A Little More “Truth About Tobacco”
- Author:
Charles Keen Taylor,
Philadelphia, Pa.
In January, 1913, Harper’s Weekly published an article which made my “eyes like stars start from their spheres”. This astonishing essay not only absolves tobacco from all wrongdoing, but even intimates that it might be beneficial. It warmly declares that the much abused weed has never been shown to have worked actual damage upon the average normal person, and that all lectures, statistics, text books of physiology, and the like to the contrary, are both absurd and ridiculous. In fact it decides that there is no “evidence to condemn tobacco in any form, not excepting cigarettes” I I marvelled greatly how such an article came to be printed in a reputable journal, and my first explanation was silly. I thought there must be one of those interlocking directorships one hears so much about, between the tobacco trust and the publishers. Abandoning this idea, I then thought that the writer, a man financially interested in tobacco or an habitual smoker, smuggled the article into the magazine when the editor was not looking. This idea was discarded as more silly than the first. Finally I arrived at the only sensible explanation. The man who wrote it thought he was doing his religious duty in destroying the damaging ideas extant concerning tobacco. He sincerely thought he was right, and in his mind’s eye no doubt beheld thousands of young men and boys arising to call him blessed. So he wrote with truth in his heart and sincerity as his goal. As for the editor, he evidently thought the article was presented as a piece of humor, a comic essay, and accepted it because it is funny.
But the fact is that the writer of the serio-comic essay in question seems to have had an unparalleled genius for making doubtful statements, so that instead of appearing to be merely funny, the contents of the article, in their possible effect, appear to be serious enough. Furthermore with the standing of Harper’s Weekly behind it, the essay if unchallenged might help to make even harder the already sufficiently difficult struggle for a better moral, mental, and physical development of the young people of this country. For this reason the present writer feels that he should set forth such information concerning the effects of tobacco as he has found in his statistical studies of children. It might be mentioned here that the author of the article in question, Dr Leonard K. Hirshberg, scrupulously avoids mentioning any of the important statistical studies made along this line. Perhaps he never heard of them.
A very simple method of taking up this subject is that of considering the doctor’s article, paragraph by paragraph, so that none of the absurdities and mistakes, due no doubt to pure ignorance of the subject, may be neglected. The first couple of paragraphs set forth the dictum that the great opposition to the using of tobacco is largely based upon a kind of puritanic dislike for anything that gives too much pleasure. Also, those who know no better object to it because “it gives its users contentment, peace, and a healthful, animal sort of enjoyment, a sublime callousness to the ethical and theological puzzles which fret and frazzle its enemies, a beautiful and irritating indifference to all but the pleasant things of life”. This last by the way is a remarkable admission, though why our friend the doctor should consider a callous indifference to the finer things of life as a distinct advantage, I am really unable to imagine. It is very true that heavy smokers, especially juvenile smokers, are often callous and insensitive: that is one of the serious charges laid against the use of tobacco; but why the estimable doctor should advertise that effect of the weed as one to be desired I cannot imagine, unless it be that he too by dint of smoking, or perhaps chewing, or both, has made himself indifferent and callous, and thinks his second state better than his first. I doubt if an unnarcoticized public will agree with him. Let us see what he says in the next paragraph. Here we have his word for it that the chief critics of the use of tobacco are the members of the Woman’s Christian Temperance Union, patent medicine advertisements, and school physiologies. This is really too funny. It has the unconscious humor which is the very funniest kind. The sight of the ignoramus parading as the sage has tickled humanity ever since the dawn of civilization. As a matter of fact, any one who knows anything at all about the question knows that the most consistent and determined opponents of smoking are the school teachers of the country, and the physical directors and athletic coaches as well. From a direct acquaintance with hundreds of children and young people they are likely to know what they are talking about. The writer for some years was a regular teacher, and since then, while carrying on special investigations of different kinds among schools and pupils, he has become acquainted with many hundreds of children, and yet in all that time he has never seen a “Temperance Union” tract on the smoking question, and extremely few patent medicine advertisements on the subject. As for the school physiologies, it is very probable that the doctor is not aware that the majority in use have been prepared by very able men of his own profession, men whose names are not at all unknown either to the medical world or to the general public. Besides teachers and those directly engaged in the endeavor to improve the physical status of children, there are very many students of childhood and of character development. If the doctor, by way of curiosity, should care to inquire of these, he would doubtless gain much valuable and startling information. Just one good example will suffice, taken from a book well known to those interested in the physical development of children and young men,?”Anthropometry and Physical Examination,” by J. W. Seaver, A.M., M.D. On page 184 of this volume we read as follows:
