Making Cigarettes History

For the last three weeks, I’ve been writing entries about the history of public health. I started by giving you an overview of the history of public health, then wrote about public health in ancient times and cholera's connection to epidemiology. Today I’m going to write about a more recent public health topic: smoking. It is an especially timely topic because today is the Great American Smokeout.

Tobacco has a long history in the Americas. Long before Europeans arrived, native populations had been using it for ritualistic and spiritual purposes. And for centuries after the Europeans arrived, smoking was a popular social activity and tobacco an important economic commodity. It was important as a cash crop in the South during the 1700 and 1800s. And many older, grand houses had separate “smoking rooms” where men would go to smoke and socialize during parties.

This popularity continued into the 20th century. Smoking was allowed in restaurants, planes, and elsewhere. Cigarettes were often seen in movies, and celebrities, such as Lucille Ball and Frank Sinatra, helped popularize it through their personal use and appearances in tobacco advertisements. With this greater visibility and the political and social climates came new smokers. Many women adopted the habit, and companies even developed “Kiddy packs” for minors.

In the second half of the century, however, the tide began to turn. Growing concerns about the health effects of tobacco use led to public campaigns including the Great American Smokeout, which began in 1977 and is celebrated with rallies, parades, and the distribution of information (and again, is today).

New regulations were also put into effect to stem the use of tobacco in American society. In 1977, Berkeley, CA became the first city to limit smoking in restaurants and other public places. Other cities followed suit and also banned smoking in the workplace. Federal bans came on smoking on public transit came into effect in the 1990s.

More recently, city- and state-wide bans have been a major topic of debate. Although smoking regulations vary widely by state, increasing numbers of cities and states are adopting bans on smoking in restaurants, bars, and workplaces. As of October 2009, an estimated 71% of Americans are “covered by a 100% smoke-free provision in workplaces, and/or restaurants, and/or bars, by either a state, commonwealth, or local law.”

Although there have been concerns about the economic effects they have on small businesses by deterring smokers from going to restaurants and other places, they have an undeniably positive impact on the general public’s health and quality of life: a recently released report from the Institute of Medicine concluded that smoking bans reduce cases of heart attacks and heart disease, and that the difference begins to show pretty quickly after bans take effect.

Advertising has also changed dramatically. The Family Smoking Prevention and Tobacco Control Act of 2009 requires that cigarette warning labels cover 50 percent of the front and rear of each pack, with the word warning in capital letters, something that has been common in Europe for a long time.

We have come a long way toward clearing smoke from our air over the past few decades, and this is significant. Yet there is—as always—more than can be done. An estimated 46 million adults in the United States today are still smokers, and their actions are continuing to affect not only their own health but also those around them. The consequences of smoking are staggering: approximately half of the US smokers will die prematurely from smoking, and it causes one in five deaths from all causes. It’s also an extremely expensive habit.

Many resources and programs exist to help people quit and if you or someone you knows smokes, they’re worth looking into. Here are a few places to start:

• According to the American Cancer Society, smokers are most successful in quitting when they have some means of support, such as: nicotine replacement products, counseling, stop-smoking groups, telephone smoking cessation hotlines, prescription medicine to lessen cravings, guide books, encouragement and support from friends and family members.
• Telephone hotlines available in all fifty states. To find counseling or support in your area, you can call 1-800-ACS-2345 (1-800-227-2345).
• Some states have specific resources available, such as QUITPLAN, a free personalized approach available to all Minnesotans (financed by funds from the Minnesota Tobacco Settlement). Try searching online to find out what is offered in your area.
• Some insurance companies such as BlueCross BlueShield (MN) also have plans to help clients with quitting.

This is the final post in a series on the history of public health which I am writing in anticipation of Public Health Thank You Day, a time when Research!America and other leading health organizations recognize public health heroes whose work helps keep our drinking water safe, air clean and children healthy. My hope is that these posts will help illustrate how far we've come, and how much more remains to be done.

To read the first post, which gives an overview of the history of public health history, click here.

To read the second post, about public health in Ancient Greece and Rome, click here.

To read the third post, about cholera and the birth of epidemiology, click here.