THE TRUTH ABOUT THE TOBACCO
HABIT
A young friend of mine of the trouser-wearing male sex recently
developed a pain in his stomach. He decided to wait it out. But it
was an indecent as well as an insidious sort of pain and finally
persisted so long that he was driven to consult a physician for
moral support. The physician said, “Do you smoke?” My friend said
“Yes.” The physician said, “That’s it, of course. Quit smoking.
Three dollars, please.” My friend went away, quit smoking, and the
pain persisted. He returned to the doctor. He was now given a little
silver nitrate. He went away, but he came back again. By that time
the physician was really angry. He said, “You’ve smoked yourself
into a nice stomach ulcer, you have. I’ll have to operate. I hate to
but I have to.” Just then buckwheat cakes and sausage made my friend
violently ill one day and he deleted them from his diet. The pain
left and has not yet played a return engagement. He smokes more than
ever now, but he throws away longer butts.
Another friend of mine classifying in the male sex which so far
tends to avoid wearing trousers--much--went to a physician. She
complained of a rash which she said afflicted her all winter.
Fortunately for the physician she smoked energetically. He therefore
told her to quit and called the next patient. Since she knew that
she smoked in summer as well as in winter she did not quit but, by
chance, consulted a scientific nutrition investigator. There was no
reason for this; she did it irrationally and by pure inadvertance.
But he asked, “Do you eat anything in winter that you do not eat
in summer?” And she at first said, “No,” because that is the most
natural answer to make under the circumstances. Then later, after a
half an hour’s cross-examination, she said, “Yes, oatmeal.” He said,
“Try cutting that out for a while.” So she conquered this craving,
but continued to smoke, and the rash departed for parts unknown. She
had an idiosyncrasy for oatmeal proteins just as some people have for
strawberry or egg proteins, and her rash was thus caused.
In a moment of more violent perversity I went not long ago to a
lecture advocating ruthless war on tobacco. In spite of the success
women have just had in smoking anti-cigarette reformers into
comas, the speaker, Daniel H. Kress, M. D., was President of the
Anti-Cigarette Alliance. Since he was a regular doctor in active
practice I had a right to expect the presentation of a scientific
case against tobacco.
This gentleman, who is personally one of the most delightful old
souls in the world, actually completed his lecture without ever
once citing a scientific authority, without once grounding upon
irrefutable scientific fact and without departing widely from the
most trivial and childish sort of argument from analogy. Thus he
stated that a famous war hero did not smoke. Wilson did not smoke.
Hughes does not smoke. The inmates of reform schools all smoke.
Smokers are physically and mentally unsafe!
This may all be true for all I can prove to the contrary, but what
of it? Many war heroes smoke. Grant certainly did. Small, defective
and generally backward children normally spring from parents who
underfeed them, who are themselves defective in heredity and who
neglect to instruct their children in any essential matters. Can
you prove that smoking alone either stunted them or put them in the
reform school? You cannot. Criminals are predominantly religious
according to their professions of faith. Did Christianity make
them criminals? If smokers are mentally unsafe may I fervently
declaim--God help research!
You hear it said that the children of smoking mothers are
inferior. Are they? How can it be proven? As a matter of fact no
scientific experiment could possibly be carried on to prove this,
for statistics, being riddled by all sorts of idiosyncrasies and
unknowns, are grossly unscientific. To prove it you might have the
same mother have two children at separate times by the same father,
smoking while she bore one and abstaining for the control child. But
that would prove nothing. Each child is a unique individual arising
from a unique chromosome mixture. The mother and father would of
necessity be older in the one case than in the other. Nourishment and
other environmental conditions would inevitably vary. The experiment
is impossible. Yet until such an experiment becomes possible we are
merely voicing opinions when we say that smoking causes inferior
children. The actual cause may be any of a thousand other and
extraneous factors.
When you consider how very often tobacco smoking is mentioned
therapeutically and how universally it seems to be assumed that it
is deleterious to health it is rather disconcerting to discover so
little reliable scientific work to confirm this prevalent viewpoint.
