Only a Pack a Day – Smoking
Poison, like crime, is such a relative matter. A little hydrocyanic acid gives a delightful flavor to cherries, a little more gives you a preferred position in an obituary column. Kill one man and you are a murderer; kill a hundred thousand and you are a saviour of mankind, or at least a great statesman. I trust I have established the point that all opinions in this life seem to be relative.
As a vigilant guardian of health I, like any other honest doctor, regard smoking as a practice of questionable value even from the standpoint of solace. When one knows of the extremely harmful effects which the poisonous products of combustion have upon the delicate little capillaries of the body, one is not inclined to look with tolerance on the manner in which people in general and our patients in particular smoke here rather than hereafter.
Recently a young lady came to me as a patient suffering from acute spastic colitis. Naturally I asked questions, questions which sought to answer the question in my mind as to why an apparently healthy young lady should be the victim of such a distressing derangement. I inquired into her habits of eating, drinking and then finally asked the question as to whether she smoked or not. In a casual manner she said: “Oh, only a pack a day,” as if this were some petty misdemeanor in the Almanac of Health. Certainly, if some friend had set out to harm her, he could have found no more certain way in which to accomplish his object than that “pack a day.”
In no surer way could such a serious derangement of that delicate mechanism known as the parasympathetic nervous system, be affected than to subject it continuously and excessively to the injury caused by those products of combustion we know as “a smoke.”
People, in general, erroneously think the chief villain in smoke is nicotine. The fact is that while it is a grievous poison, so powerful that a very minute dose—enough to cover the head of a pin—can kill twenty laboratory animals in less than a minute, yet the fact remains that it is only one of a host of poisonous substances produced in the burning of a cigarette.
Less than two thirds of a drop of pure nicotine will kill a man. If a glass rod dipped in nicotine is merely held near the beak of a bird, it will die in a few seconds. It might be interesting to smokers to know that a scientist has proved that eighty per cent of nicotine in tobacco smoke is absorbed if the smoke is inhaled. Nicotine poisoning may be evidenced by effects upon the blood pressure, catarrh of the throat and larynx, various heart and eye troubles, ulcers and other stomach disorders and, finally, irritation of the kidneys.
Tobacco smoking, by introducing into the system nicotine, a narcotic drug, and other poisons, is one very important cause of blood-vessel spasms. Such spasms occur not only in the stomach but also in the heart, the blood vessels, the fingers, and the toes. More and more people are suffering gangrene of the feet because of chronic tobacco poisoning. This often necessitates amputation.
We are less concerned here with many of the other effects of cigarettes and tobacco in general, but it is a well-known fact that smoking interferes with mental efficiency and with the health of the special senses. In other words, a special sense such as eyesight is very definitely impaired by the excessive use of tobacco. It has long been considered a contributing factor in the production of arteriosclerosis (hardening of the arteries) and smoking consequently affects blood pressure.
But more important, and far more pertinent to the subject of nervous stomach problems is the fact that tobacco has a pronounced effect upon the nerves controlling certain small blood vessels all over the body. The harm done by this powerful action on the small capillaries is the reason people who are addicted to the tobacco habit lose their youthful looks, since complexion is directly dependent upon the state of the skin capillaries, the very fine branches of the big arteries. This is the place where the veins begin to form—in other words, the most delicate part of the entire structure of our heart and blood-vessel system.
Experimenters have been able to show that, within a few minutes after smoking, the surface temperature of the extremities is lowered as much as from one to one and a half degrees. This in itself is not serious or even worthy of concern; but it does indicate the tremendous effect the poison nicotine has upon the small blood vessels.
Here, then, takes place that interchange of food substances, oxygen, and waste products which allows the entire organism to live and carry on its living functions. When a poison such as nicotine circulates in the blood system, it damages these capillaries.
Moreover, unbalancing the equilibrium of the sympathetic and parasympathetic systems, produces abnormal spasm of the small blood vessels, and this, too, interferes with the nutrition and the biological function of certain areas of cells. In fact, the most logical explanation we have today for the formation of stomach ulcer is that, through prolonged constriction of small blood vessels in the stomach lining, the nutrition of the area destined to become an ulcer is so greatly interfered with that the cells mortify.
This, I say, is the most logical explanation that modern science offers for the occurrence of stomach ulcer. It has become widely accepted by leading specialists throughout the world. Ulcers of the colon can be caused in a similar manner. Can you not see, therefore, how important it is to avoid such spasms caused by the circulation of poisonous substances in the blood or the over stimulation of the internal nervous system to such an extent that, through nervous influences, the delicate lining membrane of the stomach and duodenum becomes deprived of its normal circulation of blood?