“It has long been recognized by the ablest medical authorities that the use of tobacco is injurious to the respiratory tract, but the extent of its influence in checking growth in this and in other direction has, I believe, been widely underestimated.” Then Dr Seaver cites the results of some very simple observations made at Yale and Amherst. Studying the “growth” of a class at Yale it was found that the weight of non-users increased 10.4 per cent more than that of the regular u^ers of tobacco. In growth of height the non-users grew 24 per cent more than did the regular users, and in lung capacity the non-users increased 77.5 per cent more than did the users! Dr. Leonard K. Hirshberg with commendable discretion gives no statistics. Dr Seaver does so, with interesting results, as you see. The class of ‘91 at Amherst was studied in the same way, with very similar results. So here we have an example of a critic of a type not mentioned by Dr Hirshberg,?a type of critic to be reckoned with. To make assurance doubly sure before passing on to the next exhibit, let us consider a few figures obtained by Dr Pack of the University of Utah.* Dr Pack received figures from the physical directors of six colleges. In these colleges there were 210 candidates for positions on the first foot-ball elevens. Of these candidates 117 were non-smokers. One third of the smokers and two thirds of the non-smokers made the teams. The lung capacity of the smokers averaged 30 cubic inches less than that of the non-smokers. Also, considering scholarship, the average mark of the smokers was 74.5 and of the non-smokers 79.5. Besides this, the smokers scored twice as many failures as the non-smokers. Further criticism of this particular paragraph of Dr Hirshberg’s is unnecessary. What says the learned doctor next? Says he, “Practically all of the world’s gigantic store of anti-tobacco literature is based upon four fundamental propositions:
Quoted, not verbatim, from The’Continent, January 2, 1913.
156 THE PSYCHOLOGICAL CLINIC. “1. Tobacco contains nicotine, which is a powerful narcotic and poison. “2. In the process of smoking, nicotine is absorbed into the body and produces or induces many deadly maladies, including cancer, paralysis, heart disease, bronchitis, blindness, and tuberculosis. “3. Tobacco engenders a craving for alcohol. “4. Nicotine is such a powerful poison (this is a classical argument and appears in all the school physiology books) that one drop placed upon the tongue of a dog is sufficient to kill the animal.” The doctor now genially admits that nicotine is in fact a decided narcotic and poison, but he claims, the drug enters the body in such small quantities that “the body so soon grows immune to its effects, that it does no harm whatever”! As to the smallness of the entering quantity, first of all, infinitesimal as it is, it is yet powerful enough to produce very painful and characteristic disorders. Repetition, in truth, as the doctor says, eliminates the appearance of disorder, and this the doctor claims, proves that the body has become “immune”. And now, along the same line, comes another argument which must have been the one which made the editor decide the article was a humorous one, and consent to publish it. The doctor goes on to show that people who have once had yellow fever, or small pox, become immune to those diseases. Then says he, “it is the same with nicotine poisoning”! The man who has gone through the mild poisoning that attacks beginners is thereafter immune to all ill effects of tobacco! That a physician, a real “M.D.”, will say that the poisoning produced by a drug produces an immunity for itself just as a disease produced by bacilli produces immunity for itself, makes one pause and wonder where that physician could have obtained his M.D., or what kind of “callousness and indifference” would permit him to write such a thing. It sounds well, of course’, but drugs and poisons do not all act in the same way. Alcoholic poisoning is a beautiful example of the group of habit-forming drugs. No matter how a man is poisoned?no matter how drunken he is upon his first close acquaintance with alcohol, he is hardly less affected the next time, and the next time. In fact he can readily be poisoned to the end of his days, which are not likely to be many. Also, by taking small doses of opium, one does not seem to become immune. In fact, as in alcohol poisoning, and also in nicotine poisoning, the presence of the drug in the system seems to set up a craving for more of the drug, often with serious results. However there is no need to pursue this particular line further. The figures given by Dr Seaver and by Dr Pack show that the regular taking of nicotine, even in very small quantities, does not make the taker “immune” at all. but causes serious and perhaps permanent effects. The doctor now has one entire column devoted