HJAR Nov/Dec 2019

30 NOV / DEC 2019 I  HEALTHCARE JOURNAL OF ARKANSAS 1950s—1960s Tobacco regulations were a long time com- ing. Though tobacco smoking existed in the Americas well before the time of Colum- bus, it was not until the 1950s that several large-scale studies on the health effects of smoking were published. In fact, doctors frequently appeared in tobacco advertis- ing. The landscape changed dramatically in 1964, when a report by the U.S. surgeon general linked tobacco to lung cancer and other health problems. 1970s The following year, Congress required ciga- rette packages to bear a warning that smok- ing “may be hazardous to your health.” In 1970, Congress strengthened the warning to say the surgeon general “has determined that cigarette smoking is dangerous to your health,” and banned cigarette advertise- ments on American radio and television. The tobacco industry responded by trying COLUMN POLICY REGULATING VAPING: HISTORY REPEATS ITSELF, BUT FASTER As momentum builds for the regulation of electronic cigarettes, I think it is worthwhile to reflect on the history of tobacco regulation in our nation and our state. You could say that history is repeating itself−but in fast forward. to portray some of its products as less harm- ful. Phillip Morris led the way by beginning to market Marlboro Lights as “low-tar” in 1971. 1980s Congress changed the warning on cigarette packages again in 1984, requiring that ciga- rette makers rotate quarterly between four messages stating that smoking causes lung cancer, heart disease, emphysema, and pos- sibly pregnancy complications; that smok- ing by pregnant women may result in fe- tal injury, premature birth, and low birth weight; that cigarette smoke contains car- bon monoxide; and that quitting smoking greatly reduces serious health risks. 1990s In 1990, smoking was banned on all domes- tic U.S. commercial flights under six hours, in part as a result of flight attendants’ ad- vocacy against secondhand tobacco smoke exposure. The ban was later extended to flights of any duration. In 1992, Congress began to condition some federal funds on state adoption of a minimum legal age of 18 for purchasing tobacco products. Every state has adopted at least this minimum age, and some have set it higher. The tobacco industry generally prevailed in lawsuits seeking damages for the effects of smoking until the 1990s, when states banded together to sue tobacco companies to recover Medicaid costs and other health expenses related to smoking. By this time, a wealth of scientific evidence of the harmful- ness of smoking had been amassed, and the states were aided further by revelations that tobacco companies had long known of the damage caused by smoking, and had worked to suppress the evidence. In 1998, the major tobacco makers and 46 states signed on to the Master Settlement Agreement, which called for the industry to