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Lessons Learned from Tobacco Control


As childhood obesity advocates look to protect the public from unhealthy food and beverage products and marketing, they should study how an early group of public health advocates took on another industry Goliath — and won.

A new study published in the American Journal of Public Health examines how news reports, legislative documents and the tobacco industry framed the harms of cigarettes between 1952 and 1965, the early days of the tobacco control movement.

Written by our friends at the Berkeley Media Studies Group and Public Health Advocacy Institute, the study finds that while news coverage focused on the dangers of tobacco use, there was little talk about the tobacco industry’s role in addressing the problem. For its part, the tobacco industry focused on denying the negative health impacts of its products.

What is noticeable about these findings, the authors note, is that there was little rhetoric around the issue of personal responsibility. While both big tobacco in the 1980s and the food and beverage industry today use personal responsibility to deflect criticism that many of their products are harmful, talk about tobacco in the 1950s and 1960s centered almost entirely on the health dangers of cigarettes.

“We were surprised to find little mention of personal responsibility, even from the public comments of tobacco industry spokespeople,” the authors write. “At the time, it was enough to note that the product itself was harmful to warrant government action, or at least a robust public discussion about it.”

The 1964 Surgeon General’s Report on Smoking and Health marked a turning point for the tobacco movement, cementing that tobacco use caused lung cancer and other deadly ailments. That led the public to widely support government efforts to act to address these dangers.

But it was a different time, as the authors note. During the Kennedy and Johnson administrations, 68 percent of Americans said they “trust government to do the right thing,” according to the report. In President Obama’s first term, just 22 percent of Americans said they trusted the government.

“Profound distrust of the government has made it harder for public health advocates to make the case for protections from harmful products,” said Lori Dorfman, the study’s lead author and director of BMSG. “In the ‘60s, a belief in government’s duty to act to protect public health was the norm.”

Although today’s obesity advocates are facing a challenging political climate, lessons learned from the tobacco fight are still relevant today. Advocates first led the effort to prove tobacco was dangerous, which led the government to require warning labels on tobacco products. In doing so, the personal responsibility argument came into play, as the industry could argue customers knew about the dangers of tobacco products.

But advocates kept at it, and were able to show that the tobacco industry’s “harmful corporate behavior” made it necessary for the government to intervene.

“Tobacco control advocates, over time, were able to shift the focus from the product to the industry that manufactures and markets it, and to the government’s role in protecting the public’s health,” the authors write. “Nutrition advocates may be able to do the same with sugary, salty, high-fat foods that are linked to morbidity and mortality.”

Of course, there are some differences between tobacco and obesity, including the fact that today’s advocates are working in an era of extreme government distrust. And unlike tobacco, food is necessary for life. In addition, eating unhealthy food in small amounts isn’t as bad as consuming tobacco, which has no safe use.

But given that marketing practices for unhealthy foods and drinks are coming under increased scrutiny, and the fact that poor diets are widely believed to be the cause of many serious chronic health conditions, the study’s authors suggest nutrition advocates will be able to follow in the footsteps of their tobacco control forbearers.

“We now take for granted how effective tobacco taxes and indoor smoking bans are,” says study author and Public Health Advocacy Institute Director Mark Gottlieb. “But moving tobacco control efforts from smoking cessation to industry regulation happened over the long haul.”

Click here to read the full report, titled Cigarettes Become a Dangerous Product: Tobacco in the Rearview Mirror, 1952-1965.