The year 1964 marked the last time that anyone in America relaxed with a cigarette. The date, to be exact, was January 10, 1964. On the next day, Surgeon General Luther L. Terry released his advisory panel’s report on smoking and health. After that, people could still smoke, of course, but never again in the hazy delusion that cigarettes were harmless.

The connection between smoking and disease had been noted early on. When European explorers brought tobacco home from the New World in the sixteenth century, smoking—that is to say, inhaling the smoke—was quickly recognized as a dangerous habit. Puffing on a long pipe was medically acceptable then, as were snorting snuff and working a chaw. For hundreds of years, though, smoking was something apart, something for “fiends,” deckhands, and exotic foreigners.

The idea of smoking was taken up again in the late 19th century, thanks in part to the development of one of the most lethal inventions of all time. It was a machine that could mass-produce cigarettes, making them cheap and easy to buy. Anyway, the turn of the century was a nervous age in America, ripe for a habit that was at once reckless and reassuring. People may have been calling cigarettes “coffin nails” and “cancer sticks,” but they were lighting them up all the same. The trick was never quite coming to admit that smoking was a slow form of suicide. That was possible because the evidence of tobacco’s relation to early death was entirely anecdotal. For every comment from some old nag about cigarettes giving Cousin Jo cancer, a person could take a long puff and then cite Great-uncle Lars, who smoked three packs a day and outlived his doctors.

Irrefutable evidence was wanting. Even if the incidence of lung cancer did rise in neat proportion to the number of smokers through the first half of the century, such figures didn’t actually establish a cause-and-effect relationship. Likewise, the fact that mice whose backs were smeared with nicotine developed tumors didn’t prove anything at all, except perhaps that, to be on the safe side, people oughtn’t smear their backs with nicotine.

While medical science continued to gather data in the 1950s, the nation’s six major cigarette companies introduced filter cigarettes. The smokers who did worry about their health made them bestsellers. The habit flourished as never before: More Americans took up smoking, and those who did smoked, on average, more cigarettes. The incidence of lung cancer, undistracted by the cunning of filter cigarettes, more than doubled between 1950 and 1960. It was an epidemic of willing comers.

The situation was untenable to health officials. They decided that, since American smokers had yet to be convinced of the risk of smoking, a kind of supreme court of medicine would have to convene and issue an official government statement on the issue. In June 1962, Surgeon General Terry announced