The Right Chemistry: Tobacco smoke was not always seen as unhealthy
We know better now, just like it's become clear that vaping is not benign.
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The kits posted along the banks of London’s Thames River in the late 18th century contained emergency equipment for the resuscitation of drowning victims. There were wooden pipes to blow air through the nostrils into the lungs as well as smelling salts. But the kit also contained a flexible rubber tube, a set of bellows, and a combustion chamber for burning tobacco. If blowing air into the lungs failed to produce results, then the next step was to use the bellows and tube to introduce tobacco smoke. Not through the mouth or nose, but through the rectum! A delicate procedure to be sure.
In 1774 physician Thomas Cogan and pharmacist William Hawes had founded the “Institution for Affording Immediate Relief to Persons Apparently Dead From Drowning” and fostered the notion that the administration of tobacco smoke rectally stimulates the heart, encourages respiratory function and dries out the waterlogged insides. Needless to say, no drowning victim was ever resuscitated in this fashion.
Cogan and Hawes were not the first to claim benefits for blowing tobacco smoke up the rear. In fact, when Columbus arrived in North America he found that natives were using tobacco for the treatment of various ills. Whether they pioneered the tobacco smoke enema, as some accounts claim, isn’t clear. However, it is a fact that after tobacco was introduced into England, smoke “per rectum” was prescribed as a treatment for conditions as varied as constipation, headaches, strychnine poisoning, worms, hemorrhoids, typhoid fever and cholera. Before bellows were introduced, physicians would use their mouth to blow tobacco smoke up the rectum through a tube. This could have disastrous results if the practitioner inadvertently inhaled while administering treatment.
The greatest danger from tobacco, however, was not from futile medical treatments, but from smoking for pleasure. Somewhat surprisingly, this risk did not hit the headlines in a major way until British epidemiologist Richard Doll published his now famous study in 1950. Doll, a physician, had developed an interest in epidemiology, the branch of medicine that studies the occurrence and possible causes of disease in different groups of people.
During the first half of the 20th century, doctors had noted an increase in the rate of lung cancer and Doll with colleague Austin Bradford Hill undertook a study to investigate why this was the case. They questioned 700 lung cancer patients in 20 London hospitals, and before long discovered that the most prevalent common feature was that they were smokers. Halfway through the questioning, Doll became so convinced of the link between lung cancer and smoking that he gave up the habit.
The study was published in 1950 in the British Medical Journal, noting that the risk of developing lung cancer increases in proportion to the amount smoked, and may be 50 times greater among those who smoke 25 or more cigarettes a day than among non-smokers. In 1951, the two researchers went on to organize a prospective study by writing to all registered physicians in the U.K. asking if they would be willing to periodically fill out questionnaires about their lifestyle and health status. Some 40,000 responded and by 1954 it had become clear that smoking and lung cancer were linked.
The results of Doll’s study prompted Health Minister Iain Macleod to announce at a news conference in 1954 that “it must be regarded as established there is a relationship between smoking and cancer of the lung.” Curiously, Macleod didn’t seem to be too bothered by the relationship given that he chain-smoked through the whole press conference!
Responses from the physicians were collected intermittently until 2001 with even more revelations. Heart attacks occurred more frequently in smokers, and smoking seemed to decrease life expectancy by as much as 10 years with 50 per cent of all smokers dying of a smoking-related disease. In addition to lung cancer, kidney, larynx, neck, breast bladder, esophageal, pancreatic and stomach cancers were also implicated. Emphysema, strokes, chronic bronchitis, premature births and high blood pressure are also more likely in smokers.
Given the current state of knowledge, it comes as no surprise that many smokers would like to kick the habit. Electronic cigarettes were originally introduced as a safer alternative since they do not produce the various carcinogens and irritants found in tobacco smoke but still satisfy cravings for nicotine. However, it is now clear that “vaping” exposes users to a host of compounds originating from the decomposition of the propylene glycol, glycerol, vitamin E acetate, THC, nicotine and various flavour components e-cigarettes can contain.
As evidenced by recent cases of respiratory ailments, vaping is not benign. While it may help some to give up smoking, there is concern that it may also lead young people to experiment with cigarettes. Then there is the further issue that the readily available refills contain a potentially lethal amount of nicotine if ingested.
Warnings about vaping should not be considered as just blowing smoke up your …
Joe Schwarcz is director of McGill University’s Office for Science & Society (mcgill.ca/oss). He hosts The Dr. Joe Show on CJAD Radio 800 AM every Sunday from 3 to 4 p.m.
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