In the 1950s, when half of American adults smoked, many freshmen unpacking at college were greeted by upperclassmen paid by tobacco companies to distribute free cigarettes. In 1964, the U.S. surgeon general said smoking causes lung cancer. Most people, however, had long intuited that inhaling smoke from a burning plant is unhealthy. In a 1906 O. Henry short story, a character asks, “Say, sport, have you got a coffin nail on you?”
To enhance the credibility of the 1964 report, five of the 10 members chosen for the committee that wrote it were smokers. In her “The Cigarette: A Political History” (2019), Sarah Milov wrote that the committee “convened in a room at the National Library of Medicine. The air was thick with smoke and the table covered in papers and ashtrays.”
Until the mid-20th century, smoking seemed sophisticated and glamorous. When it became perceived as dumb and déclassé, life became more regressive: The broadly educated, information-acquiring middle class heeded public health warnings, others not so much. Now, because learning, like everything else, is perishable, smoking is making a mild comeback.
During the pandemic, when health fears left isolated people with time on their hands, some picked up cigarettes. The covid-era smoking surge abated, but now some celebrities are lighting up. (Perhaps celebrity really does subtract from intelligence.) And more smoking is appearing in movies. (Perhaps the surgeon general should label Hollywood carcinogenic.) This is an era in which, depressingly, “influencer” is an actual job/career category.
The writer and professor Katie Roiphe surmises (in the Wall Street Journal) that “in this era of wellness obsession, of kale salads and Pilates, people who are recklessly hedonistic, who choose pleasure over health, still have a certain kind of glamour.” There now are so few norms to transgress, for some aspiring renegades smoking must suffice.
Another Roiphe speculation: For young people, “the terribleness of everything” — school shooters, climate change, the price of eggs, everything — suggests: Why not “a little stylish self-destruction?” Perhaps teaching middle-schoolers that they are destined to die on a boiling planet is a gateway to smoking.
The health care sector is 18 percent of the U.S. economy and rising, partly because of known risky behavior, such as eating grilled cheese sandwiches, and smoking. At a St. Louis hospital in 1919, a doctor summoned some medical students to an autopsy, saying the deceased’s disease was so rare they might not see it again in their lifetimes. It was lung cancer. One of the students later wrote that he did not see another case until 1936. Then he saw nine in the next six months.
Technological progress, war and the emancipation of women changed things. Manufacturing coffin nails was a cottage industry until a cigarette-making machine was invented in 1881, making smoking much cheaper. Cigarettes, free or a nickel a pack, were a perk of soldiering during two world wars and Korea. Women as well as men in Ernest Hemingway’s 1926 novel “The Sun Also Rises” smoke constantly.
Today, smokers are usually among society’s pariahs, shivering in winter as they puff outside their workplaces. Even though the Father of Our Country was a Virginia tobacco farmer, today there are more American ex-smokers than smokers. But cigarette manufacturers still prosper because of what the Economist calls “the counterintuitive economics of smoking.”
Cigarette companies remain economically healthy because of those smokers who, despite dire probabilities, have not quit are “price-inelastic” consumers. They are nicotine addicts undeterred by rapid price increases that offset tobacco companies’ volume declines.
Cigarettes are among the world’s most heavily taxed consumer products. Some U.S. state governments are addicted to cigarette tax revenues and impervious to evidence that at high rates, revenue declines. New York’s tax is $5.35 a pack. Georgia? Thirty-seven cents. Guess what state is a large source of cigarettes smuggled to New York.
Calculating the net costs of smoking, America’s largest preventable cause of death, is complicated. The costs are in health care, lost productivity from illness and shortened lives, and fire damages. But mortality from smoking reduces spending on smokers’ Social Security, pensions and nursing-home care. Smoking has generated interesting product liability litigation because cigarettes are by now almost universally known to be harmful when used as intended.
“Only” one in four cancer deaths is from smoking-related causes, but who would board a plane with a 25 percent chance of crashing? And whoever said that kissing a smoker is like licking an ashtray might have done more than the surgeon general to discourage smoking.
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