Tobaccoism: “Rapidity in the Spread of a Disease-Producing Vice”

By Danielle Aloia, Special Projects Librarian

SmokeoutLogoThe third Thursday of November was designated the Great American Smokeout back in 1976. Since then it has gained national attention and helped precipitate smoke-free policies in public spaces and workplaces. It is a day to commit to quitting smoking with the theory that if you can last one day without lighting up, then you can last a lifetime.

Efforts to end tobacco consumption have a long history. Cigarettes grew in popularity during the 1850s, in tandem with the rise of Antitobaccoism movement.1 This movement was taken on by Seventh-day Adventists, whose most outspoken figure was Dr. John Harvey Kellogg.

John Harvey Kellogg, MD (1852– 1943). E. E. Doty, photographer. Source. Prints and Photographs Collection, History of Medicine Division, National Library of Medicine.

John Harvey Kellogg, MD (1852– 1943). E. E. Doty, photographer. Source. Prints and Photographs Collection, History of Medicine Division, National Library of Medicine.

The Adventists believed in a healthful lifestyle, including abstinence from coffee, alcohol, tea, and tobacco. Kellogg termed this “biologic living.”2 He and his compatriots established the American Health and Temperance Association in 1878 to expose the health risks of tobacco and other stimulants. Later, he became a member of the Committee of Fifty to Study the Tobacco Problem, presumably established after the First World War, when a “condition known as ‘soldiers’ heart’” affected British veterans.3 Kellogg also established a hydrotherapy sanitarium and wrote numerous books on healthful living. Today he is best remembered as the co-founder of Kellogg’s, a cereal company that grew out of his sanitarium’s dietary work.

Kellogg wrote Tobaccoism, or How Tobacco Kills in 1922, citing prior studies to document the ill-effects of tobacco on the biological system. This exhaustive account may be the result of his work on the Committee. Tobaccoism likely led Utah Senator Reed Smoot to introduce a bill into Congress including tobacco regulation into the scope of the Food and Drug Act of 1929, an effort that ultimately failed.4

Included in the book are some horrific images of the effects of tobacco on the human body. Unfortunately, the images are not sourced and it is hard to determine their derivation. In the text for the section “Damage Tobacco Does to the Liver,” Kellogg references, among others, a Graziani who showed “tobacco causes changes in the liver, particularly hemorrhages and areas of necrosis.” Part of the text of “Tobacco Cancer” reads: “Dr. Bloodgood, Professor of Surgery in Johns Hopkins University, in the study of 200 cases of cancer of the lip, finds smoking a common factor.”

Kellogg, John Harvey. Tobaccoism or How Tobacco Kills. Battle Creek, MI: Modern Medicine Publishing; 1922.

Kellogg, John Harvey. Tobaccoism, or How Tobacco Kills. Battle Creek, MI: Modern Medicine Publishing; 1922.

Kellogg gave figures for the growth in the tobacco habit by manufactured cigarettes per year, via the Census Bureau (the large increase in production from 1910 to 1920 has a lot to do with the First World War, when soldiers received unrestricted cigarette rations):

1902—2,971,360,447
1906—4,511,997,137
1910—8,644,557,090
1920—62,000,000,000

According to Kellogg, this meant there were 460 cigarettes for every man, woman, and child, a disturbing “rapidity in the spread of a disease-producing vice.”5 He wrote Tobaccoism in part to slow this growth by making sure people understood that tobacco was harmful and its effects irreversible.

Even with a long history of Antitobaccoism, smoking remains the leading cause of preventable death in the U.S., with 443,000 deaths annually.6 In 2011, there were over 290 billion cigarettes sold.7

There’s no better time to quit smoking than right now.

References

1. Reducing Tobacco Use. Centers for Disease Control and Prevention; 2000. Available at: http://www.cdc.gov/tobacco/data_statistics/sgr/2000/complete_report/pdfs/chapter2.pdf.

2. Marino RV. Tobaccoism revisited. J Am Osteopath Assoc 2003;103(3):120-121.

3 Lock, S. (ed.), Reynolds, L.A. (ed.), Tansey, E.M. (ed.). Ashes to Ashes: The History of Smoking and Health. Amsterdam: Rodopi; 1998.