In fact practically no comprehensive, systematic work has been done
by scientific research to prove that smoking is exceedingly harmful
to the human system. Like so many other human preconceptions this
assumption rests largely upon faith. To the acutely prejudiced
non-smokers smoking seems so utterly perverse that it surely must be
physically injurious.
A rational esthetic case could be made out against certain women
smoking. True, the modern woman so sedulously apes the other sex that
to deprive her of her cigarette is simply to deprive her gracelessly
of her masculinity. We should never do that. But the spectacle of a
really pretty, effeminate woman smoking is nevertheless an esthetic
affront. Nothing the average man can do could make him look very much
worse than he does naturally so even this slight objection does not
apply bisexually.
But we have wandered, and I am of course at fault, having set
out laudably to lead our thought procession. In my search of the
scientific literature the nearest thing to an authority I came
across was perhaps Sir Humphrey Rolleston, Baronet, K. C. B.; F.
R. C. P. and M. D. of Cambridge, England, physician to King George
V in his late 1928 illness. He discusses “The Medical Aspects of
Tobacco” in such staid British medical journals as _The Lancet_ and
_The Practitioner_. He reviews every possible lesion that might
spring from tobacco smoking, and they are many--quite as many
indeed as may spring from over eating artichokes or drinking three
gallons of well-water daily. He sets himself flatly against animal
experimentation in this matter because this cannot possibly take
idiosyncrasies into account, and reminds us that humans are both
highly individualized and exceedingly complex.
Rolleston then remarks that cigarettes are less invidious than pipes
or cigars because cigarette smoke is more air diluted. He finds
a wide diversity of opinion as to the harmfulness of tobacco; he
doubts that it ever affects the nervous system greatly and believes
that coffee and tea usually produce the heart symptoms attributed to
smoking and that a latent venereal disease accounts for much smoker’s
cancer. He doubts also that dilation of the esophagus, dilation of
the stomach, acid stomach and nervous dyspepsia are often due to
tobacco while he commends the mildly laxative properties of a pipe
after breakfast.
Finally our baronet says, and the medical journal sustains him
editorially, that in view of the universality of the habit of tobacco
smoking the rarity of the organic lesions that can be traced out as
undoubtedly due to that habit, beyond all question, is little less
than surprising. This, I should say, is the woodpile Ethiopian. It is
one thing for a physician to lean back and say cut down on tobacco,
coffee, fried stuff and pastry. It is quite another for him to prove
scientifically that these indulgences have undeniably caused the
patient’s present low physical estate.
D. T. Barry, F. R. C. S. and M. D. of the Physiological Department,
University College, Cork, is not very far off when he writes: “The
physiological effects of tobacco, as our present knowledge reveals
them, are not sufficiently deleterious to counter-balance the benign
influence of the drug in other respects. It may be abused, of course,
but so may food, and this latter form of abuse is, in my opinion,
responsible for greater evils than those resulting from the abuse of
tobacco.”
In this connection another authority, Armstrong-Jones, remarks that
tobacco smoking in moderation is not injurious to adults but is a
valuable sedative. It contributes to calm thought and efficient
mental functioning. Worst of all he casually remarks that cigarette
smoking, preferably without a holder, is the least injurious form of
tobacco indulgence. Even allowing for the fact that the gentleman has
seen some of the less comely holders I have witnessed in my time, his
statements give pause.
Of course Earp’s well-known studies at Antioch College, Ohio, did
indicate that non-smokers showed an intellectual superiority over
smokers, but whether these things were cause and effect or mere
harmless concomitants who knows? Many very eminent intellectual
giants smoked excessively. Perhaps they would have achieved absolute
omnipotence or omniscience had they been non-smokers. Again, who
knows?