Quite apart from the effect of smoking on the stomach and intestines, stomach specialists have observed for many years that excessive smoking—particularly cigarette smoking—definitely causes ulcer formation. Consider this fact, and then wonder why a government that pretends to be conducted on the basis of the greatest good to the greatest number allows cigarette manufacturers to say, “It aids your digestion.”
No one would object to the manufacturers saying that their cigarette is a good smoke. But when they step over into the field of physiology and public health, it seems to me that the government, through its public-health service or some other properly authorized agency, should step in and put an end to the spoilation of public health that is being perpetrated by such fraudulent advertising.
As an added morsel of discomfort to those inclined to pooh-pooh the idea of smoking being harmful, I might add that years ago, when I was an intern at Bellevue Hospital, the number of cases of cancer of the lungs was extremely small. In fact, it was considered a rare disease. Today, the number of cases of cancer of the lungs has increased by at least seven hundred percent.
Why? Because of the good fresh air that men and women are inhaling these days? No. When you know something of the chemistry of smoke, you know that along with the nicotine, which in itself is poisonous, there are many other harmful products of combustion known collectively as coal-tar products. These are used experimentally to produce cancer, and these are the very things you are urged to take into your lungs by the advertisers of cigarettes, who say they are “kind to your throat.”
Meanwhile, they choose to ignore the fact that the number of cases of cancer of the throat and lung has increased seven hundred percent in the last twenty years. Could it possibly be because women are smoking, more people are smoking, and all of them are smoking more than in previous years? I wonder! Only recently, there appeared in the public press detailed announcement of an elaborate research made by Drs. Ochsner and Richman. These studies proved conclusively that the horrible condition known as cancer of the lung was definitely attributable to cigarette smoking.
It may seem superfluous to state that tobacco smoke contains nicotine. Just so there will be no question in this matter, let us bear in mind that nearly one hundred percent of the nicotine in tobacco passes into the smoke, and most of this is in an uncombined state—in other words, in a highly poisonous state.
Experimental evidence has shown—and this is very important from the standpoint of stomach and intestinal ailments—that this alkaloid, nicotine, has as its very first action excitation, later followed by a paralysis of the nerve centers of the sympathetic system. These are the ones that control the normal action of the organs and the blood vessels. In fact, the most important derangements caused by nicotine are to be found in the stomach, intestines, and the heart and blood-vessel systems.
To confirm this statement, you need be no scientist, You merely have to recall that fateful moment when, as a boy, you decided to try out one of your father’s cigars. You remember, I am sure, how violently your heart began to beat. You became pale and broke out into a cold sweat, your stomach felt rather unusual, and, finally, very sick. Vomiting may have followed. In any event, you had been treated to the classical experiment of the effect of nicotine upon the heart, blood vessels, and digestive system.
You may laugh at this smugly and say, “Well, that was just the first time. Now I can take it.” True, indeed, you can take it, or at least not mind its effect so much, just like a punch-drunk pugilist who after awhile revels in serving as the punching bag of his sparring partners. But after all, does it make sense to go on poisoning yourself more and more, simply because you have acquired an inability to detect its harmful influences?
Some people may be under the impression that smoking is conducive to proper bowel action. Indeed, the morning cigarette at “habit time” has become almost as proverbial as the newspaper. However, this is entirely due to the association of ideas, and “habit time” would persist even if the stimulus were not given by this means.
It is true, of course, that when a person who has been a heavy smoker decides not to smoke any longer, various irregularities of bowel function may occur. This is due to a readjustment of the nervous system. This readjustment takes time, and during that time irregularities of bowel function may occur. It is not necessary, however, for a person to resume smoking to relieve the situation. It can be relieved in the other ways described in my chapter on “How to Conquer Constipation.”
To abandon the idea of curing oneself of the smoking habit because, to give up the habit may interfere with bowel function, is highly illogical. It merely confirms the fact that smoking has made you its slave.
Of one thing be assured—for every person whom tobacco appears to help in this matter, there are dozens whom it disturbs. Spasm of the colon can very definitely be produced by tobacco smoke. So, too, can other disorders of the intestinal tract.
If it has been easy to make you believe that tobacco in general and cigarettes in particular (1) are kind to your throat, (2) aid your digestion, (3) give you a lift, and (4) make you nonchalant, it should be equally easy to make you believe that when you respond to the hypnotic suggestion of cigarette advertising you are being invited to (1) take poison in small quantities, (2) start taking a narcotic, habit-forming drug, (3) annul the normal instincts of thirst and hunger, (4) substitute a harmful drug for wholesome food, and (5) disturb the delicate balance of your sympathetic nervous system and thus adversely affect the functions of your internal organs.
