My Generation (59 page)

T
he lamentable history of the cigarette is that of a mortally corrupting addiction having been embraced by millions of people in the spirit of childlike innocence. It is a history which is also strikingly brief. Cigarettes began to be manufactured extensively around the turn of the century, but it was not until as recently as 1921 that cigarettes overtook chewing tobacco, as well as pipes and cigars, in per capita consumption, and the 1930s were well along before cigarette smoking became the accepted thing for ladies.

The popularity of cigarettes was inevitable and overwhelming. They were not offensive in close quarters, nor messy like pipes and cigars. They were easily portable. They did not look gross and unseemly in a lady's mouth. They were cheap to manufacture, and they were inhalable. Unlike the great majority of pipe and cigar smokers, whose pleasure is predominantly oral and contemplative, most cigarette smokers inhale deep into their lungs with bladelike, rhythmic savagery, inflicting upon themselves in miniature a particularly abrasive form of air pollution. Further, the very fact of inhalation seems to enhance the cigarette's addictive power. Unhappily, few suspected the consequences in terms of health until long after cigarette smoking had gained its colossal momentum. That this type of auto-contamination is a major cause of lung cancer—that it is also a prime causative factor in deaths
from coronary artery disease, bronchitis, asthma, emphysema, among other afflictions—was established, and for the first time well publicized, only a decade ago. The effect this knowledge has had upon the public consciousness may be suggested by the fact that sales this year reached the galactic sum of one-half trillion cigarettes—one hundred billion more than in 1953. There is something historically intimidating in the idea that cigarette smoking as a mass diversion and a raging increase in lung cancer have both come about during the lifetime of those who are now no more than fifty years old. It is the very
recentness
of the phenomenon which helps make it so shocking. The hard truth is that human beings have never in such a brief space of time, and in so grand and guileless a multitude, embraced a habit whose unwholesome effects not only would totally outweigh the meager satisfactions but would hasten the deaths of a large proportion of the people who indulged in it. Certainly (and there seems little doubt that the Surgeon General's report will make this clear) only nuclear fallout exceeds cigarette smoking in gravity as a public health problem.

For its lucid presentation of the medical evidence alone,
The Consumers Union Report on Smoking
would be a valuable document. “The conclusion is inescapable,” the
Report
begins, “and even spokesmen for the cigarette industry rarely seek to escape it: we are living in the midst of a major lung cancer epidemic. This epidemic hit men first and hardest, but has affected women as well. It cannot be explained away by such factors as improved diagnosis. And there is reason to believe that the worst is yet to come.” Yet despite this minatory beginning the tone throughout is one of caution and reasonableness, and the authors—who manage an accomplished prose style rare in such collective undertakings—marshal their facts with such efficiency and persuasion that it is hard to imagine anyone but a fool or a tobacco lobbyist denying the close association between smoking and lung cancer. Yet, of course, not only lung cancer. The
Report
quotes, for instance, data based on an extensive study of smokers and nonsmokers among English physicians, where the death rate
from all causes
was found to be doubled among heavy cigarette smokers in the group of men past 65, and quadrupled in the group 35 to 44. And the
Report
adds, with the modest and constructive irony that makes the book, if not exactly a joy, then agreeable to read: “These death rates among smokers are perhaps the least controversial of all the findings to date. For with respect to any particular disease there is always the possibility, however remote, that mistaken diagnosis
and other conceivable errors may cast doubt on the statistics. But death is easily diagnosed.”

In the end, however, what makes the
Report
's message supportable to those distracted souls among the millions of American smokers who may wish to kick the habit—or who, having kicked the habit, may wonder if it is not too late—is a kind of muted optimism. For all present evidence seems to indicate that the common cocktail party rationalization (“I've smoked too long to stop now, the damage is done”) has no real basis in fact. In research carried out by the American Cancer Society, microscopic studies of the lung tissues of ex-smokers have shown a process in which precancerous cells are dying out instead of flourishing and reproducing as in the tissues of continuing smokers. Here the
Report
states, in regard to a carefully matched group composed in equal numbers of nonsmokers, ex-smokers and smokers: “Metaplastic cells with altered nuclei [i.e., precancerous cells] were found in 1.2 percent of the slides from the lungs of nonsmokers, as compared with 6.0 for ex-smokers—and
93.2 percent
for current smokers.”

