brown & Williamson executives knew about the addictiveness of nicotine. The case was settled in favor of the plaintiff, Grady Carter, awarding him $750,000 in damages, with the jury determining that Brown & Williamson was negligent for not warning the public of the danger of their product. The ruling was overturned on appeal in 1997, but once more reinstated by the Florida Supreme Court in November 2000.

In May 1994, the first tobacco lawsuit was filed by a state rather than an individual smoker. Mississippi's attorney general claimed that his state had suffered financial harm by being forced to provide the financial resources to treat ill smokers. Only a few months later, the attorney general of Minnesota followed Mississippi's example, this time adding the Minnesota Blue Cross/Blue Shield as a joint plaintiff. West Virginia and Florida swiftly followed, and the tobacco companies eventually settled all four cases.

But the precedent had been set. By the end of 1996, 18 other states had filed similar suits, and negotiations had begun to unite all the state suits into a single settlement with the tobacco industry. The Master Settlement Agreement

(MSA) was presented to the public in June 1997, by which time a total of 41 states were included. The MSA, because it was to be a binding decision on behalf of all states and government agencies against the tobacco industry, required congressional action. The bill was introduced in November 1997 and supported by President Clinton. However, the tobacco industry responded with an intensive and expensive ad campaign and a similarly intensive and expensive campaign lobbying Congress. The bill was defeated in June 1998.

That same month, tobacco companies resumed negotiations designed to settle all pending state cases. A settlement was reached in November 1998. Its requirements include:

• Prohibition against targeting youth

• Banning the use of cartoon characters in tobacco marketing

• Making industry records and research accessible

• Restricting sponsorship by brand names

• Banning outdoor advertising

• Banning the prominent placement of tobacco products in stores

• Banning the sale of merchandise bearing tobacco brand names

• Setting the minimum pack size at 20 cigarettes

• Requiring corporate commitment to restrict youth access to cigarettes

In July 2000, another historic case was finally settled. Filed six years earlier, Howard A. Engle, M.D., et al. v. R.J. Reynolds Tobacco et al. was the first class-action suit against the tobacco industry to go to trial, the longest civil action in the history of tobacco litigation. It could result in the largest punitive-damages award in U.S. history. The plaintiffs, a group of Florida residents and their survivors who had suffered or died from medical problems caused by their addiction to cigarettes containing nicotine, were ultimately awarded $145 billion in damages.

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