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Tobacco’s impact on health in the past


By Dr Sarah Inskip

Today, we are well aware of the harmful nature of tobacco use and smoking; frank images cover tobacco packaging coupled with stark warnings about health. But when was there first knowledge that tobacco, and especially smoking, was harmful? Medical research often states that the first proven connection between cigarettes and disease was in the 1950’s through Doll and Hill’s 1 and Wynder and colleagues2 work on cigarettes and carcinomas. This has led to general perceptions that tobacco-related disease is a modern issue largely related to cigarettes. However, some scholars, especially historians3,4, have highlighted far earlier concerns about the role of tobacco in ill-health.

Tobacco was first bought to Europe in the 16th century from the Americas as a possible medicine. The smoking habit likely spread from adventurers and sailors, and became a part of everyday life in England by the 17th century4,5. Significant debates about this habit quickly ensued, with the most famous opponent being King James the VI of Scotland and I of England. In his 1604 ‘Counterblaste to Tobacco’ he lambasted smoking both for its physical effects and its negative impact socially, economically and morally6. Philarates in his 1601 ‘Work for Chimny-Sweepers or A Warning to Tobacconists’7 outlines many of the illnesses today known to be associated with chronic tobacco use, albeit guised in the understanding of disease at the time. Following these, there was much debate around the ill-effects of tobacco, yet most were largely in agreement that excessive use for non-medical reasons, especially through smoking, was dangerous and addictive4. From the mid-18th century physicians across Europe and America noted the link between chronic pipe use and snuffing with nose and mouth carcinomas8. Animal experiments demonstrated the poisonous nature of nicotine by the early/mid 19th century9.

If there was knowledge about the negative effects of tobacco, why did it then come to be one of the first truly global commodities, and arguably history’s most deadly habit? This is no easy question to answer although it is likely tied up in the social personae and roles that tobacco took on in Europe, and not simply its addictive nature. Over time, tobacco became inextricably interwoven into social practices, ideas of masculinity and intellect, and was also highly lucrative for business and the state4. Understanding how these factors played a role in tobacco’s spread is crucial for understanding how it became so harmful, and could be valuable in terms of tobacco control today. This is one of the key aims of the Tobacco, Health and History Project.

References to works

1 DOLL, R., & HILL A.B. (1950). Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950;2(4682):739-748.

2 WYNDER, E. L., GRAHAM, E. A., & CRONINGER, A. B. (1953). Experimental production of carcinoma with cigarette tar. Cancer research, 13(12), 855–864.

3 CHARLTON A. (2005). Tobacco or health 1602: an Elizabethan doctor speaks. Health education research, 20(1), 101–111.

4 ROWLEY A.R. (2003). How England Learned to Smoke: The Introduction, Spread and Establishment of Tobacco Pipe Smoking in England before 16040. Unpublished Phd Thesis: University of York.

5 GOODMAN, J. (1993). Tobacco in History: The Cultures of Dependence. Routledge: London.

6 KING JAMES VI & I. (1604). A Counterblaste to Tobacco. Robert Barker: London

7 PHILARETES. (1602). Work for Chimny-Sweepers or A Warning for Tabacconists. Thomas East for Thomas Bushell: London.

8 LIZARS, J. (1854). Practical Observations on the Use and Abuse of Tobacco. Simpkin, Marshall, & Co: London.

9 MUSSEY R.D. (1836). Influence of Tobacco Upon Life and Health. Perkins & Marvin: Boston.

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