Fifty years ago this week U.S. Surgeon General Luther Terry issued a landmark report on smoking, stating emphatically that tobacco use carried serious health risks – heart and lung disease and cancer – and that smoking was hazardous to one’s health. It was a report that in the past 50 years has drastically changed the way society views cigarettes and smoking.

Before the report, smoking was accepted everywhere. People smoked in their homes and their offices, in fine restaurants and night clubs. Ash trays were as mandatory as chairs, tables and lamps in a well-furnished home. Etiquette books suggested non-smoking hosts keep boxes of cigarettes available for their guests.

Cigarettes were considered part of a meal – after dessert, people poured a cup of coffee and lit up a cigarette.

Smoking was considered sophisticated. It was the height of cinematic gallantry and romance when Paul Henreid, in “Now, Voyager,” lit two cigarettes and handed one to Bette Davis.

Advertising jingles and slogans touted the grand image of smoking as rugged and manly, and as ladylike and sophisticated.

Today, to borrow one of those slogans, we’ve come a long way, baby. Smoking is banned in most public places. Light up a cigarette in somone else’s house and you are liable do get shoved out the door. Cigarette advertising is banned in most media, replaced by public service announcements showing people disfigured by cancer surgery, or doctors squeezing excess fat out of an aorta.

Yet smoking remains the number one preventable cause of life-threatening diseases in our country. Each year about 440,000 people in the U.S. die from smoking-related illness, according to the Center for Disease Control and Prevention.

We’ve come a long way, but we still have a long way to go.