Five decades ago Dudley Hafner’s boss handed him a copy of the surgeon general’s report, “Smoking and Health.”

It was thick as a bible. And such serious business, Hafner said, that it had been under armed security until its release the week before.

To study the report without interruptions, Hafner and his boss took a Southern Pacific train instead of a plane to a meeting in Los Angeles. They wore suits with ties and carried briefcases.

They also carried their cigarettes. It was 1964.

“Two smokers sat in a compartment for two days and a night where we studied,” Hafner said. The pair huddled over the report. It was intense — so intense that the Pullman porter kept asking what they did for a living. Spies for the CIA or FBI, he guessed.

In fact, they worked for the Texas Division of the American Cancer Society.

“When we got off the train in Los Angeles you had two reformed smokers and good science information to start our war on tobacco,” said Hafner, who never smoked a cigarette again.

During that era, Hafner said, it was an ashtrays-all-around environment.

“Everyone” smoked, he said, “everywhere.”

Tobacco was on billboards, TV, radio and magazine ads. There were no non-smoking areas. Cigarettes were handed out to soldiers, high school kids and college students. Doctors and pregnant women smoked without concern. Movie stars like Barbara Stanwyck and Rosalind Russell pushed cigarettes. A tobacco company even ran an ad in which thousands of doctors claimed that cigarettes had health benefits.

“Even some of the science writers didn’t believe there was a link between tobacco smoke and tobacco problems,” Hafner said. “The U.K. was taking minor steps while the U.S. was looking the other way.”

The data had been piling up for years, Hafner said, but it hadn’t been validated.

Until the report.

It offered conclusive evidence that smoking caused lung cancer and other cancers and a variety of other diseases. And although Hafner said it gave health organizations “serious ammunition to go forward” in the fight against tobacco, there was still pushback. “Nobody wanted to believe it,” Hafner said. “It was being discarded like crazy.”

It took time, but eventually the report would start making an impact. In 1965, Congress required all cigarette packages distributed in the U.S. to carry a health warning. Since 1970 the warning is made in the name of the surgeon general. In 1969, a ban was passed on cigarette advertising on television and radio.

Hafner joined the American Heart Association in 1968. He later served as executive vice president from 1980 to 1997, and then CEO, guiding the organization through significant growth and change. This was a time when health organizations started amping up tobacco education and research and became more engaged in the political process.

“Up until that time it was considered unseemly for volunteer organizations to be out front on legislative issues,” he said.

Hafner points to the smoke-free environment as a “truly great breakthrough.”

“Banning smoking on planes and public transportation and [advocating for clean air] — those are the things that have really made an impact on smoking rates as much as anything.”

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