The Surgeon General's 1964 report on smoking and health, which declared that cigarette smoking was a cause of lung cancer, is considered a landmark in the history of medicine and public health. This article examines the impact of the report on medical student education by reviewing how the relationship between smoking and lung cancer was presented in medical school textbooks and syllabi between 1964 and 1987, changes in hospital smoking regulations and doctors' attitudes toward smoking following the publication of the report, and medical students' smoking patterns and attitudes toward cigarette smoking in the years after 1964. Although it provided some advanced students with additional insight into mechanisms of pathogenesis related to smoking, the education that many medical students received seems to have been neither a primary influence on their smoking patterns nor an important source of their scientific understanding of the causal link between smoking and lung cancer for at least a decade following the publication of the Surgeon General's report.