4. Fee, Elizabeth, Brown, Theodore M. John Harvey Kellogg, MD: Health Reformer and Antismoking Crusader. American journal of public health 2002;92(6):935. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447485/pdf/0920935.pdf.

5. Kellogg, John Harvey. Tobaccoism or How Tobacco Kills. Battle Creek, MI: Modern Medicine Publishing; 1922.

6. Broken Promises to Our Children: The 1998 State Tobacco Settlement Fifteen Years Later. Washington, DC: Tobacco-Free Kids; 2013:87. Available at: http://www.tobaccofreekids.org/content/what_we_do/state_local_issues/settlement/FY2014/StateSettlementReport_FY2014.pdf.

7. U.S. Centers for Disease Control and Prevention. Economic Facts About U.S. Tobacco Production and Use. Smoking and Tobacco Use 2014. Available at: http://www.cdc.gov/tobacco/data_statistics/fact_sheets/economics/econ_facts/index.htm#sales.

Chinese Opium Dens and the “Satellite Fiends of the Joints”

By Anne Garner, Curator, Rare Books and Manuscripts

Dr. John Thackery (Clive Owen) visits an opium den. Cinemax, 2014

Dr. John Thackery (Clive Owen) visits an opium den in The Knick. Cinemax, 2014

Dr. John Thackery passes through a number of dimly-lit opium dens in the heart of New York’s Chinatown during the course of The Knick. What were these dens really like—and who frequented them?

In the mid-19th century, the Chinatowns of America were largely isolated communities, populated by immigrants brought by labor brokers to work on the Central Pacific Railroad or other jobs. Many of these workers planned to return home after several years; there was little desire to assimilate. Scholar Gunther Barth has suggested that with the safety of a familiar culture came familiar vices.1

A large number of Chinese immigrants came from Canton, a region with a rich history of opium-smoking. As the Chinese presence spread east, opium dens cropped up in the Chinatowns of every major American city.

American Opium-Smokers Interior of a New York Opium Den/ Drawn by J.W. Alexander. [New York] : Harper and Brothers, Oct. 8, 1881. Courtesy of Images from the History of Medicine (NLM).

American Opium-Smokers Interior of a New York Opium Den/ Drawn by J.W. Alexander. [New York] : Harper and Brothers, Oct. 8, 1881. Courtesy of Images from the History of Medicine (NLM).

H. H. Kane wrote in 1882 that the first white American to smoke opium did so in San Francisco’s Chinatown in 1868.2 Until then, opium smoking had been strictly confined to the areas of Chinese settlement. By 1875, the practice was widespread enough that San Francisco passed a law prohibiting opium dens. This ordinance was America’s first anti-narcotics law.

The San Francisco ordinance coincided with an increasing anxiety among whites in large urban areas that the low-paid Chinese would threaten wages and standards of living. At the time, the country was mired in a deep recession. The federal Page Act, passed the same year as the San Francisco law, similarly targeted Chinese immigrants, aiming to “end the danger of cheap Chinese labor and immoral Chinese women.”3

Beginning with Virginia City the following year, local ordinances banning opium-smoking quickly passed across the U.S. These laws were largely ineffective. Law enforcement, focused on prosecuting Chinese dens known to attract white clientele, only drove whites deeper into Chinatown, and to smoke at higher rates.4

As opium use among whites increased, community leaders began to signal a concern about the morals of white women. Philadelphia missionary Frederic Poole cautioned that white women exposed by the Chinese to opium-smoking were at risk of “a life of degradation.”5 In 1883, Reverend John Liggins wrote of the dangers of the many New York City dens found in Mott and Pearl Streets (still the heart of Chinatown today), and quoted Kane that the habit, learned from the Chinese, contributed to “the downfall of innocent girls and the debasement of married women.”6 The same year, Allen S. Williams wrote in an early book on the opium-smoking habit about New York’s Chinatown dens:

Chinamen flit noiselessly by in ghostly, fluttering garments, and startle the Caucasian intruder by the very suddenness of their unsympathetic companionship…. the Chinese opium joint…is run for the sole purpose of pandering to a vicious taste whose indulgence is injurious to society.7

On the left coast, The Wasp, a popular San Francisco paper, sent two “reporters” to that city’s Chinatown in 1881, and published their findings:

