>>- ah, he decided that now, not yesterday... what made him change his mind?
>>- and without his decision, what would happen with that risk?

This isn't the original version: but "has now" implies current status that optionally can be qualified by a "since" or similar. The meaning would be that the Surgeon General currently is satisfied with this statement, no matter when they reached this conclusion. The insistence on needing to know exactly when, is not part of the narrative so its absence is not ambiguous. Nor is it ambiguous to wonder why s/he reached this conclusion as there's copious explanatory material.

IOW it's simply not as ambiguous as you'd like. ;-)

>>So you can't even change the lightbulb without context?

Now you're deliberately conflating the particular into a ridiculous generality. Not biting. ;-)

>>As in the preceding example, where they didn't care about what they say as long as they can cram enough buzzwords ("real!", "now!"), the propaganda warrior formulated the sentence to convey a meaning of urgency ("now!"), authority ("surgeon general", not some clerk, "decided", not just concluded, not found out, not agreed with the findings of others), without caring too much about what happens with the meaning. The sentence probably works with those already ready to accept it. But as with any weapon, and slogans are just that in a propaganda war, the targets start developing defences over time. So I learned to listen carefully to what they say - you know the song, "never mean what they say, never say what they mean", having been bitten enough times when I was that willing abettor.

Weapons? Slogans? I can see that your Chatter4u image proudly shows a cigarette... So rather than focusing on what "now" means, this is the sort of thing that allows the Surgeon General to express certainty:

- In the US, relative mortality for a smoker is three times as high as for somebody who never smoked. Source, complete with 13 full pages (count for yourself) of expert researcher contributors: http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf
- A smoker's life expectancy is 10 years shorter than somebody who never smoked, with risks rising steeply after age 40: http://www.nejm.org/doi/pdf/10.1056/NEJMsa1211128

Small wonder that the Surgeon General is comfortable to advise people to stop smoking now.