Certainly such evidence, combined with the fact that ex-smokers have a lung cancer death rate which ranges down to one-fifth of that of smokers who continue to smoke, should be of the greatest practical interest to anyone who ponders whether it may be worthwhile abandoning what is, after all, a cheerless, grubby, fumbling addiction. (Only the passion of a convert could provoke these last words. The
Report
was an aid to my stopping a two-pack-a-day habit, which commenced in early infancy. Of course, stopping smoking may be in itself a major problem, one of psychological complexity. For myself, after two or three days of great flaccidity of spirit, an aimless oral yearning, aching moments of hunger at the pit of the stomach, and an awful intermittent urge to burst into tears, the problem resolved itself, and in less than a week all craving vanished. Curiously, for the first time in my life, I developed a racking cough, but this, too, disappeared. A sense of smugness, a kind of fatness of soul, is the reward for such a struggle. The intensity of the addiction varies, however, and some people find the ordeal fearfully difficult, if not next to impossible. I do have an urgent suspicion, though, that the greatest barrier to a termination of the habit is the dread of some Faustian upheaval, when in fact that deprivation, while momentarily oppressive, is apt to prove not really cruel at all.)

But if the
Report
is splendidly effective as a caveat, it may be read for its sociological insights as well. Certainly the history of commerce has few
instances of such shameful abdication of responsibility as that displayed by the cigarette industry when in 1952 the “health scare,” as it is so winsomely known in the trade, brought about the crisis which will reach a head in this month's report by the Surgeon General. It seems clear that the industry, instead of trying to forestall the inevitable with its lies and evasions, might have acquitted itself with some honor had it made what the
Report
calls the only feasible choices: to have urged caution on smokers, to have given money to independent research organizations, to have avoided propaganda and controversy in favor of unbiased inquiry. At the very least the industry might have soft-pedaled or, indeed, silenced its pitch to young people. But panic and greed dominated the reaction, and during the decade since the smoking–lung cancer link was made public, the official position of the industry has been that, in the matter of lung cancer, the villain is any and everything
but
the cigarette. Even the American Cancer Society is in on the evil plot and, in the words of one industry spokesman, “relies almost wholly upon health scare propaganda to raise millions of dollars from a gullible public.”

Meanwhile, $200 million was spent last year on cigarette ballyhoo, and during these last crucial ten years the annual advertising expenditure has increased 134 percent—a vast amount of it, of course, going to entice the very young. One million of these young people, according to the American Public Health Association, will die of smoking-induced lung cancer before they reach the age of seventy years. “Between the time a kid is eighteen and twenty-one, he's going to make the basic decision to smoke or not to smoke,” says L. W. Bruff, advertising director of Liggett & Myers. “If he does decide to smoke, we want to get him.” I have never met Mr. Bruff, but in my mind's eye I see him, poised like a cormorant above those doomed minnows, and I am amused by the refinement, the weight of conscience, the delicate interplay of intellectual and moral alternatives which go into the making of such a prodigious thought. As the report demonstrates, however, Mr. Bruff is only typical of the leaders of an industry which last year received a bounty of $7 billion from 63 million American smokers. Perhaps the tragic reality is that neither this estimable report nor that of the Surgeon General can measurably affect, much less really change, such awesome figures.

[
New York Review of Books
, December 26, 1963.]

This piece about smoking had a singular effect on a number of people of my acquaintance. Almost more than anything I have written, it demonstrated the immediate way in which an opinion, if strongly enough expressed, can have practical results. As soon as they had read the piece, a large group of my friends, plainly gripped by anxiety, quickly stopped smoking. This included—aside from my three-pack-a-day brother-in-law—Robert Brustein, John Hollander, Peter Matthiessen, Jason Epstein, and Norman Podhoretz—representative members of the country's intellectual community who are still nonsmokers and, at this writing, alive and well. —W.S. (1982)

I
was born and reared in a major tobacco-growing and manufacturing state, Virginia, and was educated and lived for a long time in an even more important tobacco state, North Carolina. In that environment it was difficult not to be seduced at an early age into making cigarettes part of one's way of life. Back in the 1940s, salesmen from such nearby cigarette-producing citadels as Richmond, Durham, and Winston-Salem used to swarm like grasshoppers all over the campuses of the upper South, hustling their wares. Usually dressed in seersucker suits and wearing evangelical smiles, they'd accost you between classes and press into your palm little complimentary packs of four Lucky Strikes or Chesterfields, give you a pep talk, and try to sell you their brand. If you were not a smoker, which was rare at a time when cigarettes were not only in vogue but the norm, you would soon become one, made helpless by the unremitting largesse. I was hooked at age fourteen, initially succumbing because my role in a school play—that of frenetic Chicago gangster—called for me to be a chain smoker. It was a delightful rationale for commencing my addiction, although I'm certain that, given the intensity of peer pressure, I would have started smoking anyway, especially since I had acquired a whole laundry bag full of those little packs and was looking forward not only to an exciting habit but to one that for some time would be absolutely free.

