2004 Health Care Hall of Fame: He helped clear the air

Former Surgeon General Luther Terry helped lead crusade against smoking

In late 1963, Luther Terry quit smoking. On Jan. 11, 1964, the quiet, gentlemanly Southerner led the effort to encourage millions of Americans to do the same by delivering the first Surgeon General's Report on Smoking and Health.

That report, released on a Saturday to avoid rattling the stock market, concluded that smoking causes lung cancer and chronic bronchitis and could well contribute to cardiovascular disease, emphysema and various other cancers. The ripple effects, which continue to this day, have included the ubiquitous warning labels on cigarette packs and bans on cigarette advertising on TV and indoor smoking in public spaces.

"He had been a cigarette smoker until about three months before the report came out," says Eugene Guthrie, director of the Public Health Service panel that produced it. "I told him, `Luther, no longer can you smoke cigarettes, even in the closet.' He went cold turkey. And he did a magnificent job when the report came out, standing up for it against overwhelming odds. He was the right man on the job at the right time."

The most measurable effect of Terry's work may be the drop in the percentage of Americans who smoke, from 43% in 1964 to 23% today, says David Satcher, who served as surgeon general from 1998 to 2002 and is now director of the National Center for Primary Care at Morehouse Medical School. "Millions of lives have been saved because of people who have quit smoking and people who never started smoking because of that report," Satcher says.

Michael Terry says his father, who died in 1985, was hardly the first to perform research that showed the harmful effects of smoking. A British report that came out in 1962 had said many of the same things. "My father would always say that there were so many other important people who contributed to that finally being a success," says Michael Terry. "But he was the first person willing to take on the cigarette lobby. ... Here was a disease you were trying to conquer, which had its own, well-funded lobbying effort essentially working for the disease, if you want to look at it that way."

Steve Schroeder, director of the Smoking Cessation Leadership Center at the University of California-San Francisco, agrees that Terry faced an uphill battle. "The report didn't break any new ground, per se," Schroeder says. "But it was the first time the government went on record as saying smoking was hazardous to your health. The courage that he had for seeing this through in the face of industry opposition, and the fact that the report has stood the test of time, has made him a legend."

Born in Red Level, Ala., Luther Terry received his medical degree from Tulane University in 1935, interned at Hillman Hospital in Birmingham, Ala., and served his residency at the Cleveland Hospitals. Janet Terry Kollock, Terry's daughter, says her paternal grandfather was also a doctor, a general practitioner who was often paid with produce. "His father was the kind of man who treated people whether or not they could afford to pay," she says.

Seat belts and smoking

Luther Terry moved to St. Louis in 1938 and taught at Washington University before moving to the University of Texas Medical Branch at Galveston, where he taught preventive medicine and public health from 1940 to 1942. His government career began in 1942 when he went to work at the Public Health Service Hospital in Baltimore, where he became chief of medicine the following year. In 1950, he joined the staff of the National Heart Institute in Bethesda, Md., and he rose to assistant director in 1958. He continued teaching, at the Johns Hopkins University School of Medicine, from 1944 to 1961.

Michael Terry says his father mostly performed relatively low-profile clinical research during his earlier years in government, although Luther Terry did serve on two Senate investigative teams in the post-World War II era, one to assess the aftermath of the Hiroshima and Nagasaki bombings, and the other to examine claims by former German soldiers that they had been tortured by their American captors.

President Kennedy selected Terry as surgeon general on March 2, 1961, and during his first three years in that office he focused on such issues as the need for automobile seat belts and improvements in Native American healthcare, Michael Terry says.

During the months leading up to the release of the smoking report, Luther Terry and his committee worked hard to keep the document quiet, says Don Shopland, then a page with the National Library of Medicine who served as a gofer for the committee. Shopland recalls the work was done on the bottom floor of the National Library, three floors below ground, in a corner room. "It was obviously a fairly high-charged atmosphere," Shopland says.

The committee's report, based on more than 7,000 articles in the biomedical literature, concluded: "Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action." While that action was not specified, the report led to the 1964 creation of the National Clearinghouse for Smoking and Health, which has produced 23 subsequent reports on the dangers of smoking, as well as the Federal Cigarette Labeling and Advertising Act of 1965 and the Public Health Cigarette Smoking Act of 1969.

Terry continued to play a key role in pushing for remedial actions after leaving his post as surgeon general in 1965, chairing the National Interagency Council on Smoking and Health and serving as a consultant to groups like the National Cancer Society. His willingness to focus squarely on science-not politics-has much broader implications, Satcher says. "That was the first official surgeon general's report, and it set a standard for reports from the office of the surgeon general that they were based on the best available science," he says.

After leaving government, Terry served as vice president of medical affairs at the University of Pennsylvania from 1965 to 1971, teaching there in various capacities until 1981; president of University Associates, a not-for-profit consulting firm in Washington, D.C., from 1970 to 1983; and corporate vice president of medical affairs for ARA Services, from 1980-83. He died on March 29, 1985.

His eulogy, delivered by former Health, Education and Welfare Secretary Joseph Califano Jr., concluded: "He can rest now. He deserves to enjoy a peaceful journey with the Lord. In the no-smoking section, of course."