In reeking holes ‘two stories’ underground, where the light of heaven and healthy atmosphere never penetrate, we found human beings living—if it may be called living, which is at best but an existence—as contentedly as rats in a sewer, whose habitation theirs so much resembles. The opium smokers’ resorts were among the first visited…a person once there, he may well desire to make himself oblivious of such surroundings and raise himself to a temporary heaven of his own, but how white men, and even white women, can bring themselves to descend to such filthy holes, where the reeking slime courses down the walls and the air is heavy with foetid odors, is a mystery to any well-regulated mind.8

The Wasp article offers an especially disturbing example of how many Americans implicated the Chinese as a group with standards and moral habits far inferior to those of whites. As early as the 1880s, opium dens run by the French and even white American-born women could be found in New York and Philadelphia, but the imagery continued to portray them as exclusively Chinese-owned and -operated. “It’s a poor town now-a-days that has not a Chinese laundry, and nearly every one of these has its lay-out [pipe plus accessories],” wrote one white traveler in 1883.9

Fig. 2—Smoker's Outfit. In Opium-Smoking in America and China.

Fig. 2—Smoker’s Outfit. In Opium-Smoking in America and China.

The framing of opium smoking as a Chinese problem continued as the century drew to a close. Temperance advocates and moral reformers identified opium smoking with indolence and passivity, qualities out of sync with a culture that emphasized hard work and a fast-paced industrial society. These kinds of characterizations became an important way to generate public revulsion for an immigrant group perceived to threaten both economic and social stability, and to gain traction for legislative action.10

The antagonisms toward the Chinese and attendant immigration restrictions resulted in a Chinese immigrant population that decreased by 1920 to less than half of what it was in 1890.11 The last opium den in New York was raided in 1957. Decades before, many of Chinatown’s dens, largely abandoned because of the rise of opium derivatives morphine and heroin, had all but disappeared.

References

1. Courtwright, David. Dark Paradise. Opiate Addiction in America before 1940. Cambridge: Harvard, 1982. 68.

2. Kane, H.H. Opium-Smoking in America and China. New York: G.P. Putnam’s, 1882. 1.

3. Peffer, George Anthony. Forbidden Familes: Emigration Experiences of Chinese Women Under the Page Law, 1875-1882. Journal of American Ethnic History, Vol. 6 No. 1, Fall, 1986.

4. Courtwright, 79.

5. Courtwright, 78.

6. Liggins, John. The Spread of Opium-Smoking in America. New York: Funk & Wagnalls, 1883. 20.

7. Williams, Allen Samuel. The Demon of the Orient and his Satellite Fiends of the Joints. New York: [the author], [1883]. 12.

8. The Chinese in California, 1850-1925.

9. Courtwright, 73.

10. Musto, David F. The American Disease. Origins of Narcotic Control. New Haven: Yale, 1973. 294-300.

11. Courtwright, 85.

More Doctors Smoke Camels

By Johanna Goldberg, Information Services Librarian, with Andrew Gordon, Systems Librarian

This is part of an intermittent series of blogs featuring advertisements from medical journals. You can find the entire series here.

From the 1930s into the 1950s, medical journals—including the Journal of the American Medical Association and the New England Journal of Medicine—ran advertisements for cigarettes.1,2 The New York State Journal of Medicine alone published 600 pages of cigarette advertisements spanning more than two decades, starting in 1933.3 Around the same time, advertising agencies created campaigns featuring physicians; these continued until 1954, as concerns about the negative health effects of smoking grew.2

"How mild can a cigarette be?" Published in the New England Journal of Medicine, volume 240, number 17, April 28, 1949. Click to enlarge.

“How mild can a cigarette be?” Published in the New England Journal of Medicine, volume 240, number 17, April 28, 1949. Click to enlarge.

Presented chronologically below are some of the cigarette advertisements—and one cigarette paraphernalia‎ ad—that appeared in medical journals during the 20-year period. Note especially the 1945 series of ads that ran in several medical journals, including the Medical Woman’s Journal, celebrating the work of war doctors and suggesting that a Camel cigarette could be a welcome break.

Notable, too, is that the earliest ad shown here—printed in Preventive Medicine in 1937—comes from a New York Academy of Medicine publication.

For more information on the history of cigarette advertising, including the use of medical professionals in ads, visit SRITA, Stanford Research into the Impact of Tobacco Advertising.