to the argument that after all the smoker, even the cigarette smoker, really obtains but a very small amount of nicotine, a fraction indeed of the amount of the drug which existed in the smoked cigars, cigarettes, and pipes. The cigarette too, let us say in passing, is absolved of all blame, the user receiving no worse effects than could be obtained by smoking kindling-wood, hay, or dried leaves. This last of course is absurd, but we have no quarrel with the first part of this statement. The smoker does in fact receive very little of the amount of nicotine existing in his cigar or cigarette, but that little, as our statistics seem to show, has some effect after all, and one not to be left unconsidered. Next the doctor lights upon the saying that tobacco-using may bring on cancer, catarrh, bronchitis, blindness, and the like. But who on earth ever says that smoking is responsible for the occurrence of any affection really caused by bacilli? As to cancer and blindness however, our medical expert is rightly cautious, for too many smokers have developed cancer on the lips, tongue, or in the throat, and too many have had eye troubles directly attributable to nicotine poisoning to give a disclaimer much weight. So he dubiously admits that in certain cases, far remote from ordinary, such things may happen as cancer or eye-trouble as a result of too great an indulgence in tobacco, but only in the case of very abnormal people. Even if nicotine can encourage such effects in only a few the argument is clear enough that it does have some effect. But we will let that go for the time being, while we see what comes next. I wish we could go over the entire article in complete detail, but space is wanting.
Next he declares that tobacco-heart has nothing whatever to do with tobacco. He endeavors to show that Dr Osier agrees with this, but with poor success, though the effort from a standpoint of ingenuity is first class. Then he quotes from Osier, as a “clincher”, “cardiac pain without evidence of arteriosclerosis or valvular disease is not of much moment.” Well this is true enough, for ordinary cardiac pain, as anyone who knows anything about the heart will tell you, is no evidence that anything is the matter with the heart itself. But I wonder if the enthusiastic doctor ever heard of a sphygmograph, or of a plethysmograph, and if he ever obtained pulse-records of numbers of smokers and non-smokers with the aid of these ingenious instruments. Many such records have been made by me and I have seen the trembling finger of the instrument, moving lightly over the blackened paper, mark the characteristic little irregularities that appear in the pulse of the habitual smoker. There is no cardiac ;pain at all. Says Dr Kenelm Winslow, formerly Assistant Professor of Comparative Therapeutics at Harvard University, “In true organic disease of the heart muscle, when the action is unusuallystrong and rapid, the patient is, in most instances, completely unconscious of it”. So one may have a cardiac trouble without pain in the heart. And so one may have tobacco-heart without pain, too. There is no question of pain at all. But that the regular use of nicotine does cause the introduction of an irregularity into the pulse is easily demonstrated, and anything that will cause an irregularity in something as important as the pulse, must be a matter of serious consequence indeed. Unfortunately we cannot stop at every sentence, and pick out the very visible flaws, but we will have to consider one or two more remarks before closing. Says the doctor, many have “pointed out the indubitable fact that the average boy smoker is not so bright as the boy who does not smoke.” Then he goes on to say that only stupid boys smoke any way, boys who are stupid from birth and who will remain stupid through life. I should like to ask, if it is not an indiscretion, whether the doctor smoked when he was a boy! Next he says that bright and healthy boys, if kept away from evil companions, will not smoke. He then says, if you do not believe it, ask any observant school-teacher. Well, for one, here is a former school-teacher writing this present article, a teacher who has incidentally made physical measurements and individual study of many hundreds of boys. This particular teacher does not believe any such thing as the learned doctor proposes. Why do boys smoke? Not because they are stupid from birth, not at all. Merely because they wish to imitate “grown-ups”. In two things a boy can imitate a man?one kind of a man. A boy can be as profane and a boy can smoke as much, or almost as much. Then too, active boys like to be considered “sports”, and are not generally shown the difference between “cheap sports” and “real sports”. The cheap sport is usually in evidence; he is no athlete, he is usually a corner-lounger, and of course he smokes largely; also he is usually profane. So the boy wishing to be looked upon as older and more mature than he is, adopts the striking vices of this striking type of “sport”, and so becomes a smoker. This has been not only my observation, but that of all close students of the question with whom I have become acquainted, one of whom I may mention, Dr Arthur Holmes, late Assistant Professor of Psychology in the University of Pennsylvania and now Dean of the Faculty of State College. The boy,?the average boy and not the abnormal one,?smokes in imitation, and suffers serious consequences thereby.
