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Old But Good Advice

By Eric Van De Graaff, MD August 10, 2009 Posted in: Heart Health

Tobacco has a long history of being condemned by medical professionals

I was rummaging through my old medical school texts the other day and came across an antique book that came from my father’s old collection. How to Keep Well, authored by Dr. Albert F. Blaisdell and originally sold in 1897 for the staggering sum of 45 cents, contained a lengthy recitation on the subject of tobacco use. Having often heard of the medical establishment’s early embrace of smoking I expected to find paragraphs extolling the merits of cigarettes: strengthening the constitution, regulating the bowels, purging evil humors—that sort of thing.

Instead I found passages that are anything but laudatory:

“The use of cigarettes cannot be too severely condemned.  Cigarettes are so common and so cheap that their use to an injurious extent by thousands of young people is becoming a very serious matter.  Tobacco often produces palpitation of the heart, certain forms of dyspepsia, irritation of the throat and lungs, and a general breaking-up of the nervous system.”

The link between cigarette smoking and lung cancer was first made in a 1950 report in the British Journal of Medicine. Fourteen years later the surgeon general’s office began stamping the now ubiquitous warnings on the sides of cigarette cartons.  From that point on we’ve been inundated with a slew of public service campaigns, educational initiatives and tobacco cessation programs.

Here’s my confusion.  It’s pretty clear to me that medical professionals from Dr. Blaisdell in 1897 to C. Everett Koop in 1984 have done a pretty darn good job of educating us Americans on the dangers of smoking.  I’d be willing to wager that you couldn’t find a single man, woman or child in this country who doesn’t know that smoking will kill you.  How is it, then, that people—especially teenagers—ignore all they know and take up the habit?  It certainly can’t be that we haven’t educated them enough.  What is it?

Here are some sobering facts about cigarette use among teens (courtesy of the American Lung Association):

  • According to a 2001 national survey of high school students, the overall prevalence of current cigarette use is about 28 percent.
  • Half of adults who smoke were regular smokers by their 18th birthday, and 90 percent started by the age of 21.  The average age of daily smoking initiation for new smokers in 2006 was 19 years.
  • People who begin smoking at an early age are more likely to develop a severe addiction to nicotine than those who start at a later age. Of adolescents who have smoked at least 100 cigarettes in their lifetime, most of them report that they would like to quit, but are not able to do so.
  • Half of teenage smokers who are unable to quit will ultimately die from their habit.

Mmm, tar and carcinogens, so satisfying

I guess I just don’t see the allure and romance in sucking tar and carcinogens into your lungs, especially if you know that you stand a good chance of someday dying a horrible miserable death from it, not to mention the stale, stagnant stench that you emanate while you’re still alive.

Dr. Blaisdell got it right with this last part on what he calls “the use of tobacco from a moral point of view”:

“Tobacco has the power, through its effect upon the brain and nerves, to deaden the user’s affection for his family and friends as well as his sense of politeness, or propriety as to the rights of others.  All have a right to pure air to breathe.

“The smoker puffs his tobacco smoke into the faces of people on the street-cars and the ferries, in waiting-rooms, hotels, and places of amusement, regardless of the fact that it may be very disagreeable to others.”

In the end I’m not sure that more education will fix the problem of kids taking up smoking.  One thing that might help is a good example set by parents, especially those of you who are smokers.  Show your children that good health is a vital part to a happy life by kicking the habit now instead of when your heart and lungs are already in decay.  Put your knowledge into action and be an example of good living.

I think it’s time we start applying the good advice we were given 112 years ago.

Eric Van De Graaff, MD
Eric Van De Graaff, MD

Eric Van De Graaff, MD is a Heart & Vascular Specialist at CHI Health Clinic.

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