"Let Your Own Experience Guide You." Published in Preventive Medicine, volume 7, number 1, April 1937. Click to enlarge.

“Let Your Own Experience Guide You.” Published in Preventive Medicine, volume 7, number 1, April 1937. Click to enlarge.

"Look this way for more pleasure." Published in the New England Journal of Medicine, volume 218, number 14, April 7, 1938. Click to enlarge.

“Look this way for more pleasure.” Published in the New England Journal of Medicine, volume 218, number 14, April 7, 1938. Click to enlarge.

"How much do you smoke?" Published in JAMA, volume 12, number 11, March 11, 1944. Click to enlarge.

“How much do you smoke?” Published in JAMA, volume 12, number 11, March 11, 1944. Click to enlarge.

"The Army Doctor's Call to Action!" Published in Medical Woman's Journal, volume 52, number 4, April 1945. Click to enlarge.

“The Army Doctor’s Call to Action!” Published in the Medical Woman’s Journal, volume 52, number 4, April 1945. Click to enlarge.

Combat Team in White! Published in Medical Woman's Journal, volume 52, number 5, May 1945. Click to enlarge.

Combat Team in White! Published in the Medical Woman’s Journal, volume 52, number 5, May 1945. Click to enlarge.

"The Flying Capsules." Published in Medical Woman's Journal, volume 52, number 6, June 1945. Click to enlarge.

“The Flying Capsules.” Published in the Medical Woman’s Journal, volume 52, number 6, June 1945. Click to enlarge.

"Welcome Home, Doctor!" Published in Medical Woman's Journal, volume 52, number 12, December 1945.

“Welcome Home, Doctor!” Published in the Medical Woman’s Journal, volume 52, number 12, December 1945. Click to enlarge.

"Recommended by Physicians to Patients who are 'Problem Smokers.'" Published in JAMA, volume 133, number 11, March 15, 1947.

“Recommended by Physicians to Patients who are ‘Problem Smokers.'” Published in JAMA, volume 133, number 11, March 15, 1947. Click to enlarge.

"Some questions about filter cigarettes that may have occurred to you, Doctor." Published in the New York State Journal of Medicine, volume 53, number 12, June 15, 1953.

“Some questions about filter cigarettes that may have occurred to you, Doctor.” Published in the New York State Journal of Medicine, volume 53, number 12, June 15, 1953. Click to enlarge.

"When your patients ask . . . 'Which Cigarette Shall I Choose?'" Published in the New York State Journal of Medicine, volume 54, number 12, June 15, 1954. Click to enlarge.

“When your patients ask . . . ‘Which Cigarette Shall I Choose?'” Published in the New York State Journal of Medicine, volume 54, number 12, June 15, 1954. Click to enlarge.

References

1. Healy, M. (2011, August 4). Cigarette packages in medical journals: New look for a new age. Los Angeles Times. Retrieved from http://www.latimes.com/health/boostershots/la-heb-cigarette-packages-medical-20110804,0,7658494.story#axzz2rL60QSQm.

2. Gardner, M. N., & Brandt, A. M. (2006). The Doctors’ Choice Is America’s Choice. American Journal of Public Health, 96(2), 222–232. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470496.

3. Blum, A. (2010). When “More doctors smoked Camels”:  Cigarette advertising in the journal. Social Medicine, 5(2), 114–122. Retrieved from http://www.socialmedicine.info/index.php/socialmedicine/article/view/461/0.

Smoking and Health, 50 Years Later

By Johanna Goldberg, Information Services Librarian

On Saturday, January 11, 1964, fifty years ago this past Saturday, the U.S. Surgeon General released a report that took the country by storm: Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service.

While surgeons general had made statements regarding cigarette dangers as early as the 1920s,1 this report marked the beginning of the Office of the Surgeon General’s practice of releasing “authoritative scientific statements,”2 which continues to this day. It also marked the first time a surgeon general report received enormous media attention.1

"Percentage of persons who have never smoked by sex and age, United States, 1955." A chart from Smoking and Health. Click to enlarge.

“Percentage of persons who have never smoked by sex and age, United States, 1955.” A chart from Smoking and Health. Click to enlarge.

