Authors: Richard Kluger
The absence of documented danger hardly concerned those most outspoken against the cigarette in the period just preceding the Great War. The line between moral and medical objections to smoking, blurred from the first, grew even hazier now. No one in America spoke out more forcefully against cigarettes in particular than the scientist-industrialist Thomas Edison, who was sure the problem lay not with the tobacco itself but with acrolein, a compound released by “the burning paper wrapper,” as he wrote in 1914 to fellow industrial titan Henry Ford, and that foul substance “has a violent action on the nerve centers, producing degeneration of the cells of the brain, which is quite rapid among boys.” The clinical evidence for this assertion was never forthcoming, but the celebrated inventor was sure that the damage caused was permanent and uncontrollable and thus, “I employ no person who smokes.”
That was good enough for the straitlaced Henry Ford, who supposed that his mastery in the new automobile business qualified him as the nation’s moral mentor, and in 1916 he had issued under his name
The Case Against the Little White Slaver
, a widely disseminated broadside that spread the anticigarette gospel according to Edison and Miss Gaston. Anyone who examined the clues of pathologic behavior in the typical criminal, Ford insisted, “will find that he is an inveterate cigarette smoker. Boys, through cigarettes, train with bad company. They gerwith other smokers to the pool rooms and saloons. The cigarette drags them down.” Ford’s views were challenged by American Tobacco’s president, Percival Hill, who wrote the carmaker to assure him that cigarette
paper had been carefully tested for toxicity and the tobacco it held was pure and contained less nicotine than other forms of smoking, so that “their temperate use is in no way injurious to normal smokers.” But no tobacco company officer then—or since—ever spelled out the meaning of moderation in smoking.
Spurred by Edison, Ford, and other business leaders, a number of large U.S. companies began to actively discourage cigarette smoking, among them the Cadillac Motor Car Company, business-machines maker Burroughs, the giant Marshall Field and Wanamaker department stores, and Montgomery Ward, the mail-order merchandiser. Eminences in other spheres joined in the denunciation, including the labor union chieftain Samuel Gompers, the black educator and inspirational force Booker T. Washington, and the swift scourge of the baseball diamond, Ty Cobb.
Probably no more comprehensive or conscientious summation of the case to discourage cigarette use was produced in this period than
Tobacco and Human Efficiency
, a 1918 book-length study by Frederick J. Pack, a geologist at the University of Utah, a Mormon stronghold where tobacco smoking was considered, as by Islam, to be an ungodly defilement of the flesh. Pack’s book, a collage of clinical observations, suppositions, and moral bias, noted that cigarette smoke, while containing less nicotine than cigar or pipe smoke, had the unfortunate tendency upon being inhaled of mixing the highly toxic gas carbon monoxide into the bloodstream; the precise consequences of this introduction were not yet clear. And because inhaled cigarette smoke came into contact with “hundreds of square feet of mucous membrane in comparison with the square foot or two on the surfaces of the oral cavity when inhaling is not indulged in,” Pack stated that the injury inflicted by cigarettes was “almost directly proportional to the area reached by the poisonous fumes.” But the nature and extent of such injury as well as the data to support this sweeping conclusion were not provided.
Congressional passage of the Eighteenth Amendment outlawing alcoholic beverages early in 1919 set off alarm bells in the tobacco industry. The war boom had peaked, and powerful reform groups like the Women’s Christian Temperance Union and charismatic religious spokesmen like the Reverend Billy Sunday, needing fresh targets to sustain their tumescent moralism, turned now from the demon rum to the demon weed. With such allies, the ceaseless crusader Lucy Gaston made one last charge against the smoky citadel of sin and, since women were now voters, announced her candidacy for President. Her victorious opponent was that handsome “cigarette face,” Warren G. Harding, to whom she wrote asking that, for both his own sake and the youth of the nation, he give up using the little smokes. Under Gaston’s harangue, Harding may well have cut down on his smoking—at the least he no longer flaunted the habit in public—but too late if indeed it had compromised his health; he died of a stroke midway through his term of office. Any facile linkage, though, between
smoking and mortality that might have been inferred from Harding’s case was frayed when Gaston herself died a year after the President; the cause in her case—cancer of the throat—was then considered far more likely to have been tobacco-induced, but so far as was known, Miss Gaston had never been kissed and never smoked.
