Questions 196–203 are based on the following passage.
The following passage is an excerpt from a recent introduction to the
momentous1964 Report on Smoking and Healthissued by the United
States Surgeon General. It discusses the inspiration behind the report and
the report’s effect on public attitudes toward smoking.
No single issue has preoccupied the Surgeons General of the past four
decades more than smoking. The reports of the Surgeon General have
alerted the nation to the health risk of smoking, and have transformed
the issue from one of individual and consumer choice, to one of epi-
demiology, public health, and risk for smokers and non-smokers alike.
Debate over the hazards and benefits of smoking has divided physi-
cians, scientists, governments, smokers, and non-smokers since
Tobacco nicotianawas first imported to Europe from its native soil in the
Americas in the sixteenth century. A dramatic increase in cigarette
smoking in the United States in the twentieth century called forth
anti-smoking movements. Reformers, hygienists, and public health
officials argued that smoking brought about general malaise, physio-
logical malfunction, and a decline in mental and physical efficiency.
Evidence of the ill effects of smoking accumulated during the 1930s,
1940s, and 1950s.
Epidemiologists used statistics and large-scale, long-term, case-
control surveys to link the increase in lung cancer mortality to smok-
ing. Pathologists and laboratory scientists confirmed the statistical
relationship of smoking to lung cancer as well as to other serious dis-
eases, such as bronchitis, emphysema, and coronary heart disease.
Smoking, these studies suggested, and not air pollution, asbestos con-
tamination, or radioactive materials, was the chief cause of the epi-
demic rise of lung cancer in the twentieth century. On June 12, 1957,
Surgeon General Leroy E. Burney declared it the official position of
the U.S. Public Health Service that the evidence pointed to a causal
relationship between smoking and lung cancer.
The impulse for an official report on smoking and health, however,
came from an alliance of prominent private health organizations. In
June 1961, the American Cancer Society, the American Heart Asso-
ciation, the National Tuberculosis Association, and the American Pub-
lic Health Association addressed a letter to President John F. Kennedy,
in which they called for a national commission on smoking, dedicated
to “seeking a solution to this health problem that would interfere least
with the freedom of industry or the happiness of individuals.” The
Kennedy administration responded the following year, after prompt-
ing from a widely circulated critical study on cigarette smoking by the(1)
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