Should You Stop Smoking?

Smoking is the burning question of the day. Everyone wants to know, for certain, the answer to this question: "What is the effect of smoking on my health?" "To smoke or not to smoke" is a frequent topic of conversation of the more than 100 million American smokers. Until recently, the public has been as confused as the medical profession was in the past. Now overwhelming evidence on the harmful effects of excessive use of tobacco can no longer be disregarded. In spite of all this evidence, however, the public is either uncertain or resistant. This is perfectly exemplified by my patient, Mr. R. He was suffering from "tobacco angina," an old term used to describe chest pains in coronary artery disease induced in his case by excessive cigarette smoking. "Dr. Morrison," he said, "I guess I should stop smoking, what with all the newspaper stories on the relationship of excessive cigarette smoking and cancer of the lungs. But I play golf with my family doctor, Dr. X, who is a chain smoker, and I notice my dividends from investments in tobacco stocks keep going up! Now, if cigarettes are harmful to health, why do so many doctors continue to smoke and why does the American public smoke more and more?"

Smoking has been with us for a long time. The smoking habit is known to be deeply ingrained from the very dawn of man's history. Archeologists tell us of their finding evidence of smoking pipes among the South American Indians in Venezuela, 6,000 years before Christ. The legendary origin of the birth of tobacco and the "tobacco habit" is even told charmingly in Greek mythology. Zeus was banqueting with his gods and goddesses on Mount Olympus. During the dancing after the banquet, Vulcan, the god of fire, forging and smelting, was urged to dance. He was ashamed to dance, however, because of his hunchback, and his fear of ridicule. In his nervousness and embarrassment he sought comfort by lighting his pipe with a burning coal and filled Olympus with a dense cloud of foul tobacco smoke. Zeus was enraged at Vulcan's extremely bad behaviour. He cast a thunderbolt at the pipe, which smashed it and spread bits of the pipe and the tobacco all over the world. Rain then fertilized the seed and the tobacco plant grew luxuriantly forever after!

One of my patients, Mrs. A, tells me she is completely at a loss as to which doctors and statisticians to believe. So many seem to be in complete disagreement on the harm from smoking. I tell her that differences in opinion make medical meetings and horse races possible, and that virtually the same controversy raged over 350 years ago. In 1604, King James I was anxious to improve the health and well-being of his loyal subjects. After careful medical advice from his court physicians he issued the following frightening but delightful proclamation on tobacco: "A Custom loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs (italics - mine), and in the black stinking fumes thereof, nearest resembling the horrible Stygian smoke of the hell pit that is bottomless." The king's apparent first-hand knowledge of hell-fire is a triumph of the imagination.

A little later, in 1689, the Medical School of Paris studied and reported the effects of tobacco smoking upon health and its influence on the span of life. They concluded and maintained for long after that tobacco definitely shortens life, and that it causes colic, diarrhea, "ulcerations of the lungs," asthma, coughs, "pains in the heart," undernourishment and impotence. Enough to frighten even the stoutest of Frenchmen!

Yet despite the death penalty for tobacco smoking, imposed by many kings and rulers in the 16th and 17th centuries, smoking flourished. The reason, apparently, was and is that it is an ingrained part of man's very social life. It is something that must be conquered by intelligence and will-power. Otherwise it becomes a bio-chemical as well as social "addiction."

What is the truth about smoking? Let us now examine the tobacco habit in the light of modern scientific knowledge, and group the advantages and disadvantages of smoking as, "good, bad, and indifferent."