Her death seemed to draw to an end the campaign to proscribe cigarettes. Ironically, the product gained stature now when contrasted with alcohol. Tobacco in general and cigarettes in particular neither intoxicated nor excited the passions, and, far from being a destructive influence on family life, as booze most emphatically could be, a good smoke lured men home for contemplative lingering by their hearth, argued the tobacco industry. Leading intellectuals, moreover, like the philosopher John Dewey and political conservatives like former President William Howard Taft, warned that if the so-called reform process that had begun with the fruitless effort to halt the sale of alcohol was extended to other purportedly harmful practices, such as smoking, it would fuel a misguided puritanism that would run roughshod over American liberties. The disastrous experience that Prohibition was proving to be—an open invitation to criminal pandering to backdoor licentiousness—was, for many, evidence enough of the ineffectuality and imprudence of government intrusion upon privately exercised pleasures, however offensive to bluenoses.
The ironical enhancement of tobacco’s position
vis-à-vis
alcohol was well captured just before Harding’s election in an article in the
Atlantic
entitled “Is a Tobacco Crusade Coming?” and predicting that “the present gale of vilification will blow itself out and die unnoticed at the feet of scientific truth … . That the claims of those who inveigh against tobacco are wholly without foundation has been proved time and again by famous chemists, physicians, toxicologists, physiologists, and experts of every nation and clime.” A more judicious reading of the social climate was made in 1921 by the journal
Current Opinion
when it stated that while science might suspect that smoking was injurious to the throat, heart, and nerves—no mention was made of the lungs—the state ought not casually to prohibit the practice “unless it makes out a better case against tobacco than it has done up to the present … .”
True to the highly pragmatic strain in the American character that has always run as deep as its soaring principles, the nation then adopted a more immediately useful policy toward cigarettes than clamoring about their alleged nastiness and undemonstrated peril to health: it began taxing them more heavily. There was a world of difference between branding their use a sin and making it a crime. If the former, a user’s fee could be imposed with relatively good conscience; if the latter, government could succeed only in immersing itself in a fresh swamp, its police powers failing hopelessly against human nature. Thus, the federal excise levy on cigarettes was boosted to six cents a pack, and in 1921 Iowa became the first state to tax cigarettes, charging two cents a pack
on top of the U.S. rate. Other states shortly followed, even as Kansas, in 1927, became the last state to drop its prohibition against cigarette sales. By 1930, federal tax collections on tobacco products, which had amounted to $58 million in 1910 (13 percent accounted for by cigarettes), had risen to nearly ten times that figure—and 80 percent came from cigarette sales. So embedded in American life had the product become that
The New York Times
wrote in a rhapsodic editorial in 1925, “Short, snappy, easily attempted, easily completed or just as easily discarded before completion—the cigarette is the symbol of a machine age in which the ultimate cogs and wheels and levers are human nerves.” H. L. Mencken’s
American Mercury
that year commended the cigarette as “the most democratic commodity in common use” since both the banker and his bootblack could share a brand, the
Mercury
scoffed, as was its wont, at all “the appalling charges” lodged against the little smokes and wound up, “A dispassionate review of the [scientific] findings compels the conclusion that the cigarette is tobacco in its mildest form, and that tobacco, used moderately by people in normal health, does not appreciably impair either the mental efficiency or the physical condition.” This view would prevail as the American consensus for another twenty-five years.
V
BY
the end of the 1920s, as the per capita use of cigarettes by Americans eighteen or older reached four a day, a few medical investigators reported, more with curiosity than alarm, on the faintly measurable increase of a disease that had been quite rare—cancer of the lung. A special study by the U.S. Census Bureau in 1914 had found a death rate from the disease of 0.6 per 100,000 living Americans; by 1925 the lung cancer mortality rate had risen to 1.7, a threefold increase that was nevertheless still quite low in absolute terms and relatively unnoticeable when compared to such still virulent contagious diseases as influenza and tuberculosis. But in various urban centers sampled over selected time periods, the death rate was noticeably higher than the overall national figure for lung cancer. In Albany, New York, the number was 2.5 for 1919–23, and across the state in Buffalo it was 3.2 for 1922–26; in Boston for 1920–24 the rate had been 3.9, and in San Francisco for the same period it reached 4.7. In England and Wales, where cigarette smoking had also grown greatly, the rate had been 1.0 for the first decade of the century but had risen to 2.33 by 1926.
