The U.S. Public Health Service and smoking in the 1950s: the tale of two more statements

During the 1950s, the United States Public Health Service prepared two statements on the link between smoking and lung cancer that have not been recognized by other historians. This article employs extended discussions of these two statements as vehicles to explore both internal developments at the federal health agency and larger questions surrounding the disciplinary emergence of chronic disease epidemiology. The primary cast of characters includes Surgeons General Leonard A. Scheele and Leroy E. Burney, Lewis C. Robbins (a lower-ranking Public Health Service officer, who had chief responsibility for the agency's smoking-related programs from 1958 through 1962 and who left behind a daily professional diary), and Journal of the American Medical Association (JAMA) editor John H. Talbott. These men, and others, are seen grappling (at varying levels of engagement) with the appearance of what we now recognize as a profoundly different way of understanding chronic disease causation, which centers on survey-taking and statistical analysis of risk factors.