Description of Tobacco. Per Cent Per Cent Per Cent Nicotine Nicotine Nicotine in Tobacco in Smoke in Smoke (Pipe). (Cigarette).
Virginian Cigarettes (Sample 1) 1.40 0.74 0.12 Virginian Cigarettes (Sample 2) 1.60 0.60 0.06 Caporal (French) Tobacco 2.60 2.20 0.95 Turkish Cigarettes 1.38 0.51 Egyptian Cigarettes 1.74 0.21 Pipe Smoking Mixture (1) 2.85 2.20 2.25 Pipe Smoking Mixture (2) 2.81 1.53 Pipe Smoking Mixture (3) 2.04 0.23 Perique Tobacco 5.30 1.27 0.57 Cavendish Tobacco 4.15 3.85 Latakia Tobacco 2.35 1.20 Havana Cigar 0.64 0.20
From this a.n.a.lysis it appears that pipe mixtures contain the largest amount of nicotine in the tobacco (2.04-2.85%). Egyptian and Turkish cigarette tobaccos come next (1.38-1.74%). Virginian cigarette tobacco shows similar figures (1.40-1.60%). French tobacco (Caporal) contains 2.60%, and Perique 5.30%. For all practical purposes the tobaccos consumed by the public according to this report seldom contain more than 3% of nicotine and generally less, the average being about 2%, which is much lower than previous writers lead us to expect.
The cigarette, whether Egyptian, Turkish or American, yields the least amount of its total nicotine to the smoke formed, while the pipe yields a very large portion (in some cases between 70 and 80%) of its nicotine to the smoke. a.n.a.lysis of cigar smoke gives figures midway between the two.
With the results of Bush and the _Lancet_ before him the user of tobacco will be better able to judge of the opinions of those who describe the effects of nicotine on the vision, heart, digestive organs, etc., as likely to be the results of tobacco smoking.
Thus the disturbance of vision ascribed to tobacco smoking is called tobacco amblyopia.
Dr. W. S. Franklin of San Francisco (_Calif. State Jour. of Med._, 1909, V. 7, p. 85), says that to produce this disease it is necessary to smoke daily from .75 to 1.0 gms. of pure nicotine. If 17% of the nicotine of tobacco is carried in the smoke, in order to absorb that quant.i.ty 7 or 8 cheap domestic cigars, 10 or 11 Cubans or 60 cigarettes should be smoked.
Now very few smokers consume this amount and according to Bush, and the _Lancet_, and others there is no such percentage of nicotine in the smoke.
To the use of tobacco is ascribed an acid dyspepsia--this, however, is noticed more particularly in habitual chewers and in this case the nicotine not being burnt has no chance of being decomposed. All writers have agreed that chewing is the worst way that tobacco can be used. Dr. R.
V. Dolbey says: (_Northwest Medicine_, 1909, V. 1 p. 99).
"In chewing, quant.i.ties of watery extract of tobacco are swallowed and taken down with the food containing a large percentage of nicotine and causing severe dyspepsia. While tobacco juice solution in the laboratory kills intestinal bacteria, excessive tobacco chewing does not have this effect on the human body owing to the fact that the gastric and pancreatic juices act on it and alter it."
Dr. I. S. Gilfilian discusses the effects of tobacco on the heart in the St. Paul _Medical Journal_, July, 1912, p. 338. He says that the important part whether organic changes in the cardio-vascular system may be produced by tobacco is still doubtful, and that it has never been shown that smokers suffer more from organic heart disease than nonsmokers.
General opinion is that smoking lessens the pulse rate and slightly increases the blood pressure, and that it is a cause of arterio-sclerosis.
With regard to arterio-sclerosis, Dr. A. Lorand of Carlsbad who is a world-wide authority on the effects of toxic substances on the blood, says in his book, _Old Age Deferred_ (English translation, 1910, p. 367):
"Clinically we have observed the great frequency of arterio-sclerosis in _great_ smokers, but we do not think that two or three light cigars a day, but never before meals, can do any harm save in exceptional cases. Indeed there are a few instances of persons living to be over 100, notwithstanding the fact that they were smokers--a fact contrary to the observation of Hufeland who pretends that he never heard of such a case.
The famous English painter, Frith, who died in October, 1909, used to smoke 6 cigars a day, and Mr. F. of Chartres, in France, pa.s.sed last year his 100th birthday in spite of his having taken snuff all his life."
