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The 1964 report of the U.S. Surgeon General on Smoking and Health is widely recognized as one of the most important documents for public health in the second half of the 20th century. However, less widely appreciated is that there was another Surgeon General’s report, released 2 years before the report on smoking and health, focused on air pollution. Both air pollution and cigarette smoking, and their relationship with lung cancer, were receiving widespread media attention throughout the 1950s and 1960s. Both issues also generated public debate and political controversy, as well as influence from industry stakeholders. However, the Surgeon General and the Public Health Service had little authority to take action on either problem. The prevailing political view at the time was that health issues were primarily a matter for State and local governments, not for federal intervention. But as the evidence mounted and public alarm grew, these reports served as an impetus for new legislation and federal action to address both cigarette smoking and air pollution. The 1962 Surgeon General’s report on air pollution played a critical role in the development of legislation to establish the first U.S. national air pollution control program in the 1960s. While this paper focuses on the U.S. experience, similar discussions and development of regulations were occurring in other countries at the time as well, such as in the UK, and the debate sheds light on the challenges of translating science into public health action.

The other Surgeon General’s report: history of the U.S. public health response to air pollution, cigarette smoking, and lung cancer