The phenomenon was still too minor to qualify as a trend, and even as the figures continued their upward movement, some observers were quick to attribute them to better diagnostic tools, of which the X-ray machine was among the most prominent. Deaths, that is, that had been wrongly attributed to other
diseases earlier were likely to have been due in fact to lung cancer. But sites other than the lung, examinable by the same new diagnostic methods, were not revealing a comparable rate of rise in cancer. Nor were the mortality rates climbing comparably for other diseases, as advances in immunology were beginning to add significantly to human longevity, largely by reducing infant deaths. Frank E. Tylecote, a British investigator reporting in
The Lancet
in 1927, found it notable that the climb in lung cancer rates was by no means limited to the working classes, “as might be assumed,” and then added, “I have no statistics with regard to tobacco, but I think that in almost every case I have seen and known of the patient has been a regular smoker, generally of cigarettes.”
The first sizable and systematic study comparing cancer patients with those suffering from other diseases, undertaken by a pair of investigators from the Massachusetts Public Health Department and the Harvard School of Public Health, was reported in April of 1928 in the
New England Journal of Medicine
, the nation’s most highly regarded publication devoted to comprehensive coverage of the healing arts. Herbert Lombard and Carl Doering examined the histories of 217 cancer victims statewide and a comparable number of patients free of the disease but closely comparable in age, gender, and economic status. Their study, aimed at considering potential causes of cancer, dwelled on their subjects’ dietary and exercise habits and their use of alcohol (though illegal at the time), laxatives, and tobacco. Perhaps the most revealing discovery in their study was that in sites generally considered most susceptible to harm from smoking—the lips, cheeks, jaw, and lungs—all but one of the thirty-five cancer sufferers were heavy smokers. But certifiable tobacco users in the group with cancer outnumbered only slightly users in the control group free of the disease. The findings were therefore open to at least two varying interpretations: the use of tobacco was (1) irrelevant to the incidence of cancer or (2) a necessary contributor to the disease but not sufficient in and of itself to be the cause of it.
A more free-ranging exploration of the lately detected increase in lung cancer, by a Prudential Life Insurance Company statistician, Frederick Hoffman, writing in 1929 in the
American Review of Tuberculosis
, contrasted the 50 percent decline over four decades of tuberculosis, the vastly more prevalent lung disease. Because lung cancer occurred mostly in men, speculation arose that it might be linked to certain occupations in which possible irritants were unavoidable, such as wood dust in carpentry and millwork and mineral particles in mining and metals processing. At least as likely a contributor, though, was the immense increase in automobile road traffic, with its emanations of gasoline vapors, oil particles, and coal tar; a growing number of studies were showing that tar products and coal combustion, then the most common heating fuel source, had “a unique carcinogenic efficacy,” as Hoffman put it, and so other
petrochemical products were naturally suspect. Not quite as an afterthought, he also noted, “There is no definite evidence that smoking habits are a direct contributory cause toward malignant growths in the lungs.”
VI
THE
scientific consensus that had thus far exonerated the cigarette of any demonstrable harmful effect on human tissue served as a license in the late ’Twenties for tobacco manufacturers to push the ever more successful product with growing resources and commitment.
R. J. Reynolds Tobacco, purveyors of the industry-leading Camel brand, was now spending some $10 million a year in advertising, most of it on the one brand. And unlike most medical commentators, RJR, as Reynolds came to be familiarly called, sounded no cautionary note about the desirability of moderate or temperate use of cigarettes. Quite the opposite. “Each successive Camel you smoke brings a fresh pleasure no matter how constantly you smoke,” declared a typical ad. Another from 1927 saluted “experienced smokers” who “have paid Camel the highest compliment: ‘No matter how liberally we smoke them, Camels never tire the taste. They never leave a cigaretty after-taste.’”