If there were any serious lesions caused in the human system by the continued use of tobacco we might naturally expect that life insurance companies would take notice of it, but hear what they have to say (_Medical Record_, New York, July 12, 1913):
Dr. H. G. Turney, at the meeting of Life Insurance Medical Officers a.s.sociation, London, January, 1913, said that as far as observation and study of the literature went he did not consider that there was much evidence that the habit of smoking can be convicted of any serious effect on the mortality table. One must confess rather to a feeling of surprise that the life-long absorption of so potent a drug as nicotine by a large proportion of the male population should not be accompanied by more obvious results in the way of serious injury to the cardiac muscle than appears to be the case.
Dr. A. Marvin of the Department of Pharmacology, Vermont University, made numerous experiments on the effects produced by tobacco. In the cases of the respiratory system, he states that in rapid smoking the respiratory rate is increased, due more to the effort than to the drug. In deliberate smoking there is very little effect. In the digestive system the effects produced were, increased flow of saliva and stimulation of the mucous membrane of the stomach and intestines. Marvin did not find any important symptoms of systemic irregularities except where there was excessive use of tobacco. He says: "Tobacco produces, _when used to excess_, symptoms in a very small per cent and often it is only one factor in producing the conditions observed." A very cautiously expressed and noncommittal opinion.
It is to be remembered that of the percentage of nicotine in tobacco smoke only a small portion is drawn into the smoker"s system. The greater part pa.s.ses off again in the smoke pa.s.sed out; also that the products of combustion of tobacco include acqueous solution as well as smoke; it will not probably be questioned that some of this watery solution is drawn into the mouth as well as the smoke and probably contains minute quant.i.ties of nicotine or its derivatives.
The smoker may obviate any slight harmful effects of these substances by care. If he is a cigar smoker he must avoid chewing or sucking the b.u.t.t end of the cigar in which the acqueous solution finally gathers, and he would find it better to smoke long thin cigars which afford a small area behind the burning point for the collection of acqueous vapor and give a better combustion. Judged from these viewpoints the best and most expensive thick cigar is likely to be more harmful than the very worst kind of a cigarette, for although there may be a much smaller percentage of nicotine in the cigar tobacco, a much larger proportion of it may reach the mouth of the smoker through the water produced by combustion, in the case of the cigar than in the case of the cigarette.
Every cigar and cigarette smoker should use a holder for the reason stated. The cigarette from the nicotine point of view is the least objectionable form of smoking. In fact expert opinion is recognizing that unless where the smoke is inhaled cigarette smoking if not excessive is probably harmless. It is hard, of course, to kill a popular prejudice, but we have to deal with demonstrated facts not prejudices. In the case of inhalation of cigarette smoke the danger is from carbon monoxide gas and not from nicotine.
When the difference of opinion amongst authoritative investigators are discounted their general results will be found to agree very well with the general facts observed by all users of tobacco. What they see is that probably seventy per cent of the adult male population under all conditions and circ.u.mstances use tobacco within limits of moderation. They see around them men who have for many years used it, and they do not observe any particular harmful results in the user of tobacco compared with the nonuser. Men as a rule are not more nervous, more subject to heart troubles or age troubles than women, who as a s.e.x, do not use tobacco. Smokers do not deny and never have denied that the abuse of tobacco is harmful.
The general view that both scientific investigators and popular observation is able to support is well expressed by Clouston, who is a world known authority on nervous and mental disease. (See _Hygiene of Mind_, 3rd Ed. London, 1906, p. 260.)
"If its use is restricted to full grown men, if only good tobacco is used not of too great strength, and if it is not used to excess, then there are no scientific proofs that it has any injurious effects, if there is no idiosyncracy against it.... Speaking generally, it exercises a soothing influence when the nervous system is in any way irritable. It tends to calm and continuous thinking and in many men promotes the digestion of food.
"Tobacco, properly used may, in some cases, undoubtedly be made a mental hygienie."
Mann (_Brit. Med. Journal_, 1908, V. II, p. 1673), expresses a similar opinion thus: "Most men if they choose to smoke can do so within certain limits without injury to health. Some men can exceed such limits with apparent impunity. The extent of the limitation must be determined by each man for himself."
CHAPTER XVIII
THE BENEFICIAL EFFECTS OF TOBACCO
ITS DISINFECTING ACTION. PROTECTION AGAINST INFECTIOUS DISEASE.
PSYCHOLOGICAL EFFECTS OF SMOKING.
THE BENEFICIAL QUALITIES OF TOBACCO
In the previous chapters the possible harmful effects of using tobacco have been dealt with at length. In this chapter we shall deal shortly with some positive beneficial effects.
