Dr. Elders also sidestepped any assertion that tobacco advertising causes smoking but was less circumspect when it came to R.J. Reynolds Tobacco Co. and its controversial Joe Camel campaign that tobacco foes contend targets children.
"I am challenging the Federal Trade Commission to act on petitions pending before it about the Joe Camel advertising campaign," she said.
The closest she came to endorsing an ad ban was to say "We should not support any advertisement of anything that we know kills people in America."
The report was hailed by anti-tobacco groups as providing official research-based evidence linking advertising to youth smoking. And the most stri dent calls for government action against tobacco came from Antonia Novello, the previous surgeon gen eral, who urged denying tax de ductibility to tobacco marketers.
Responding to the report, Sen. Tom Harkin (D., Iowa) said he hopes Congress will reduce the de ductibility of tobacco ad expendi tures when it takes up healthcare reform.
Dr. Novello hailed a study published in this week's Journal of the American Medical Association as establishing a link between increased smoking among girls in the late 1960s and early 1970s, and the concurrent onset of ad campaigns that were aimed specifically at women.
Dr. Elders, however, qualified her remarks, saying the report "appeared" to show such a link.
"She used the word `appears' and also said about marketing to children that it might or might not be intentional," said Hal Shoup, exec VP of the American Association of Advertising Agencies.
"For the last 20 years, evidence has shown that there is no causal link between advertising and smoking," Mr. Shoup said. "You'd think that if she wanted to inflict a blow to the advertising of these products, there would be new evidence to reinforce the notion that there is a relationship."
Both RJR and Philip Morris USA endorsed portions of the report but challenged assertions linking advertising to smoking.
"There was no new evidence offered up of any advertising connection," said Peggy Carter, manager of media relations for RJR. "They are reinforcing what we have all known-that peer influence is the principal player in deciding whether people smoke."
The effect of the surgeon general's challenge to the FTC remains to be seen. Nearly three years ago, anti-tobacco groups asked the FTC to act against Joe Camel. The FTC staff recommended the commission issue a complaint, but no more action has been taken.
In other tobacco developments, McDonald's Corp. last week said it would ban smoking in its 1,500 company-owned restaurants.
And the California Department of Health Services announced a new $10 million anti-smoking campaign from Livingston & Co., Los Angeles, using the line "I'm mad, and I'm not going to take it anymore."