For nearly 50 years, the American Cancer Society has held the Great American Smokeout on the third Thursday of November, providing people who smoke with an opportunity to commit to healthy, smoke-free lives. While acknowledging that it may not be possible to quit smoking in one day, the event encourages individuals to view the date as “Day One” on the journey toward a cigarette-free life, thereby significantly reducing the risk of cancer.

Let’s take a look back at the history of smoking and lung cancer and the subsequent creation of the Great American Smokeout.

Cigarette Smoking and Lung Cancer

While lung cancer was rare in the 1800s, technological advances that allowed for the mass production of cigarettes along with ad campaigns glamorizing smoking, led to skyrocketing lung cancer rates in the 20th century. By the early 1950s, it was the most commonly diagnosed cancer in American men.

While several small-scale research studies conducted between the 1920s and 1940s had suggested a possible link between smoking and lung cancer, none provided the evidence necessary to establish a definitive connection. American Cancer Society scientists, E. Cuyler Hammond, Ph.D., and Daniel Horn, Ph.D., changed all that through a cohort study. In 1952, the pair recruited approximately 188,000 American men, aged 50 to 69, across 10 states. The study, which enlisted the help of 22,000 ACS volunteers, asked the men about past and present smoking habits and required frequent follow-ups.

After following the group for approximately 20 months, Hammond and Horn found that men with a history of regular cigarette smoking had a considerably higher death rate than those who had never smoked or who only smoked cigars or pipes. While the study provided links to multiple diseases, it specifically called out lung cancer. In the years that followed, Hammond and the American Cancer Society continued to collect data, conducting a larger and more robust long-term follow-up study that would later lead President John F. Kennedy and his surgeon general, Luther Terry, to classify cigarette smoking as a health hazard in 1964.

History of the Great American Smokeout

Despite Hammond and Horn’s findings, smoking remained common among American men for several more decades. To help combat this trend, ACS launched the Great American Smokeout, which has caused a dramatic shift in Americans’ attitudes about tobacco use.

In 1974, Lynn R. Smith, the editor of the Monticello Times in Minnesota, spearheaded the state’s first Don’t Smoke Day, or “D-Day”. Smith’s event sparked the idea for the American Cancer Society’s own campaign. On November 18, 1976, the California Division of ACS successfully helped nearly 1 million people quit smoking for the day, marking the first official Great American Smokeout. By 1977, ACS had made the Smokeout a national event, providing valuable information and resources that have led to significant changes in views and the enactment of lifesaving legislature and smoke-free laws.

Great American Smokeout Timeline

Lung cancer incidence in men has been declining since the mid-1980s, thanks in large part to the Great American Smokeout. In the years since the inaugural event, smoke-free advocacy groups have called for meaningful change and earned major policy victories, as detailed below.

  • 1977: Berkeley, California became the first community to limit smoking in restaurants and other public places.
  • 1983: San Francisco passed the first strong workplace smoking restrictions, eliminating smoking in private workplaces.
  • 1990: The federal smoke-free law for all domestic flights of 6 hours or less took effect.
  • 1994: Mississippi filed the first of 24 state lawsuits seeking to recuperate millions of dollars from tobacco companies for smoking-related illnesses paid for by Medicaid.
  • 1994: ABC News reported that cigarette companies manipulated the nicotine in their products to cause and sustain addiction in people who smoke.
  • 1994: The U.S. Food and Drug Administration (FDA) opened an investigation into the tobacco industry’s manipulation of nicotine and the targeting of children in advertising.
  • 1999: The Department of Justice filed suit against cigarette manufacturers, charging the industry with defrauding the public by lying about the risks of smoking.
  • 1999: The Master Settlement Agreement (MSA) was passed, requiring tobacco companies to pay $206 billion to 45 states by the year 2025 to cover Medicaid costs of treating people who smoke. The MSA agreement also closed the Tobacco Institute and ended cartoon advertising and tobacco billboards.
  • 2009: The Family Smoking Prevention and Tobacco Control Act was signed into law. It gives the FDA the authority to regulate the sale, manufacturing, and marketing of tobacco products and protects children from the tobacco industry’s marketing practices.
  • 2017: More than 11 years after a federal court first ordered them to do so, the major U.S. tobacco companies began publishing “corrective statement” advertisements telling the American people the truth about their deadly and addictive products. Tobacco companies had to publish corrective statements in the nation’s top-selling newspapers from November 2017 to April 2018, according to the court ruling. The court also required corrective statements to air on major television networks from November 2017 to November 2018. The American Cancer Society, along with other public health groups, played a major role as an intervenor in the Justice Department’s litigation against Big Tobacco.

The Great American Smokeout Today

While there has been significant progress, lung cancer remains the leading cause of cancer death in the US. Approximately, 80% of all lung cancer deaths in the US are still caused by smoking. In response, the Great American Smokeout continues to bring people together across the country by challenging individuals to give up smoking for a day, while providing the tools, resources, and community necessary to do so. This year’s event will take place on November 17. We encourage you to learn more at or call 1-800-227-2345.