“Don’t Smoke—Unless You Like It”: A 1950 Case Against Antismoking

Tobacco was promoted in Europe in the 17th century as a cure for a number of ailments, including toothache, fatigue, and joint pains, as well as a calming agent. Smoking for enjoyment, however, was mainly responsible for the growth of the tobacco industry. By the time the following Collier’s article was published in 1950, a campaign to warn smokers—who by then made up more than half of the American population—of potential dangerous effects of smoking was underway. Opposed to these efforts, the author argued that scientific attempts to link tobacco products to lung cancer and heart disease had failed and that the antismoking crusade interfered with needed research into more likely cancer causes. In 1951, an important medical study in London concluded that smoking was “an important factor” contributing to lung cancer. Despite a growing antismoking movement, aided by a 1979 Surgeon-General’s report linking smoking to heart disease and the classification of nicotine as an addictive drug by the Food and Drug Administration in 1995, over five trillion cigarettes were sold that year. Threatened with state and local class-action lawsuits, the U.S. tobacco industry agreed in 1998 to a consent decree that settled 37 pending cases, quieted future claims, and ended certain types of tobacco advertising.

For centuries tobacco has brought mankind peace and cheer. Now some scientists say smoking is dangerous. But are their findings conclusive? The answer is No.

For more than 400 years, ever since the first paleface was lulled toward a treaty by an Indian peace pipe, tobacco has been decried as a moral and a physical menace. Yet, all through these centuries, an ever-growing portion of mankind—and more recently of womankind—has ignored these cries and found comfort in the glowing bowl of a pipe, solace in the delicate aroma of a cigar, and an outlet for nervous tension in a few quick puffs on a cigarette.

Americans, most of all, have taken the cigarette to heart. More than three quarters of all our adult men, and more than 40 per cent of all women, now smoke. We consume almost 400,000,000,000 cigarettes each year. We average nearly a full pack each per day.

Recently, however, the ranks of the antitobacco forces have been swollen by new recruits. Serious scientists and physicians have solemnly reported the results of intensive research in authoritative medical journals. These studies, if only because of their source, cannot be laughed off as were the denunciations of “the filthy weed” by the wild-eyed soapboxers of generations past.

Newspapers, the radio and television have picked up these reports and spread them broadcast. Condensing and oversimplifying them—with the ifs, ands and buts omitted—they have made smoking look, to many, like a dangerous habit indeed.

Millions of us have been led to worry whether the innocent-looking white tubes we casually light and puff are not really lethal weapons, slowly poisoning our systems, giving rise to ulcers, heart troubles, circulatory diseases, tuberculosis and even cancer. A few of us have given up smoking entirely. Others have cut down to four or six or eight cigarettes a day. Many, while puffing away as busily as ever, still remain disturbed and vaguely frightened at the menaces that they have been told lurk in the seemingly innocuous cigarette.

Are these worries really justified?

Is the new evidence against the cigarette really valid, really conclusive?

Has tobacco been found guilty of endangering health and even lives?

Or have many of us been scared, unnecessarily scared, by sensationalized stories about limited, inconclusive and controversial research?

Fortunately, for those of us who love to smoke, the latter seems to be the case. Some scientists have, tentatively, indicted tobacco. But a tremendous gap exists between such tentative indictment and a full-scale conviction shared by all scientists. This doesn’t mean that you ought to sit back and laugh if your doctor suggests that you cut down on smoking. Tobacco—like fat foods, lean foods, exercise, lack of exercise, too much sunshine, too little sunshine, and a host of other factors—may be undesirable from a health standpoint for some individuals in certain circumstances. On the other hand, if you have nothing much wrong with you, tobacco—despite all the scare stories—probably is the one indulgence least likely to send you reeling toward the hospital or the grave. . . .

Experts at the U.S. Public Health Service’s National Cancer Institute point out that both the Graham-Wynder and the Levin-Goldstein-Gerhardt studies are limited to smoking as a possible cause of cancer. Yet many environmental and occupational factors have been proved to cause lung cancer and still others are equally or more suspect than tobacco.

That such concentration upon a single cause, to the exclusion of all others, can lead to serious error was demonstrated in a research study conducted by Drs. René Huguenin, Jean Fauvet and Jacques Bourdin, of the Institut du Cancer, Paris. They were confronted with a substantial group of cases of cancer of the lung which had been blamed, originally, on tobacco. But when they considered the possibility of other causes, they were able to demonstrate that a substantial proportion of these patients had been exposed, in their work, to a cancer-causing oil mist. The easy road, of blaming tobacco, actually had served only to obscure the real cause in these cases, an occupational exposure to a dangerous cancer-causing agent that, once understood, could be attacked and controlled or eliminated.