Like renegade Catholics and alcoholics who have sworn off, ex-smokers
are often tediously zealous about the addiction they have left behind. I confess to being a member of that group and in fact feel so strongly about the dangers of cigarettes that the subject has frequently turned me into a bleak moralist. But I have my reasons. In my mid-twenties, after I had been smoking for a decade, persistent attacks of bronchitis drove me to a very good New York doctor who examined me with a fluoroscope (no longer in general use) and told me that he had detected what looked like scar tissue on my bronchial tree. He advised me to stop smoking, which was fairly advanced advice for a physician of the early 1950s, who could only have deduced empirically what the later reports of the Surgeon General demonstrated scientifically: cigarettes are a direct cause of chronic bronchitis. The Surgeon General's reports also point out another sinister fact: the earlier one begins smoking, the greater the risk is of permanent damage to the lungs, especially the bronchial tubes.

I ignored the doctor and continued to smoke for the next fifteen years. I stopped cold turkey after a winter of bronchial attacks that came one after another and left me weak and, I might add, rather scared. I have never had a moment's doubt that my decision to stop salvaged me from dire illness, and I only wish that the cure had been more nearly complete. I have abstained from cigarettes for twenty-three years, more than double the time one should stop in order to achieve the mortality rate of lifelong nonsmokers, and therefore I have reason to believe, or hope, that in terms of lung cancer and heart disease I bailed out in time. Yet although the attacks of bronchitis are not nearly so virulent and debilitating as they were when I was still a smoker, they do come back with chronic, often exhausting persistence, casting a somber cloud over all my winters. I trace their origin to that first long and thrilling drag I took from a Philip Morris at the age of fourteen.

I have dwelt in this clinical and, I'm afraid, somewhat testimonial way on my own experience only to lend credence to the all but blind rage I feel I must express when confronted with the cigarette companies and the Tobacco Institute and their stupefying lies. It is intolerable to be told by their mouthpieces that no causal link can be shown between smoking and any serious illness, when after ceasing to smoke I experienced immediate and long-lasting relief from the acute manifestations of a disease. Plainly the Tobacco Institute proceeds on the assumption that most lay people are too stupid, or too supine, to care to take a look at either of the Surgeon General's
major reports, which, for bureaucratic documents, are written in surprisingly lucid prose.
¹
The reports show that the lungs of a young person who began smoking at fourteen or earlier will often show damage, while those of a young nonsmoker will most likely show none. It is intolerable to accept the bland claims of the cigarette industry that such a finding has no bearing on health. Of the quartet of major diseases caused by smoking—lung cancer, heart disease, emphysema, chronic bronchitis—bronchitis is the least deadly, yet it is a wretched ailment and a possible precursor of emphysema. The fact that the havoc it causes is often the result of smoking at an early age should justify outrage at anyone who would promote or tolerate cigarette advertising, which even in a television culture is read by the very young.

But the advertising of cigarettes in the print media isa troublesome matter because it presents ethical issues that a zealot like myself would initially like to see sidestepped. It is necessary to adopt the politic view. That cigarettes might be phased out of existence through education and by way of antismoking laws currently being enacted everywhere is a bright hope in lieu of making them illegal, which would likely be impossible if not undesirable, given the memory of Prohibition. Although the warnings attached to media ads possess good sense, if limited efficacy, an outright ban on advertising does not seem to square with our accepted principles of freedom of the press as long as cigarettes remain legal. That leaves the moral option in the hands of the newspaper and magazine publishers, who have not shown themselves willing to make honorable decisions.

In defending their right to help seduce the young through cigarette ads, newspaper publishers like to protect themselves by some blurred doctrine of fair play, pointing to the inconsistency of eliminating cigarette advertising while retaining ads for numerous products that might in some way harm the flesh or addle the brain. Chief among those, of course, is alcohol. But to equate in this way the harm, actual or potential, of liquor, wine, and beer with that of cigarettes seems to me a cop-out—for reasons I will mention—and also brings into focus two factors concerning cigarettes that are generally overlooked: their aberrant nature as articles of pleasure and their uselessness.

