Of Mad Men, Crusaders and Cigarettes

A cigarette dangles from every hand in the chain-smoking advertising agency in the smash television drama Mad Men, a symbol of tobacco's grip on American lives in the 1960s and its role as a Madison Avenue cash cow. At the time, Joe Califano, the real-life government official who would later launch a controversial anti-smoking campaign, was himself a four-pack-a-day smoker working as then-President Lyndon B. Johnson's chief-of-staff in the intense White House cauldron. This week he received a prestigious health award for his professional career as a crusader against tobacco, alcohol abuse and illicit drugs.

Reached by telephone, Califano recalled that America's changing attitudes toward cigarettes began with the release of the first Surgeon General's report in 1964. The government's top health officials' definitive warning that "Cigarette smoking is causally related to lung cancer" was considered such a bombshell that the top-secret report was released to reporters on a Saturday morning in a locked State Department auditorium. 

The report put one of the first nails in the coffin of this deadly habit--one that was tacitly acknowledged in a recent Mad Men episode dubbed "Blowing Smoke" and is highlighted on Mad Men's own AMC blog. After losing the Lucky Strikes advertising account, Don Draper, the creative genius of a fictional ad agency, launched a bold--even cynical--counter-attack in a full page-ad in the New York Times.

In his fictional open letter, "Why I'm quitting tobacco," Draper wrote: "For 25 years, we devoted ourselves to peddling a product for which good work is irrelevant because people can't stop themselves from buying it. ... The product has never improved, it causes illness, and it makes people unhappy. But there was money in it. A lot of money. In fact, our entire business depended on it. We knew it wasn't good for us, but we couldn't stop." He went on to announce, "Here was my chance to be someone who could sleep at night because I know what I'm selling doesn't kill my customers. So as of today, Sterling, Cooper, Draper, Pryce will no longer take tobacco accounts."

If only it had been so. The reality, however, was that advertising agencies were not about to blow the whistle on cigarettes. They were too busy getting rich pushing cigarettes to the public, glamorizing their image in television and print ads with rugged cowboys and movie stars helping to sell them to Americans of all ages. In 1964, after the Surgeon General's report, tobacco companies agreed not to promote cigarettes to those under age 21 but have repeatedly been questioned about the reality of this pledge.

It was not until 1978 that Califano, using his Cabinet platform as Secretary of Health, Education, and Welfare, launched a controversial government-led health campaign to curb smoking, which he dubbed "slow-motion suicide." This week the Institute of Medicine bestowed its prestigious 2010 Lienhard Award on Califano for his career efforts to curb smoking and broader work in reducing addiction and substance abuse.

Califano acknowledged that back then he could never have imagined that the national anti-smoking effort that he and others championed would have so much impact in the decades to come: smoke-free airplanes, offices, hotels, restaurants and even bars in many parts of the United States have pushed smokers into an endangered minority. Today about 20 percent of American adults still smoke, down from about 42 percent in 1965.

"To be honest, I doubt if I ever foresaw this much progress," said Califano, the founder and chair of the National Center on Addiction and Substance Abuse (CASA) at Columbia University. "I used to say, 'I want a world in which instead of, Do you want a cigarette? people would ask, Do you mind if I smoke?'" said Califano. The growth of public smoking restrictions have so dramatically changed the cultural norms that "today smoking is simply not cool. It is not socially acceptable," he said.

Califano recalled the political firestorm that ignited following his January 11, 1978, announcement of a broad government campaign to educate the public about smoking's widespread health hazards. He also made his department's headquarters smoke-free--immediately--so when he came to work the next day "there were employees protesting in front of the building because they couldn't smoke in their offices" (he characteristically did not back down).

At the time I was a national health and science reporter for the now-defunct afternoon paper, The Washington Star. To my surprise, the 1978 anti-smoking announcement received a six-column headline across the top of the front page, "Califano Declares War on Smoking," above my two bylined stories, one on the antismoking campaign and the other on reaction, particularly from the powerful Tobacco Institute which represented the top cigarette manufacturers. (A cartoon by the Star's Pat Oliphant picked up on it: a school principal hovering over some elementary school kids sneaking a smoke barks, "No, I'm not going to tell your parents! I'm going to do worse than that--I'm going to turn you in to Joe Califano!")

Presented by

Cristine Russell is a senior fellow at Harvard Kennedy School of Government and the president of the Council for the Advancement of Science Writing.

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