To Smoke or Not to Smoke?

Articles from the 1860s to the 1990s take up the contentious question

For decades, scientists have noted a strong correlation between smoking, lung cancer, and high death rates. But only recently has government at both the national and local levels taken aim at the practice of smoking. Why, one might wonder, has it taken so long? As this collection of Atlantic articles—spanning more than a century—makes clear, the debate on that seemingly straightforward question is older and more complex than one might think.

From Atlantic Unbound:

Sage, Ink: "Truth in Advertising" (October 14, 1999)
A cartoon by Sage Stossel.

In "Tobacco" (August 1860), Atlantic contributor David W. Cheever pointed out that tobacco use has been a highly contested practice since it was first adopted by western culture in the 1500s. Through the ages, he observed, it has been outlawed by popes, kings, shahs, and sultans as a crime punishable by excommunication, execution, mutilation, and even (in Turkey) skewering of the nose with one's own pipe. But he defended smoking for its many beneficial effects.

All classes, all ages, in all climates, and in some countries both sexes, use tobacco to dispel heat, to resist cold, to soothe to reverie, or to arouse the brain, according to their national habitations, peculiarities, or habits....

It relieves the little vexations and cares of life, soothes the harassed mind, and promotes quiet reflection.

Beginning in the mid-twentieth century, scientists began to take note of smoking's potential health hazards. In "Lung Cancer and Smoking: What We Really Know" (January 1956), Dr. Charles S. Cameron, the director of the American Cancer Society, marshaled evidence from the growing body of lung-cancer research to argue provocatively and convincingly that smoking was linked with cancer. "If it has not been proved that tobacco is guilty of causing cancer of the lung," he wrote, "it has certainly been shown to have been on the scene of the crime."

A year later, in An Open Letter to Dr. Clarence Cook Little (October 1957), Dr. David D. Rutstein, the head of the Preventive Medicine Department at Harvard Medical School, criticized the arguments of Clarence Cook Little, a tobacco-industry-supported researcher who was making repeated public statements refuting a definitive smoking/cancer correlation. Dr. Rutstein addressed Dr. Little directly:

You have consistently ignored or brushed off all of the human evidence whenever a statement relating cigarette smoking and lung cancer has been released to the press by a research worker, by the British government through its Medical Research Council, or by the Surgeon General of the United States Public Health Service speaking for the United States government....

Dr. Little, is there really any justification for your continuing to demand the discovery of the "cause" of lung cancer before we attempt to save human lives by recommending a decrease in cigarette smoking?

Dr. Little responded to Dr. Rutstein's criticisms two months later in "The Public and Smoking: Fear or Calm Deliberation?", reiterating his view that definitive proof of a link had not yet emerged.

The public has been heavily propagandized along one definite theory of causation by those convinced by one level of information. Some of us demand a different order and level of knowledge before we accept causation or condone presentation of conclusions to the public.

Of course, in the early years of cancer research, even those whose scientific objectivity was not filtered through the potentially distorting lens of tobacco-industry funding sometimes found reasons to question the smoking/cancer link. A study by Harvard anthropologist Carl C. Seltzer indicated that certain people may be biologically predisposed to the smoking habit. In his article "Why People Smoke" (July 1962), Seltzer speculated that perhaps the same factors responsible for an innate predisposition to smoking might also be responsible for an increased susceptibility to lung cancer—thereby undermining claims of a definitive cause-and-effect relationship between smoking and lung disease.

Politics also played an important role. In "The Quiet Victory of the Tobacco Lobby: How It Found the Best Filter Yet—Congress" (September 1965), Elizabeth Drew explained how businesspeople with vested interests in the tobacco industry were exploiting their high-level political connections to influence tobacco-related government policies. And in a 1992 article, France: An Ambivalent War Against Smoking," Judson Gooding discussed how similar factors were then operating in France to stymie anti-smoking legislation. In this case, he explained, the vested interests resided not with outside lobbyists, but, paradoxically, within the government itself, which owned the nation's cigarette-manufacturing monopoly and reaped substantial tax revenues from cigarettes.

Finally, in an untitled "Accent on Living" piece (April 1957), Atlantic editor Charles W. Morton offered an inspiring account of his own successful and surprisingly easy effort to quit smoking. He conceded that the lure of smoking—as promoted by Madison Avenue—is strong:

The propaganda for cigarettes on the airwaves is transcribed ecstasy on a 24-hour basis, with its hymn of jubilation over the latest filter, the new cigarette, or the old cigarette with its newly discovered richer-milder-smoother-finer—where have we heard those words before?—qualities. The hymn fades suddenly into the voice of the high priest, who repeats in the voice of hysteria the inanities of the ritual: Don't miss the fun of smoking. Smoke real. Smoke modern. Smoking is a pleasure. Togetherness. Be a real American. Come along with the rest of us. Don't be an outsider. Smoke, smoke any old thing just so long as you smoke something and don't try to be so different from other folks.

But the benefits of giving smoking up, he found, were great:

The rewards of shifting from fifty cigarettes a day to none at all so far outweighed the difficulties and came so promptly that the great issue of "will power" never arose at all: the choice was a state of near-invalidism and acute discomfort.... An asthmatic, who has been breathing noisily for a score of years, finds suddenly that he can lie down and sleep the night through, breathing deeply and quietly....

Even more enjoyable than sleeping so comfortably was the sudden access of energy for the working day, the disappearance of afternoon fatigue, the resumption of a far more active way of life than I would have believed possible for myself even ten years ago, let alone today.