No possible claim can be made for cigarettes as enhancers of life on any level. The solace they provide is a spurious one, since they merely quell the pangs of an insatiable addiction created by one of their pharmacological components, nicotine. Also it should be remembered how recently cigarettes
have appeared on the scene. In the chronicle of human pleasure, cigarette smoking is a gruesomely freakish phenomenon. In any universal sense cigarettes have existed for scarcely a couple of generations, and their toxicity and carcinogenic nature have been scientifically validated only in the past twenty-five years. They should be regarded, then, as the vile little marauders that they are, possessing no merit and vast lethal capacity, needing to be banished with the passion that we banish any other product that we innocently adopt only to discover that it endangers our lives. (How many truly conscientious publishers would have continued advertising products containing DDT or an item like the Dalkon Shield after learning of their deadly nature?)

With alcohol, by contrast, we have lived in a state of mixed grace and distemper since the dawn of the species. It has been an integral part of our experience, rooted in virtually all cultures as deeply as food and fire. It has been far from an unqualified blessing. Its destructive potential has been recognized ever since the first crocked Cro-Magnon slid into a gully, and measures have always been taken to restrict its use. Most of the current limitations placed on the advertising of various forms of alcohol are judicious enough, especially those that help curtail their use by minors; still, it would seem intensely desirable to reduce the flamboyance of much alcohol advertising to a tone commensurate with moderate tippling, enjoyment of wine and beer as an adjunct to meals, and safe driving. But unless one is a prohibitionist one could not discover an ethical need for the eradication of ads for liquor, wine, and beer, since it would be tantamount to calling for an end to those beverages themselves. It is difficult to find any persuasiveness in the publishers' view that so long as they are allowed to advertise alcohol the banishment of cigarette ads would be a form of discrimination. Throughout history there has been bountiful pleasure and a calculated risk in drinking; in its own short and nasty history, cigarette smoking has produced merely bogus pleasure and incalculable harm. The publisher who cannot accept this simple distinction might be able to cover himself with honor if, in forgoing a small slice of what are often enormous profits, he would consign those malign solicitations to the oblivion they deserve.

But I suspect that this is a vain hope. Whenever I think of the self-concern and intransigence that prevent certain people from facing up to this plague, I recall the tobacco manufacturer I encountered some years ago. I am an alumnus of a so-called prestigious Southern university, and I met the
gentleman on a spring morning when we sat in our robes waiting for the commencement exercises to begin. The university has been endowed principally through fortunes made in cigarettes, so it was not unfitting that he, a member of the board of trustees, was also chief executive officer of one of the largest tobacco companies in America. Although he lived in New York, he was a Southerner (you could tell from his down-home accent and a kind of countrified friendliness that he was a good ole boy), and as we sat in the heat, shooting the breeze, I gradually perceived that he was in something less than robust health. His complexion was sallow—no, waxen—bags hung haggardly beneath his eyes; his lips had a violet, cyanotic hue. His end of the conversation was interrupted by thick, croupy coughs. Unfiltered cigarettes of the brand he manufactured never left his lips except when he removed a butt to light a fresh one. He was a caricature of a chain smoker, but then I asked myself, What did I expect? Certainly not abstinence in a tobacco tycoon—but even moderation?

Finally his voice grew serious. He said he was in a long, drawn-out fight with the Surgeon General, whom he called a son of a bitch. He expressed his belief that the Surgeon General's report on smoking was a plot, although he didn't say whose. I listened patiently for a while, and I suppose I should have been more circumspect, but I wasn't. I told him, in as delicate a fashion as possible, that I had quit cigarettes some years before due to chronic bronchitis and that, begging to differ with him, I felt that the Surgeon General's report had made a good case for smoking as the cause of my trouble. At that point I sensed a veil coming down between us, and his eyes narrowed, reflecting betrayal. “There's not an iota of truth in that entire book,” he said sharply, “and you are very gullible if you buy any of its cheap line of garbage.” Those were his exact words, and they are imprinted on my memory as clearly as the terrible convulsion that seized him at that instant, turning his face crimson and causing him to lose his voice in a fit of strangulation. Both embarrassed and concerned, I rose to fetch a glass of water, but when I returned I saw that he had wheeled about and his back was implacably set against me. I was the enemy. We never spoke again. Thus always yawns the chasm between the apostate and the true believer.

[
Nation
, March 7, 1987.]