Kicking butts: more than 50 years of progress

Cigarettes were in fashion long before we knew they could kill. Civil War soldiers rolled their own on the battlefields, movie stars puffed away in classic films, everyday Americans lit up at the breakfast table. But in the 1950s, news started to emerge about the health risks of smoking—and attitudes began to change. Here’s a look at 10 anti-smoking efforts since then that have helped save millions of lives.

The first Surgeon General’s report on smoking and health was published and it recognized the proven link between smoking and lung cancer. The report fueled newspaper headlines and TV news. It was later ranked among the top news stories of the year. But it wasn’t news to everyone: Eight years earlier, a Surgeon General’s scientific study group had established the link between excessive smoking and lung cancer.

Cigarettes started carrying a health warning that read, “Cigarette smoking may be hazardous to your health.” Over the years, different (and much more specific) warnings were issued, including: “Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy.”

Smoking sections were becoming common, but Minnesota wanted them everywhere. The Minnesota Clean Indoor Air Act, which took effect in 1975, was the first statewide law requiring separate smoking areas in public places. That same year, the Army and Navy stopped including cigarettes in rations for service members.

The U.S. Food and Drug Administration approved nicotine gum to help people quit smoking. Considered a medication, nicotine gum supplies the body with nicotine to reduce cravings. A specific chewing technique ensures the right dose gets absorbed into the bloodstream.

It’s hard to believe that as late as the 1980s, you could light up on an airplane! But passengers were free to smoke cigarettes on planes until 1988, when smoking was banned on U.S. flights less than two hours. In 1990, smoking was banned on all commercial U.S. flights.

In 1998, California was the first state in the nation to ban smoking in bars. It was also the first to have a statewide smoke-free air law, which bans smoking in most public, enclosed spaces. As of 2024, there are 28 states with smoke-free air laws. “If we look at recent years, I would say it’s harder and harder for smokers to lie to themselves that smoking isn’t harmful,” says Keith W. Roach, MD, FACP, associate professor of clinical medicine at Weill Medical College of Cornell University in New York City and an associate attending physician at New York-Presbyterian Hospital.

The Surgeon General releases a report that says the "debate is over" about secondhand smoke: It is absolutely harmful to health. “We now know that the earlier you’ve been exposed to secondhand smoke and the longer you’ve been exposed to secondhand smoke are clear correlations with increased risk of death,” says Dr. Roach.

It happened practically under the radar—“light” cigarettes couldn’t be called that anymore. New restrictions took effect that prohibited cigarette companies from using “light” and other misleading health descriptors. Marlboro Lights cigarettes, for instance, were renamed Marlboro Gold (for the color on the box).

E-cigarettes (or electronic cigarettes), also known as vapes, are battery-operated devices that release doses of vaporized nicotine along with scents and flavors—and a range of harmful chemicals. They were originally touted as a safer way to smoke, but experts have since discovered that they are likely just as dangerous as conventional tobacco products.

Several important reports came out in January 2014, coinciding with the 50th anniversary of the Surgeon General’s first report on smoking and health. A study in The Journal of the American Medical Association found that anti-smoking initiatives since 1964 have helped save some 8 million lives.

The CDC has tracked declines in smoking rates over the years. For example, smoking rates in the United States among adults have dropped from 20.9 percent in 2005 to 11.5 percent in 2021. Lung cancer rates have dropped significantly, as well.