Acting Surgeon General Confident in
the Battle Against Tobacco, Ebola,
and Preventable Diseases
RADM Boris D. Lushniak, a career PHS officer, is committed to using the office
to take on major domestic and global health care challenges.
Not many health care leaders can transition smoothly from discussing the importance of walking 30 minutes per day
to the need to send PHS officers to
help control the Ebola epidemic in
West Africa. The Surgeon General
has to. As the most prominent public health official, the Surgeon General must offer a reassuring voice on
health care issues big and small. With
over 26 years at the PHS, Rear Admiral (RADM) Boris D. Lushniak, MD,
MPH, is well equipped to handle the
A year after assuming the role and
just before delivering a plenary address at the 2014 AMSUS meeting,
RADM Lushniak agreed to a wide-ranging conversation with Federal
Practitioner (for more on the AMSUS
meeting, see page 43). The following is condensed and edited, but the
complete interview can be found at
The 50th anniversary of the Surgeon
General’s report on smoking
RADM Boris D. Lushniak, Acting
Surgeon General. Go back to Janu-
ary 1964 and realize what a different
world we lived in back then. In fact,
that report, which came out after a
year and a half of scientific delibera-
tions, of looking at facts, of searching
through the literature, came up with
a very important conclusion. That
conclusion, simply put was: Smoking
is bad for you.
Now it really was a landmark report from that perspective, but when
we look back 50 years, what did it
prove? It proved that cigarette smoking was directly associated with only
1 cancer at that point, specifically
lung cancer in men. The report had
a very simple but beautiful conclusion. It said that cigarette smoking is
a health hazard of significant importance in the U.S. to warrant appropriate remedial action....
A half-century later, the social
norms of our society have changed.
We don’t have ashtrays all around.
We don’t smoke on airplanes anymore. We oftentimes can’t smoke in
bars and restaurants and establishments like that. We’ve moved from
43% of our population that smoked
in 1964 to 18% currently.
We’ve had 32 Surgeons’ General reports since that first one....We
brought up the issue of secondhand
smoke 25 years ago. We talked about
the successes and failures over these
years, but 50 years later smoking remains a major public health problem
in this country....
When we look to the future,
what’s the goal? Well we really want
to get to a zero point. We reannounced with the 50th anniversary
report, which was released in January
2014, that this is an endgame strategy. At some point we have to realize that it’s not good enough to get
down to 18% because of the health
impact. Cigarettes and tobacco use in
this country bring no good; no good
to the individual, no good to the individual who has to deal with secondhand smoke, and no good for the
future of our nation. So we’re really
talking about an endgame strategy....
Our 50th anniversary report
wasn’t just looking backward....It
contains current data that now show
us that we’re up to 13 different cancers caused by tobacco use. We know
the impact on the whole human
body. In essence, it affects almost
every single system of the human
body now. Brand-new diseases, formerly not associated with smoking,
are still being discovered.
Most recently, we’ve seen diabetes and colon and rectal cancers as
some of those diseases. We’re talking about blindness associated with
smoking. We’re talking about diseases such as erectile dysfunction,
which are associated with smoking.
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