To produce Smoking and Health, Surgeon General Dr. Luther L. Terry assembled a committee of 10 doctors from a variety of disciplines, none of whom who had previously spoken publicly about tobacco use, to review more than 7,000 publications, including articles, reports, statements from tobacco companies, and conference proceedings. The committee did not carry out original research, instead performing a thorough review of the literature, completed in just over two years.3

"Trends in Age-Adjusted Mortality Rates for Cancer by Sex." A chart from Smoking and Health. Click to enlarge

“Trends in Age-Adjusted Mortality Rates for Cancer by Sex.” A chart from Smoking and Health. Click to enlarge

The 387-page report made some dire conclusions:

  • Smokers are 70% more likely than non-smokers to die of coronary artery disease; 500% more likely than non-smokers to die of emphysema and chronic bronchitis; and 1,000% more likely to die of lung cancer.
  • Male cigarette smokers have a “9- 10-fold risk of developing lung cancer.” That risk rises to 20-fold for heavy smokers.
  • Cigarette smokers have a 70% higher mortality rate than non-smokers.3

On Sunday, January 12, newspaper front pages and other media sources  around the country featured the report.4 The New York Times alone published 10 articles mentioning the report that day,5 with one on reporters and government employees (including the surgeon general’s assistant for information) smoking in front of the nine no-smoking signs outside the news conference auditorium.6

The report had an immediate impact. In New York, the cigarette tax revenue was 5% lower in January 1964 than the previous year, and 18% lower in February. Cigarette consumption dropped 3.5% nationwide; while it rose in coming years, it never again reached its 1963 peak. One week after the report’s debut, the Federal Trade Commission (FTC) released plans to require health warnings in cigarette advertisements and packaging. In place of the FTC’s plans, Congress passed the Cigarette Labeling and Advertising Act of 1965, followed by additional labeling laws.7

"Mortality from Cancer (All Sites), U.S. Death Registration Area of 1900, 1900-1960," a chart from Smoking and Health.

“Mortality from Cancer (All Sites), U.S. Death Registration Area of 1900, 1900-1960,” a chart from Smoking and Health.

How far have we come? In 2011 (the most recent year available from the CDC),  about 19% of adults in America smoked, compared to the approximately 40.3% in 1964.8,9 Looking for information on how to quit smoking and reduce this percentage further? Visit smokefree.gov.

References

1.The Reports of the Surgeon General: Brief history. (n.d.). Retrieved January 7, 2014, from http://profiles.nlm.nih.gov/ps/retrieve/Narrative/NN/p-nid/58.

2. The Reports of the Surgeon General: Changing conceptions of public health. (n.d.). Retrieved January 7, 2014, from http://profiles.nlm.nih.gov/ps/retrieve/Narrative/NN/p-nid/59.

3. United States Surgeon General’s Advisory Committee on Smoking and Health. (1964). Smoking and health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. Washington, D.C.: U.S. Department of Health, Education, and Welfare. Public Health Service. Accessible in full online at http://profiles.nlm.nih.gov/NN/B/B/M/Q/.

4. Housman, M. (2001). Smoking and health: The 1964 U.S. Surgeon General’s Report as a turning point in the anti-smoking movement. Health Policy Review, 2(1). Retrieved from http://www.hcs.harvard.edu/~epihc/currentissue/spring2001/housman.html.

5. NYTimes.com search. (n.d.). Retrieved January 7, 2014, from http://query.nytimes.com/search/sitesearch/#/surgeon+general/from19640112to19640112/.

6. Hunter, M. (1964, January 12). Smoking banned at news parley. But some reporters puff sheepishly in corridors. New York Times. Retrieved from http://legacy.library.ucsf.edu/tid/zbg90c00/pdf.

7. Sullum, J. (1998). For your own good: The anti-smoking crusade and the tyranny of public health. New York: Free Press.

8. CDC’s Office on Smoking and Health. (2013, June 5). Smoking and tobacco use fact sheet: Adult cigarette smoking in the United States. Retrieved January 7, 2014, from http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/.

9. United States Public Health Service Office of the Assistant Secretary for Health Office on Smoking and Health, & United States Public Health Service Office of the Surgeon General. (1979). Smoking and health: A report of the Surgeon General. Appendix: Cigarette smoking in the United States, 1950-1978 (pages A-1 through A-29) (Official reports). Retrieved from http://profiles.nlm.nih.gov/ps/retrieve/ResourceMetadata/NNBCPH.