It is significant that Earp’s non-smokers showed no physical
superiority over his smokers; that is, it is interesting when you
remember that the American university is an institution of athletic
training wherein some intellectual education is offered to the
feeble-bodied as a consolation prize. Intelligence tests are not
affected by smoking, the non-smokers ranking just as high after
smoking as before they had ever touched the vile weed. Finally, the
correlation between the length of a student’s indulgence in tobacco
and his scholarship is so negligible as to indicate that there can be
no chronic cumulative poisoning from tobacco.
Laymen do not realize how difficult it is to trace a diseased
condition to a specific cause even when bacteria abound, as is
not the case in smoking. For instance certain bacteria so closely
resemble each other that even experts are hard put to tell them
apart. Diphtheria germs possess such a dead ringer. Real diphtheria
cultures were once sent out to clinical laboratories along with
other cultures containing no diphtheria germs, but germs so closely
resembling them that the laboratories involved returned all sorts of
results. Some reported that the actual diphtheria cultures contained
no diptheria germs at all; others that some of the germs simulating
diphtheria in appearance were positively the real thing. So a tooth
or a tonsil may contain a germ so similar to those found at the seat
of secondary infection that they are indistinguishable, yet the germ
may be harmless in one case and virulent in the other.
Certainly it is unlikely that we carry virulent germs about in teeth
and tonsils for long years. For one thing they get acclimated to
us and can change their murderous habits. For another we get used
to them. This organism of ours is an hospitable sort of thing.
The body tends to adjust in neighborly fashion to germs upon long
acquaintance, or familiarity breeds contempt, just as it adjusts to
morphine, to opium, to over-eating, to the corrosive harness oils
now sold as bootleg whiskey and to tobacco, of course. Perhaps long
acquaintance ripens into real friendship and mutual aid.
Nicotine is the active agent in tobacco. Mendenhall tells us that
tobacco sometimes stimulates and sometimes depresses the bodily
sensory mechanism, depending largely upon the state of fatigue
prevalent at the moment. When stimulation occurs the effect is
precisely that of a certain portion of high potential rest, for in
this case, says our authority, tobacco has rested us artificially.
Certain work seems to prove quite clearly that tobacco slows down
the gastric motility as well as pepsin and rennin secretion. At
least it produced such results on certain individuals, although the
majority of mankind may be immune for all we know. This would slow
down digestion, but it takes considerable smoking to accomplish such
a result even with the susceptible, and one cigarette after a meal,
even a cigar, would scarcely be sufficient. It has also been stated
in scientific journals that tobacco _may_ play an etiologic role in
gastric neurosis, in gastritis, in ulcer and cancer of the stomach
and, likewise, in mouth or throat carcinoma.
But, putting your mind rigidly to the task, can you readily think of
anything from hot soup to worry that has not at some time by some
person been accused of causing these conditions? Why is this? Holding
a clay pipe in the mouth may cause mouth cancer; holding an ordinary
pipe might; continuously holding a roughened stick there might also,
with tobacco never involved. How do these anti-tobacco ideas arise?
Why are we told that so many things cause ulcer, cancer, kidney
trouble, heart lesions or high blood pressure? Why are there so
many theories of evolution or of creation, or of salvation for
that matter? Why are there so many and such diverse theories of
economic and political betterment? Why are there such varied schools
of treatment often imposing diametrically opposed procedures to
combat the very same maladies? Why do men differ so widely in their
hypotheses about government, religion, tobacco, women? Simply because
nobody as yet knows anything positively definite about these matters,
and just so long as this condition of inspired ignorance persists, so
long will infinitely varied opinions be inevitable.
In chemistry, in physics and in bacteriology, for instance, we do
possess certain definite knowledge and we can rightfully cite certain
facts. In sociology, in politics and in economics, we possess certain
dogmas or beliefs and we can pardonably express certain theories or
opinions--so long as we candidly admit their opinionative status. But
when we get beyond a certain definite point in any science, even in
physics and chemistry, we begin to hypothecate just like an economic
determinist or an anti-vivisectionist or a religious fundamentalist,
people who are habitually beyond this point of separating fact from
belief anyway. We begin to express our opinions vociferously, to
dress them up in moral overcoats, and to justify them just because we
do lack certain scientific knowledge.
