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50 years after Surgeon General's warning, smoke still clearing

| Friday, Jan. 17, 2014, 12:48 p.m.
Stephanie Strasburg | Tribune-Review
Vance Borio, 46, of Allentown, lights up a cigarette at Jack's Bar in the South Side on Friday, Jan. 17, 2014. 'I do feel discriminated against, but I abide by the law,' said Borio, of being a smoker in 2014. 'You get looked at differently.' At 46, Borio isn't planning on changing his habits. 'I like to go have a beer and a cigarette… I remember going to Three Rivers Stadium and you could smoke in the park,' he said.

For years, Kevin Joyce staunchly defended the right of people to smoke in Pennsylvania's restaurants and bars.

Since reading about increased heart, lung and other health problems of workers in smoke-filled Las Vegas casinos, the former head of the Pennsylvania Restaurant and Lodging Association has changed his mind.

Joyce began lobbying for a smoking ban in restaurants and bars, which partly came to fruition in 2006.

“It was a complete reversal, but sometimes you have to change,” said Joyce, an ex-smoker who owns the Carlton Restaurant, Downtown. “No one likes the government butting into your business, but we had to protect our employees.”

The government first told Americans to quit smoking 50 years ago on Friday, with a landmark report by Surgeon General Luther Terry that warned cigarettes cause lung cancer.

At the time, about 43 percent of adults smoked. Today about 18 percent do, according to the Department of Health and Human Services, which released a report on Friday on the progress made since the surgeon general's first warning.

“There is no good reason to be smoking,” said Dr. Nancy E. Davidson, director of the University of Pittsburgh Cancer Institute and UPMC Cancer Center and a report co-author. She noted that cigarette smoking accounts for at least 30 percent of all cancer deaths and a long list of other problems.

The United States remains home to 42 million smokers.

“I feel it's my right to smoke,” said Vance Borio, 46, of Allentown, over a cigarette and a beer in Jack's Bar in the South Side. “I'm turning 47 this year, (so) I'm not going to change my habits. I'm not going to quit smoking. It's the way I am.”

Borio said public opinion has changed dramatically since the days when people smoked in restaurants, airplanes and workplaces and some of pop culture's biggest icons were chain smokers, such as Humphrey Bogart and Steubenville's Dean Martin, both of whom died of cancer.

“You get looked at differently,” Borio said. “I feel discriminated against.”

More than 20 million Americans died of smoking-related illnesses in the past 50 years. The report estimates Luther's warning helped prevent 8 million early deaths from smoking.

Aside from the sharp decline in smoking rates, those who continue to smoke are lighting up less frequently. But the threat posed by cigarettes has grown, the report said.

“Smokers today have a greater risk of developing lung cancer than they did when the first surgeon general's report was released in 1964, even though they smoke fewer cigarettes,” said Acting Surgeon General Boris Lushniak.

“How cigarettes are made and the chemicals they contain have changed over the years, and some of those changes may be a factor in higher lung cancer risks,” Lushniak said.

While lung cancer was identified as the threat 50 years ago, today's list of risks includes diabetes, colorectal and liver cancers, rheumatoid arthritis, erectile dysfunction, age-related macular degeneration and other conditions that threaten nearly all of the body's organs, the report said.

The report calls for increased tobacco control efforts. Unless smoking rates drop, the report predicts about 5.6 million children alive today — or one out of 13 — will die prematurely from smoking-related illnesses.

Some important anti-smoking efforts are taking place in Pittsburgh.

In a program started in March at UPMC's Presbyterian and Montefiore hospitals in Oakland, every patient is asked whether they smoke. Those who do are asked if they would meet for at least five minutes with one of the health system's three tobacco treatment counselors.

Less than 5 percent of smokers turn down the offer, said Hilary A. Tindle, an assistant professor of medicine at the University of Pittsburgh who specializes in smoking cessation. About 3,300 patients have been counseled, said Dr. Tindle, a co-author of the Health and Human Services report.

“You can do a lot in five minutes,” Tindle said, adding counselors explain how smoking can make patients more susceptible to pneumonia or impair bone and wound healing and inform patients about smoking medications that can help double “quit rates.”

UPMC, which employs more than 55,000 people, plans to impose a ban on employees smoking during their shifts starting in July, Tindle said. Workers caught smoking will be reprimanded, and repeat violators could be fired, she said.

“We have to keep our foot on the gas pedal,” said Karen Hacker, Allegheny County health director. “The thing about public health is that when things get better, people are inclined to ease up, and important funding can go elsewhere.”

Tom Fontaine is a staff writer for Trib Total Media. He can be reached at 412-320-7847 or

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