You are also invited (6) to run the risk of impairing your eye-sight and hearing. Finally, you are asked (7) to hasten your old age and early demise by contributing to that hardening of the arteries which is the basis of nearly all the organic changes incident to old age. Add them all up and see if the old saying doesn’t make sense: “A smoke is a little fire at one end and a big fool at the other.”
The harsh things I have said about tobacco do not represent my prejudiced opinion or, the ranting reproaches of a reformer. All the available statistics science has to offer, and all my experience as an intestinal specialist extending over nearly a quarter of a century, conclusively prove that the incidence of stomach and intestinal troubles is much greater among smokers than non-smokers.
Those highly practical commercial institutions, the insurance companies, are greatly concerned over the fact that the death rate among smokers is ninety-three per thousand as compared to fifty-nine per thousand among nonsmokers. Their figures also show that forty-one percent of the nonsmokers among their policy holders survived the expectancy average while only seven percent of moderate smokers lived beyond their life expectancy.
This should mean something to any thoughtful man or woman. It most assuredly will, unless the traditional first law of Nature, self-preservation, has been repealed.
Having been convinced by the foregoing evidence that tobacco road leads to ruin—at least to the ruination of one’s stomach and intestinal system, no doubt you are debating with yourself. I am sure the debate is not as to whether or not you should give up smoking. If, after reading this, you still feel that you want to risk wrecking your nervous system, then the affair is entirely your own —certainly the funeral will be! Truly has it been said there are none so blind as those who will not see. But if the debate is, as I believe to be, one of ways and means, the following suggestions will be of value.
In the first place, you should realize that much of the smoking you do is done not because you want to smoke, but because you are in the habit of smoking. This habit may come from within or it may, because of the hospitality of friends, come from without. In other words, I am sure that there are many times throughout the day when you are offered a cigarette or a cigar that you automatically accept.
Your first step should be to learn to say no. Or, perhaps better still, say, “No, thank you!” Curiously enough, you will soon find yourself saying this just as automatically as you previously accepted and smoked the cigarette. In other words, this is a defensive habit that will quite offset one cause of excessive smoking.
The next thing is to recognize that this desire from within is not actually a burning need for a smoke but a sensation of thirst asserting itself in a perverted way. Be kind to your throat; in fact, be kind to your whole body, in which, I am sure, you have a certain amount of natural self-interest. Give it a drink: that is what it is asking for!
If, every time you have a desire for a smoke, you were to take half a glass of water or a full glass of water, you would find two effects. Firstly, it would kill the desire for the smoke; secondly, you would find your health in general greatly improved as the amount of water you drink approaches the normal requirement of your body.
A question still remains: “Should I cut out smoking entirely or merely cut down on it?” There is an old adage that probably covers this point. It reads, “There is no fool like the fool who fools himself.” In other words, the idea of gradually cutting down rather than completely abandoning the practice is an insincere desire to rid oneself of the habit and should be cast out as unworthy. There is only one way to do it, and that is the right way. Cut the smoking habit completely. If, after a reasonable time, you have completely mastered the habit and thereby shown that you, and not the weed, is the master, then you may establish a sane basis of moderate use.
Like parlor tricks, do you? Well, here’s one with a touch of mystery. First find a pretty young lady and ask her to light a cigarette (no particular brand). Promise her you won’t blindfold her, but make no promises not to dumbfound her.
Now then, you say, “Take a deep puff of your cigarette and please do not inhale, just blow the smoke through your handkerchief.”
“My, what a filthy brown stain!” Looks like we didn’t do right by our Nell. But no, folks, this is only half of the trick.
Now you say, if you are still on speaking terms with the pretty young lady, “Take another puff and this time I ask you to inhale and then blow the smoke through the handkerchief.”
Well, now that is different; nothing to get excited about. No stain at all or at least scarcely any.
“So what?” ask the guests and the pretty young lady. “Simply this,” must be your reply, “something must have caused that dirty smudge on the first trial, and it was something which was not there on the second trial.”
Well, who is good at guessing? Where do you think the coal tar chemicals which represented the first dirty smudge could possibly have gone? We know that they were in the smoke when it was in her mouth—but after inhaling the smoke deep into her lungs, it was no longer there on exhalation. Could it possibly be that this dirt was left in the lungs? Good heavens, what must the lungs of a smoker look like if one small puff soiled a handkerchief? A little arithmetic will give you some idea of how soiled those lungs must be. Neat trick, isn’t it?
Well, the sad part of it is not so much in the mere mechanical soiling of the lungs, but in the fact that this stain was composed of many irritant chemicals, always to be found in the products of combustion. Experimentally we know that coal tar products can produce cancer. Observation over a period of years leads many people to believe that it does so in human beings.
