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Cannon, Aub, and Binger[53] have also shown that nicotin stimulates the adrenal glands, small organs adjacent to the kidneys, which secrete a substance that in excess powerfully affects the blood vessels, constricting them and temporarily increasing the blood pressure. This influence may be partly responsible for the change in the blood vessels noted in heavy smokers.
Excessive smoking is often an important factor in causing insomnia.
Blindness or tobacco amblyopia, a form of neuritis, is not an uncommon affection among smokers. There is also often an irritant effect on the mucous membranes of eyes from the direct effect of the smoke.
Catarrhal conditions of the nose, throat and ear have also been noted.
Acid dyspepsia is a common affection among smokers.
Few people realize that so many ingredients in tobacco and tobacco smoke are deadly poisons. Few people know that one drop of nicotin on the unbroken skin of a rabbit will produce death.[54] Two drops on the tongue of a dog or cat will prove fatal; moreover, fatal poisonings have occurred in man from swallowing tobacco and even from external application of strong solutions. A case was recently reported from New Haven of fatal poisoning in a baby,[55] who had been fed from a milk bottle and milk-mixture in which some tobacco had been accidentally spilled.
SUMMARY
From the ma.s.s of evidence and opinion with which medical literature is loaded, a few salient facts stand out:
First: Tobacco and its smoke contain powerful narcotic poisons.
Second: It has never been shown to exert any beneficial influence on the human body in health, and it is not even included in the United States Pharmacopia as a remedy for disease, notwithstanding the claims that are made for its sedative effects and its value as a solace to mankind.
If these benefits are real and dependable, they should be made available in exact dosage and applied therapeutically. If they are not real and dependable in a medical sense, they are not real and safe as a mere drug indulgence.
Third: The symptoms following tobacco-smoking are identical with the effects of tobacco-chewing among those not accustomed to its use; hence, any collateral psychic effect, such as the sight of smoke, the surrounding, etc., are of minor importance in establis.h.i.+ng the habit.
The main charm to the smoker is the drug effect, as in any other similar indulgence. Nicotinless tobacco is not popular, notwithstanding the efforts of the French and Austrian Governments to make it so.
Fourth: Fortunately, the sedative drug effect is so slight, as compared to that of other narcotics--opium, alcohol, cocaine, etc.--that the tobacco habit is less seductive and may be broken with comparative ease and is therefore less harmful morally. Men who have smoked or chewed steadily for 40 years have been known to give up the habit without experiencing much physical discomfort. Like any other habit, however, there is a tendency to increasing indulgence, and this is a risk that the smoker takes, just as does the alcohol user or the opium habitue who begins with so-called moderate indulgence.
Fifth: The well-known effects of tobacco on the heart and circulation should lead one to pause and consider the possible cost of this indulgence, especially as--
Sixth: It is difficult to determine, years in advance, whether or not one is endowed with sufficient resistance to render so-called moderate smoking comparatively harmless.
Seventh: The vital statistics show that diseases of the heart and circulation are rapidly increasing in this country in which--
Eighth: The per capita consumption has rapidly increased in recent years, while--
Ninth: In the United Kingdom, where these diseases are decreasing, there has been no material increase in the use of tobacco, and the per capita consumption is less than one-third that of the United States.
[Sidenote: Increase of Smoking]
In 1880 the annual per capita consumption of tobacco in the United States was about 5 lbs., while in 1914 it had risen to more than 7 lbs.
In the United Kingdom the per capita consumption is about 2 lbs., and there has been no material increase in recent years.
The cigaret bill, in particular, has grown enormously, having more than doubled in the past five years, while there has been a slight increase in the consumption of cigars, smoking tobacco, chewing tobacco and snuff, as shown in the following table:[56]
------------------------------------------------------------------------ Fiscal Tobacco, Year Cigars Cigarets Chewing and Snuff Smoking --------+----------------+----------------+---------------+------------- 1910 8,213,356,504 7,884,748,515 436,608,898 31,969,111 1911 8,474,962,786 9,254,351,722 380,794,673 28,146,833 1912 8,350,119,103 11,239,536,803 393,785,146 30,079,482 1913 8,732,815,703 14,294,895,471 404,362,620 33,209,468 1914 8,707,625,230 16,427,086,016 412,505,213 32,766,741 ----------------+----------------+---------------+------------- Total 42,478,879,326 59,100,618,527 2,028,056,550 156,171,635 ------------------------------------------------------------------------
Tenth: The poetic effusions of the lovers of the weed are no safer guide than the exaggerated and intemperate denouncements of people who have idiosyncrasies against tobacco and simply hate it.