There is very little doubt that tobacco is a strongly protective agent against infection from disease. Its germicidal qualities are well-known and recognized. It is now recognized by medical writers that the mouth is one of the princ.i.p.al, if not the princ.i.p.al channel of infection for many infective diseases. The cavities of the teeth are the breeding places of hosts of pathogenic bacteria, of which there are about 100 different varieties arising from decaying food and other sources. These destructive agents, many of them highly pathogenic, easily find their way from the mouth through various channels to the inside of the body. Many infective organisms floating in the air are drawn into the mouth in the act of respiration and this is a common method of falling a victim to contagion.
The effect of tobacco juice on the bacteria of the human mouth was investigated by Dr. W. D. Fullerton and is reported by him in the _Cleveland Med. Journal_ 1912, page 585.
In his experiments Fullerton used tobacco juice obtained from the human mouth by chewing plug tobacco. He also used a solution of smoke obtained from a well seasoned pipe. These were first thoroughly sterilized in order to obtain a pure natural mixture of tobacco and saliva. Cultures of well-known species of bacteria were made using every laboratory precaution so as to obtain accurate results. Specimens of these bacterial cultures were then submitted to the action of the tobacco juice. It was found that exposure for one hour killed or rendered innocuous 15 to 98 per cent of the bacteria; exposure for 24 hours acted similarly on from 84 to 100%.
Dr. Fullerton gives his opinion, from his results, that it seems that a pipeful of tobacco was more toxic to bacteria than one chew; but chewing tends to loosen retained food particles, foci of bacteria, etc., and much of this is ejected from the mouth. Fullerton"s work agreed very well with the results obtained by other workers in the same line of investigation.
In Miller"s _Micro-organisms of the Human Mouth_, p. 246, it is stated that the organisms of the mouth lead only a miserable existence in a mixture of an infusion of tobacco, sugar and saliva; and that the smoke of the last one-third or the first one-fourth of a Colorado Claro cigar sterilized ten cubic centimeters of beef extract solution which had been richly inoculated with bacteria from decayed teeth. Arnold, _Lancet_ (London, 1907) reports similar experiences with some of the most virulent types of infective bacteria.
Both nicotine and its derivative pyridine as well as the tarry oils resulting from tobacco distillation are strong and effective disinfectants; and formaldehyde, one of the most powerful germicides known, is so formed. Trillat, _Annales de l"Inst.i.tut Pasteur_ (Paris), Vol. 19, p. 722, shows that 100 grams of pipe tobacco will yield .063 grams and 100 grams weight of cigar .118 grams of formaldehyde. Also that a dilution of 1/1000 formaldehyde is germicidal to all bacteria although it has very little deleterious effects on man.
As far as can be ascertained there has not been very much investigation for the purpose of demonstrating the actual results of clinical experience regarding the antiseptic qualities of tobacco in the case of smokers, but facts, so far as they have been recorded, bear out the experiments. Rideal _Disinfection and Preservation of Food_ (London and New York, 1903) states that the investigations of Tessarini showed that tobacco smoke pa.s.sed over the organisms of human cholera and pneumonia killed them in from 10 to 30 minutes. He also states that the Cigar Manufacturers a.s.sociation of Hamburg reported that in the cholera epidemic of 1892 in that city, only 8 out of 5,000 employes in the cigar factories there were attacked by the disease and that, there were only 4 deaths. Professor Wenck, of the Imperial Inst.i.tute of Berlin, has published an account of this cholera epidemic (see _Laucett francaise_, Paris, 1912, p. 1425). His conclusions favor the preservative action of tobacco. It was clearly shown that slightly moist tobacco was a fatal germicide for the cholera bacillus; all microbes die in it in 24 hours. The examination of cigars made in Hamburg during the epidemic showed that they were absolutely free from bacilli.
Wenck a.s.serts also that cholera microbes die in 1/2 hour, 1 hour, and 2 hours after having been placed in contact with the smoke of Brazilian, Sumatran and Havana tobacco. The fumes of tobacco will besides kill in five minutes the cholera microbes obtained from saliva. Fullerton already quoted examined a small number of mouths (74) in the Johns Hopkins Hospital at Baltimore. Of those who did not use tobacco in any form a larger percentage showed signs of dental caries and decay of an advanced stage than in the case of tobacco users. Similarly in the case of women who never used tobacco; and, although there was a much greater care and cleansing of the teeth, yet the percentage of decay and disease was higher than in the case of men using tobacco. Fullerton says, "The smoking or chewing of tobacco is decidedly germicidal. Chewing, by exercising the teeth, helps nutrition and eliminates pathological agencies both by destroying them _in situ_ and by removing them in the expectoration."