In closing, I take the liberty of publishing, mostly for the first time,.the results of some extended observations among school-children, both of public and of private schools. Let us first consider records taken from 450 private school boys,* boys of what we are pleased to term the “upper middle class”. Records were taken of boys of from twelve to seventeen years inclusive. It was found that 15 per cent of the twelve year old boys, 20 per cent of the thirteen year old, 38 per cent of the fourteen year old, 29 per cent of the fifteen year old, 57 per cent of the sixteen year old, and 71 per cent of the seventeen year old boys were either regular or occasional smokers. Does Dr Hirshberg dare to claim that 71 per cent of the boys in these schools were born stupidf It is not likely. Now follow the grades for these boys, contrasting those of the non-smokers with those of the smokers. These grades were averaged from their school reports for three successive months, and included marks for lessons as well as for conduct.
Age 12 13 14 15 16 17 Grade, non-smokers 83 90 89 84 87 85 Grade, smokers 73 75 73 75 75 68 Even considering the fact that the smoker is likely to be an outdoor boy, and less of a natural student in consequence than the non-smoker, these figures are rather significant. Let us now consider a group of 263 public school children, twelve years old and older, in grades from 5th B to 8th B inclusive.
These boys were pupils in a public school of a very fine type and high standing, and in a good neighborhood. The average age for each class was found, and then the boys who were older and younger than the average were studied, not only as to their smoking?that was merely incidental?but as to many other interesting data. But with regard to tobacco, this was found,?of the boys who were two years younger than the average for their class, 2.3 per cent were smokers, of those one year younger than the average, 10.5 per cent were smokers. Boys of the average age included 38 per cent smokers. Boys a year older than the average had 41.2 per cent of their number smokers, 81 per cent of those two years over the average were smokers, and 83.5 per cent of those three years over average. This is rather significant. But, you say, the older boys would naturally possess a higher percentage of smokers anyway. Well, let us consider all of the boys of one age in these grades. Taking all those of twelve years of age we find that in the highest grade there were no smokers of this age and none in the next lower grade, in the next 14 per cent of the twelve year old boys were smokers, in the next lower 16.7 per cent, in the next 20 per cent, and in the next 23 per cent. Although we cannot concede that these boys smoked because they were “born stupid”, we can see plainly that the boys who are advanced for their age are not smokers, while those who are low for their age are so in considerable proportion.
A study was made of the “disease” records of these 262 boys. The total percentage of smokers was 30.4 per cent. Now if smoking had no effect, we would be likely to see the proportion of smokers having had “stomach trouble” to the non-smokers having had the same disorder to be the same as above, that is 30.4 per cent. Such, however, is anything but the case. The records show that of the boys having “nerve disorders”, all, that is 100 per cent, were smokers. Of all having “stomach troubles” 71.4 per cent were smokers. Perhaps this was caused by swallowing smoke and nicotine-laden saliva. Of those having typhoid-pneumonia, 50 per cent were smokers, the same is true of appendicitis. Of all who had diphtheria, 38.5 per cent were smokers, and of those having disorders in the naso-pharynx 37 per cent were smokers. These percentages, you will note, are all larger than the legitimate proportion of 30.4 per cent as noted above. It is only when we consider the common diseases of early childhood, which come before the “smoking age”, that we find the proportion the one that Dr Hirshberg would expect, for it is exactly 30.4 per cent, as one would suppose.
It is hardly necessary to give the difference in growth rate of smokers and non-smokers among boys, for they are much like those of the college men, as noted by Dr Seaver.
With all this evidence before us we cannot help coming back to our first question, and that is, how did such an article happen to be published in a careful and influential magazine? And we can arrive only at the same conclusion,?that the editor printed it as a bit of humor, and that the writer himself was so callous and indifferent to ethical considerations, that he really did not care what its effect might be upon his juvenile readers and upon the uninformed among his adult readers.
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