Eleventh: Those who now smoke should have a thorough physical examination to determine the condition of the heart and blood vessels.
This examination should be repeated at least annually, in order to detect any adverse influence on the circulation.
_REFERENCES_
[38] _The Toxic Factor in Tobacco_, The Lancet (London), 1912, I, p. 944.
[39] French Department of Agriculture, Compt. Rend. Acad. de Science, CLI, p. 23.
[40] Garner, W. W.: _The Relation of Nicotin to the Burning Quality of Tobacco_, U. S. Department of Agriculture, Bureau of Plant Industry, Bulletin No. 141, Sept. 30, 1909, p. 15; _A New Method for the Determination of Nicotin in Tobacco_, U. S. Department of Agriculture, Bureau of Plant Industry, Bulletin No. 102, July 6, 1907, p. 12.
[41] Lehmann, K. B.: _Untersuchungen uber das Tabakrauchen_, Munchen, med. Wchnschr., 1908, LV, pp. 723-25; _The Physiological Action of Tobacco Smoke_, Med. Rec., 1908, LXXIII, pp. 738, 739.
[42] _The Toxic Factor in Tobacco_, The Lancet (London), 1912, II, pp. 944-947.
[43] Garner, W. W.: _The Relation of Nicotin to the Burning Quality of Tobacco_, U. S. Department of Agriculture, Bureau of Plant Industry, Bulletin No. 141, Sept. 30, 1909, p. 15.
[44] Zhebrovsky, E. A.: _The Effect of Tobacco Smoke upon the Blood Vessels of Animals_, Russky Vratch, 1907, VI, p. 189; 1908, VII, pp. 429-431; Med. Rec, 1908, Lx.x.xIV, pp. 408, 409.
[45] John, H.: Editorial, Jour. A. M. A., 1914, LXII, pp. 461-2; _Ueber die Beeinflussung des systolischen und diastolischen Blutdrucks durch Tabakrauchen_, Ztschr. f. exper. Path. u. Therap., 1913, XIV, pp. 352-365; Pawinski, J.: _Ueber den Einfluss unma.s.sigen Rauchens (des Nikotins) auf die Gefa.s.se und das Herz_, Ztsch. f. klin. Med., Berl., 1914, Lx.x.x, pp. 284-305.
[46] Pack, Frederick J.: _Smoking and Football Men_, Popular Science Monthly, 1912, Lx.x.xI, p. 336.
[47] Fisher, George J. [Monograph not yet published.]
[48] Bush, Arthur D.: _Tobacco Smoking and Mental Efficiency_, N. Y.
Med. Jour., 1914, XCIX, pp. 519, 529.
[49] Mayo, Wm. J.: Personal communication.
[50] Dwight, Edwin Wells: Proc. a.s.soc. Life Ins. Med. Dir., Oct., 1911, II, p. 474.
[51] Favarger, Heinrich: _Experimentelle und klinische Beitrage zur chronischen Tabakvergiftung_, Wien. klin. Wchnschr., 1914, XXVII, pp. 497-501; _Experimental and Clinical Study of Chronic Tobacco Poisoning_, Jour. A. M. A., 1914, LXII, p. 1764; Pekanovits. _Effects of Tobacco Smoking_, Jour. A. M. A., 1914, LXXII, p. 1907.
[52] Bangs, L. Bolton: _Some Observations on the Effects of Tobacco in Surgical Practice_, Medical Record, LXXIII, March 4, 1908, pp. 421-23-51.
[53] Cannon, Aub. Binger: _Effect of Nicotin Injection on Adrenal Secretion_, Jour. Pharm. and Exper. Therap., 1912, p. 381; Editorial, _Nicotin and Adrenals_, Jour. A. M. A., 1912, LXIII, p. 1287.
[54] Hare, Hobart Amory: Fiske Prize Dissertation, No. 34, p. 1884.
Dixon, A. S.: Proceedings of the Academy of Natural Sciences, Philadelphia, Nov. 11, 1884.
[55] Reynolds, H. S.: Jour. A. M. A., May 30, 1914, LXII, p. 1723.
[56] Annual Report of the Commissioner of Internal Revenue, 1914, p. 34, Government Printing Office, Was.h.i.+ngton, D. C.
Bamberger, J.: _Hygiene of Cigar Smoking_, Abstr. Jour. A. M. A., 1904, XLIII, p. 706; Zur Hygienie des Rauchens, Munchen. med. Wchnschr., 1904, LI, pp. 1344-1345.
Current Comment: _Some New Evidence on the Tobacco Question_, Jour.
A. M. A., 1912, LIX, p. 1798.