Rideal (already quoted) mentions that Dr. Burney, the senior medical officer of Greenwich Hospital, London, a.s.serts that the tobacco smoking inmates of that inst.i.tution enjoyed comparative immunity from epidemics.
From these opinions and examples it seems quite clear that whatever portions of the decomposition products of tobacco reach the mouth and mix with the saliva, or propagate themselves in the immediate surroundings of the smoker, are likely to have extremely good effects. It would be easy to multiply these opinions but there is no use laboring the argument. There is a matter, however, it will do no harm to mention here. Today it is being gradually recognized by the medical profession that the conditions which lead ultimately to gastric and intestinal ulcer including appendicitis are entirely due to infection. At the 1912 meeting of the British Medical a.s.sociation this was clearly manifested and some of the leading authorities in England pointed out the importance of the mouth as a focus of infection in such diseases. Now if this is so, it is at once apparent how important tobacco as a mouth disinfectant and germicide becomes; and it may incidentally throw some light (otherwise unexplained) on the fact constantly observed that in persons under 30 years old these diseases are far more common amongst women than in the case of men. The use of tobacco is not a.s.serted as a reason, but it may be.
With regard to other beneficial effects--Clouston, Fullerton and Marvin, state that the moderate use of tobacco has a beneficial effect on the digestive system as in general it causes an increased flow of saliva and gastric juice which helps in the digestion of food; it also stimulates the muscles and mucous membrane of the stomach and intestines. The sedative effects of tobacco on the nerves is a preventative of nervous dyspepsia and is valuable for the promotion of good digestion.
While much has been written on the effects of excessive smoking on the nervous system little has been said of the good effects of moderate smoking. Every smoker realizes that the soothing effects of tobacco on the nerves is perhaps its most valuable property. Clouston"s opinion, already quoted (and none could be better), is that "tobacco exercises a soothing influence when the nervous system is in anyway irritable; it tends to calm and continuous thinking." Fullerton says, "It gives a composure and feeling of well-being which are beneficial to mind and body." Of these facts there can be no doubt because they are matters of common daily observation and experience. Most smokers find a solace and quieting influence from their evening smoke after the worries of a troublesome day which no other agent can give them. The effect produced may be partly psychological but that does not matter. Indeed the strenuousness of life in the age in which we live seems to demand such a help and nothing appears to supply the want so efficiently, so pleasantly, and with less harm, than a quiet smoke. It puts the smoker at peace with himself and at peace with others. Bush found in his investigations on the mental effects of tobacco on college students that there was a temporary loss of ten per cent in mental efficiency in certain faculties of the mind. This is probably true enough though his results are not quite conclusive. On the other hand many men find that they can think more clearly and more consecutively when helped by a smoke. Indeed they smoke when they have a knotty problem to solve. The point need not be argued; all smokers will agree with it.
Judged from a psychological standpoint the effects of tobacco are entirely favorable. To the sleepless, the worried, to him who is troubled in mind or vexed in spirit, the pipe or cigar is a never-failing remedy to soothe and cheer. It is the feeling of betterment which it engenders and the spirit of good will which tobacco creates that are responsible for its universal use by men differing widely in grade and condition of life as well as in mental caliber; it reaches the common springs which move humanity; its qualities are those which have made the pipe a symbol of peace and a bond of fellowship and union between man and man from Pole to Pole.
From a general summing up of the opinions which have been quoted the question might finally be asked, "Is tobacco on the whole harmful or beneficial to its users?" The answer seems to be this: "Tobacco to the extent used on the average has some slight injurious effects and some slight beneficial effects on the physical system. It is an excellent preservative agent against contagious and infectious disease. Mentally its effects are overwhelmingly beneficial." In every particular case a man must judge for himself, taking account of his individual idiosyncrasies and conditions whether the use of tobacco is beneficial to him or otherwise.
REFERENCES
_Laucet._ London, 1906. Vol. I, p. 984. _The germ-destroying properties of tobacco._
ARNOLD, M. B. _On the effects of the Exposure of Tobacco Smoke on the growth of pathogenic micro-organisms._ _Laucet._ London, 1907. Vol. I, p.
1220.
MURRAY, J. C. _Smoking; when injurious, when innocuous, when beneficial._ London, 1871.