Thus we can go to the scientific work and find an investigator saying
that very large quantities of tobacco smoke will paralyze the gastric
contractile power. All right. But this very same investigator also
sagely adds that small amounts of the smoke will actually stimulate
this very gastric contractility and urge along digestion. Or we can
go to the _Journal of the American Medical Association_, the highest
current medical authority in the United States. We find a query by
some doctor on cigarette smoking and we read the reply. Authority
completely absolves cigarette papers from blame for poison. It adds
that any cigarette smoker is safer from harm than a tobacco smoker
of any other sort. For one thing he actually smokes less tobacco. If
he nervously smokes many cigarettes he throws away longer and longer
unused portions and thus keeps his consumption at about the same
figure.
_The Laryngoscope_ should be an authority on throat conditions as it
is the publication of throat specialists. We find in here a statement
to the effect that from a medical or laryngeal point of view there
is no reason why anybody should give up tobacco or alcohol if it
does them no very apparent harm. This is because the use of both in
moderation by millions proves the harmlessness of the habit which is,
in fact, often actually beneficial.
You can go further than that. If you want to be really mean you
can find an authority to state that visual acuity is increased by
smoking. When non-smokers smoked for they first time they saw better
than they did before smoking. The sight of habitual smokers was
unaffected by an additional smoke. They had already smoked themselves
into the best possible eye-sight. This may be unreliable testimony.
Far be it from me to judge it. The point is that it is quite as
reliable as any of the testimony advanced against the tobacco habit.
In short we are here in a region where exact scientific investigation
has not yet established reliable criteria of judgment. We cannot
cite irrefutable facts. We can only express opinions and opinions
are usually grounded in prejudice. Physicians tend normally to
prohibit, but they rarely prohibit judiciously because, under our
present chaotic medical system, they cannot afford to make a sound,
thorough-going clinical examination of every patient and must regard
medicine as an art--_i. e._, fall back upon empiricism.
As for prejudice, it amounts to little. Cromwell and his Puritans
smoked excessively. About 1840 women smoked outrageous stogies and
cumbersome pipes so shamelessly that men were alarmed and vigorous
caricatures satirized them in the periodicals of the day. Early in
the Victorian era smoking was all but a lost art. Today it is again
in ascendency, yet human depravity has remained at about one level
throughout.
In an editorial upon the subject during 1925 _The Journal of the
American Medical Association_ especially emphasized the fact that
variations in human susceptibility and tolerance were factors as
yet little understood. Extreme caution in generalization was wisely
advised on such subjects as the harm inherent in tobacco smoking,
and the reader was admonished that over-indulgence in turnips or
parsnips, or even in water, would turn out a great deal worse than he
might anticipate on immature consideration.
This factor of human individualization is rightly coming to the
front in medical literature today. Advances in biological chemistry
constantly attest the fact that each human individual is unique
chemically. What Smith can do with impunity Jones can only do with
a prospect of sudden death. This is not a superficial matter, but
one deep seated in the cellular structure of the human body, a
thing going back through ages of inheritance via the complex and
ill-understood chromosome. More and more it is being realized that
routine diets, prescriptions and prohibitions will not do in all
cases--in fact are actually unsafe and dangerous in many.
For all we definitely know today with positive assurance we cannot
deny the proposition that tobacco smoking is probably beneficial to
many people. Not long ago everybody was urged to go in for bran
because we all sadly needed roughage. Bran would cure constipation
and a thousand routine diets spattered the press. It was all very
well, except that constipation persisted. Today it is realized that
nervous and psychic factors have much more to do with constipation
than diet and the parade has set in that direction now. In fact some
authorities declare that these rough diets have actually had fatal
consequences in certain instances where a smooth diet was required.
But medical science really does not know sufficient about the
positive, absolutely undeniable effects of tobacco smoking upon human
beings to parade in any direction as yet without painful danger of
finding itself hopelessly bogged in error at some date in the near
future.