Time and time again, as you read the daily newspapers, you read of prominent men, known to be inveterate smokers, who succumb to the dread spectre of cancer of the lungs. Is this merely coincidental, or does it mean that though some cigarettes are less irritating than others, that they are all irritating in varying degree, and that this irritation can and does produce disease conditions, one of which may be cancer?
If you would like to try another little experiment that may redound greatly to your benefit, let’s try this one.
Take a cigarette in your hand, and with a penknife slit the paper so that you can get the tobacco out. Throw the tobacco away as it will not be necessary in our experiment. Take the paper and grasping each end, twist it lightly so that it has the form of a torch. Then light one end of it and drop it into the bottom of a tall tumbler. Watch until the entire paper torch has been burned. Then take a good smell of the air in the glass.
If you follow directions and get a good whiff of this, I defy you to smoke another cigarette for the rest of the day. I have known more than one person who never smoked another cigarette after getting a good whiff of the smoke of the paper of the cigarette.
I am suggesting the foregoing for your reflection. The smoke you inhale, (or at least take into your mouth) when you smoke a cigarette, is not only the smoke from the tobacco, but it is also the smoke from the paper that has burned, and that in itself is highly harmful and distasteful to the mucous membranes.
I doubt, however, whether, once you have given it up, you will ever return to what is at best a filthy habit. As a matter of fact, when you see the amount of increased appreciation of food that is possible to a non-smoker, you will actually become an evangelist in the cause of not smoking.
Moreover, you will be inclined to become impatient and intolerant of those people who do, as you used to do, sit across the table and blow clouds of smoke into your face while you are eating or who go around all day with the odor of tobacco upon their breaths. In short, you will in this way obtain the opportunity to see yourself as others saw you when you were a victim of the habit. I doubt very much whether you will ever return to it.
The object of this measure of giving up the tobacco habit is to spare your sympathetic nervous system the severe disturbing influence that nicotine and smoke in general have upon it. I am not preaching a moral reform: I am suggesting a health measure. Certainly, you would object to somebody putting poison in your coffee; yet, in effect, that is what you do when you do smoke. Moreover, whether we like it or not, a man lives by what is in his head, and if he uses what is in his head intelligently, he will lead a healthy, happy life. To do this, he must control his nerve forces. He, above all, must be master; and he certainly cannot be master if he weakly allows himself to be the slave of a craving. The same mastery of nerves, the same control that will enable you to abolish this habit, will also serve you in good stead in controlling your emotions, which, after all, is the secret of avoiding or conquering a crazy colon.
“Do you smoke Doc”? said one of my patients to me after I had laid down the law to him about not smoking if he wanted to recover from his spastic colitis. I mention this question for several reasons. Firstly, to show you the frame of mind into which most people get themselves after being a habitue for any length of time. Secondly, in order to point out, as I did to my amateur district attorney, that the point was entirely irrelevant.
After all his concern should be for his own welfare not for mine, if indeed it was solicitude for my welfare that prompted the question. But the fact of the matter is, regardless of how a doctor deports himself, he is not the possessor of the colon wild with spasm and crazy with a disordered nervous mechanism; it is the patient. If therefore tempted to question whether the doctor follows his own advice, please bear this in mind.
Should you think that I am ignoring the question put to me by my esteemed friend and patient, I will gladly admit that I personally do not totally abstain from smoking. Thus my case against smoking (while suffering from colitis) is all the stronger since, if I were an unreasoning and unreasonable fanatic you might very well discount what I have to say as being the ranting of an anti-cigarette man.
However, my objection to excessive smoking is based upon no such narrow platform. Instead it is based on what appears to be the only sensible approach to the matter and that is the factual one. Does it help? or does it hinder? the solution of our health problem? My answer to that is based on far more observation than any layman could possibly give and I am absolutely dispassionate in my conclusion that sufferers from colitis or any form of “nervous stomach problems” are doing themselves a grave injustive by smoking while such a condition exists.
Please, dear reader, do not think that I am unsympathetic. I know how hard it is to give up smoking or even cut down. I am really and truly sorry for you because I realize that the fact that you cannot give up or won’t give it up indicates rather clearly that you are a mental case—a psychological pushover for any zealous moron who can write an ad for the tobacco company. That is why I am so sorry for you; that is why I am so sympathetic; and that is why I expect you, after reading this paragraph, to hit the ceiling and say: “Is that so? So I’m a mental case, am I? I’ll show you,” and throw your cigarette (and matches) out of the window, or at least give them to your worst enemy.
If you don’t, I will just ask you one question: “Who do you think you are hurting?” There is a strong possibility that some day, when the cause of cancer is known, that the chemicals involved in smoking will stand indicated as the true cause of cancer. If by chance you happen to be one of the luckless victims do not say: “Somebody should have told me.” They did! Written By: J. F. Montague, M.D., Continue Reading: A Friendly Cup of Java