Smoking

By the 1940s, when American scientists first detected a correlation between cigarette smoking and lung cancer (German scientists had found the same correlation in the 1920s and spearheaded the first antismoking campaign in modern history), humans already had a relationship with tobacco that reached back thousands of years. Widespread cultivation of tobacco began about 5,000 years ago; in addition to daily use (chewing, drying and inhaling, smoking), tobacco was used as an insecticide, medicinally as an analgesic or antiseptic, and for various ritualistic practices. Though tobacco has been celebrated for far longer than it has been denigrated as an unhealthy habit, condemnation of tobacco smoking has deep roots, too, reaching back to early Christians who viewed indigenous peoples’ smoking as evil and satanic. Still, by the 1600s, tobacco was touted across

In addition to daily use—including chewing, drying and inhaling, and smoking—tobacco has been used as an insecticide, as an analgesic or antiseptic, and for various ritualistic practices. U.S. Department of Agriculture scientists studied the natural insecticidal compounds found in these wild tobacco plants, eventually identifying the active substances to be sugar esters.

Europe for its medicinal properties as well as for the simple, base pleasure of smoking, chewing, or snuffing it.

The cigarette, which is the most common tobacco-delivery system today, has its roots in Aztec practices of rolling tobacco in maize husks; this method was embraced by Spaniards and eventually by the French, who came into contact with cigaritos when the French army occupied Spain early in the 19th century. That same century, in the United States, it was accidently discovered that heat-cured tobacco was milder and more flavorful than was smoke-cured tobacco; then, in 1880, a Virginian made the first cigarette-rolling machine, which could produce 200 cigarettes a minute. These two innovations—heat-cured tobacco and mass manufacture—dramatically increased tobacco smoking in the United States.

Today, there are more than one billion tobacco smokers in the world, and it is estimated that smoking kills almost five million people worldwide annually. Despite the fact that women comprise only 20 percent of the world's smokers, tobacco use among women is increasing, as tobacco companies have intensified their marketing efforts to capture this burgeoning market. Still, men are more likely to smoke than women, poor people are more likely to smoke than the wealthy, and people in developing countries are more likely to smoke than those in developed countries. In the United States, over 40 million people smoke tobacco, resulting in the deaths of almost 500,000 people per year and causing serious illness in nearly nine million others; tobacco use is considered the single most preventable [Page 442]cause of disease, death, and disability in the United States. People with psychiatric disorders, particularly depression, schizophrenia, and post-traumatic stress disorder, are more likely to smoke tobacco than are those without psychiatric diagnoses, and those with psychiatric diagnoses smoke almost half the cigarettes consumed in the United States.

Nicotine is the addictive element in tobacco, and in small doses it acts as a stimulant. It constricts arteries, making it harder for the heart to pump blood, and repeated exposure is linked to cardiovascular disease, heart attacks, and high blood pressure. Nicotine is also linked to stomach ulcers, acid reflux disorders, and strokes. In addition to nicotine, tobacco contains more than 19 known cancer-causing chemicals, which are most commonly referred to as tar, as well as more than 4,000 other chemicals. The health risks associated with smoking include the

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