It is precisely because incidents of this sort have occurred that men like Dr. Austin V. Deibert and Dr. W. C. Hueper, of the National Cancer Institute, regard the recent emphasis upon smoking as the cause of cancer of the lung as dangerously one-sided. They know that many industrial dusts have been demonstrated to cause cancer among workers in these fields. They fear that an all-too-easy emphasis upon smoking as the culprit may lead industry and public health authorities to neglect protective measures against these far more definitely proven cancer causes.

As Dr. Deibert put it in his critical letter to the A.M.A. Journal, “It seems advisable not to close our eyes to the possible or probable existence of other cancerigenic agents in any future search for the causes of cancer of the lung.” . . .

Another more recent study, once again published by the A.M.A. Journal, reported upon a far more extensive investigation by a group of doctors from Columbia University’s College of Physicians and Surgeons and from New York’s Presbyterian Hospital. Drs. Robert L. Levy, James A. L. Mathers, Alex A. Mueller and John L. Nickerson wanted to find out whether smoking was bad for people who already had heart disease.

They tested persons of different ages, some of whom suffered from various heart conditions and some of whom didn’t. They tested young people and old. They used both ordinary cigarettes and the denicotinized types.

Facts That the Tests Revealed

They found, first of all, that cigarettes had widely differing effects on different people—effects that varied without any discernible relation to whether or not the people had heart disease.

Except in a small minority of susceptible persons, they found that smoking cigarettes caused only slight changes in the circulation and did not significantly increase the work demanded of the heart.

Among none of their subjects, including even those with coronary heart disease, did they find that smoking caused any cardiac pain.

Their viewpoint? “Most patients with a cardiac disorder, including those with a disease of the coronary arteries, can smoke moderately without apparent harm. In fact, for many, smoking not only affords pleasure but aids in promoting emotional stability.”

That, of course, does not mean that all heart patients should smoke. Dr. Levy and his group were careful to point out that smoking should be forbidden for certain types of heart disease—“congestive heart failure, the acute stages of cardiac infarction and active rheumatic heart disease.”

The antismoking propagandists have another major line of attack. Smoking, they tell us, shortens the life-span. The cigarette, they assert, is in actuality what we used to call it jokingly, a “coffin nail.” . . .

Untouched by prejudice against the cigarette, many a physician has come to appreciate a new attitude toward smoking in recent years. They ascribe no curative virtues to tobacco. They recognize that smoking is an expensive habit. But they also recognize that many of their patients find, in a pipe or a cigar or a cigarette, a pleasure and solace and a relief from nervous tension that should not, too readily, be denied them.

They have noted, for example, that when they take their heart patients abruptly off their tobacco ration, mild depressions often ensue.

They find that among their neurotic and nervous patients, the denial of cigarettes often produces outbreaks of other, and far less desirable, nervous habits. Such people unable to channel their energies into puffing, become face-pickers, foot-tappers, icebox raiders.

Even the appetite-depressing effect of cigarettes, which seems to be scientifically well established, is now being recognized as not by any means always an evil. The smoker who starves himself into malnutrition is an extremely rare, if not a totally nonexistent, phenomenon. But the man who smokes to stifle a tendency toward overeating is familiar to most doctors.

Medical Consensus Summarized

Perhaps the best and most judicious summary of the most generally accepted medical viewpoint is to be found in an editorial published a few years ago in the Journal of the American Medical Association. “Actual surveys indicate,” it stated, “that the majority of physicians themselves smoke cigarettes. From a psychological point of view, more can be said in behalf of smoking as a form of escape from tension than against it. There does not seem to be a preponderance of evidence that would indicate the abolition of the use of tobacco as a substance contrary to the public health.”

To that authoritative statement it might be well to add the advice given me by a Washington physician after a long evening of discussing the pros and cons of smoking. Together with two cancer researchers and a statistician, we had all puffed away for hours while we analyzed the medical evidence for and against the cigarette. When we finally quit, at three in the morning, a deep blue haze filled the room.

“Summing it all up, Doctor,” I asked, “would you advise me—an average, sedentary, moderately healthy character—to keep on smoking or to quit?”

Cigarette in hand and glancing at the overloaded ash trays, he laughed.

Then he leaned over and whispered, “I’m going to tell you exactly what I tell most of my patients. Don’t smoke—unless you like it.”

Source: Albert Q. Maisel, "Don’t Smoke—Unless You Like It, Collier’s, November 4, 1950, 18.