Every road-weary traveler yearns for the comfortable routines of home. Returning from Washington, D.C., on an evening flight in January 1964, Len Schuman was no doubt looking forward to smoking a few of the cigarettes that he kept in the breezeway between his garage and house.
But when he got home, the place he kept them was empty. He went into the house and said to his wife, “Marie, what happened to my cigarettes? They’re all gone!”
“I heard what they said on the radio,” she replied. “You’re going to quit.”
‘What they said on the radio’ was part of the landmark 1964 report, Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. Schuman played a key role in drafting the report, which outlined a clear connection between smoking and disease. “It hit the country like a bombshell,” Surgeon General Luther Terry later recalled. “It was front-page news and a lead story on every radio and television station in the United States, and many abroad.”
A gifted teacher and consummate educator
Leonard Schuman joined the School of Public Health at the University of Minnesota in 1954 and served as director of the division of epidemiology until his retirement in 1983. A physician by training, he established the nation’s first doctoral program in epidemiology.
Schuman was a gifted teacher. Michael Osterholm, professor and director of the Center for Infectious Disease Research and Policy, vividly recalls Schuman’s skill in the classroom.
“He was a consummate educator and would tell these spellbinding stories,” Osterholm says. “He had this deep voice and each one of his lectures was almost a performance — and I mean that in the most complimentary way. Students were in awe of him, and he inspired a lot of people.”
“He was a very gregarious, fun man,” says Lee Stauffer, dean of SPH from 1970-82. “But there wasn’t any idle chatter outside his door: it was the whats, the whens, the whys. He was an active teacher and had a very active mind.”
Schuman drew on a wealth of experience in his teaching, including serving on both the Salk and Sabin polio vaccine clinical trials. He focused on principles that would apply to any emerging infectious disease.
“When it came to the basic principles we needed, he was the definitive teacher,” Osterholm says. “His lessons were very valuable to me. Anybody can be current on the events of today, but the question is: does he or she have the fundamental underpinnings to put those events into context?”
SPH honors Schuman’s teaching legacy with the annual Leonard M. Schuman Excellence in Teaching Award, the school’s highest teaching honor.
A call to service
Schuman was an internationally recognized researcher who published more than 150 articles in the course of his career on topics ranging from diphtheria and polio to childhood leukemia, prostate cancer and chronic disease.
In the first half of the twentieth century, a growing body of research documented the relationship between smoking and a wide range of health issues, including a strong suspicion that smoking was the chief culprit behind an epidemic of lung cancer. The impetus for an official report on smoking and health came when a number of health organizations — the American Cancer Society, American Heart Association, National Tuberculosis Association and the American Public Health Association — wrote to President John F. Kennedy in June 1961 and called for a national commission on smoking.
From November 1962 through January 1964, a committee of 10 experts organized by Surgeon General Luther Terry conducted a comprehensive review of the scientific literature on smoking. Committee members came from a wide range of disciplines and could not have taken any previous stand on tobacco use. The committee reviewed more than 7,000 scientific articles and called on some 150 consultants in the course of its appointment.
The committee’s work was the subject of much speculation by the media and others. Schuman’s secretary occasionally received calls from reporters who casually inquired as to whether the doctor was still smoking.
“High security was maintained so that no disconcerting leaks would occur — leaks which would not only have provided premature ammunition for attacks on the committee’s deliberations, but would have wasted its limited time in rebuttals and repeated expositions of the process of judgmental evaluation,” Schuman later wrote. “Guesswork among outsiders was rampant and on at least one occasion came very close to the ultimate judgments of the committee.”
As a longtime smoker, Schuman recalled that part of the reason he agreed to serve on the committee was that he didn’t want to believe there was a relationship between smoking and disease. But scientific method prevailed, and Schuman proved to be a key member of the committee. Surgeon General Terry relied on him a great deal, and he reportedly wrote a large portion of the final report.
A milestone in a long journey
The 1964 report highlighted the widespread negative health effects of tobacco use. Among its findings:
- cigarette smoking was responsible for a 70 percent increase in the mortality rate of smokers over non-smokers
- average smokers were estimated to have a nine- to ten-fold risk of developing lung cancer compared to non-smokers; heavy smokers had at least a twenty-fold risk. The risk rose with the duration of smoking and fell when smoking ceased
- smoking was the most important cause of chronic bronchitis and the report pointed to a correlation between smoking and emphysema, and smoking and coronary heart disease
- smoking during pregnancy reduced the average weight of newborns.
The report had a major impact on public policy and on attitudes about smoking. From changing beliefs about smoking and cancer to adding health warnings on cigarette packages to banning cigarette advertising on television and radio and beyond, the report helped bring about widespread change.
But the battle continues. “One of the things he (Schuman) would say over and over again is that public health’s work is never done,” Osterholm says. “That’s what he recognized very clearly, and that was part of the purpose of his whole infectious disease work.”
“He would not be satisfied with the progress that’s been made,” says Dr. Ed Ehlinger, Minnesota health commissioner. “We need to continue to have the coalitions of people focusing on tobacco, recognizing that there’s still a long way to go.”
Waging the battle today are SPH researchers like Harry Lando, Kelvin Choi and others who are doing critical research on tobacco- and smoking-related health issues. The University is currently taking steps to create a smoke-free campus in the Twin Cities.
And what about the pack-and-a-half per day smoker whose stash disappeared and who was confronted by his wife? Schuman relished retelling the story in later years, concluding with: “And I quit cold turkey!”
Ever the teacher, Leonard Schuman walked the talk where it mattered most.
~Originally published January 15, 2014, on UMN School of Public Health blog