Occasionally we are asked why, if smoking is really harmful, do doctors condone it? Dr. Martin Gumpert9 has answered this question lucidly and unequivocally: It is, of course, an open secret that medical prohibition or tolerance of tobacco depends a great deal on the physicians own smoking habits.
Dr. Gumpert, once a heavy smoker, was forced to give up smoking because of a heart attack. He was aware of many warning signals preceding the heart attack, but like many others who are addicted to smoking, disregarded them. My pulse rate had for some time been definitely higher than it should have been; yet the extra beats were merely considered by me as of no consequence.
He went on to say that it took a heart attack to make him realise the dangers of smoking.
Dr. Alton Ochsner has confirmed Dr. Gumperts explanation. He stated: Unfortunately many physicians, probably because they themselves smoke, are unwilling to admit that there is a causal relationship between smoking and cancer of the lungs, in spite of the overwhelming statistical evidence.10
In the past many doctors who condoned smoking maintained that no direct relationship had been found to exist between smoking and heart disease. This argument certainly does not hold water. What difference does it make whether the harm is caused directly or indirectly ?
Dr. Lemmon Johnson, dealing with the subject of smoking in the British Medical Journal, Lancet, after mentioning that tobacco contains a number of poisons such as nicotine, pyridine bases, carbon monoxide and arsenic went on to say that smoking becomes a general analgesia against lifes little, or even big, stresses and vexations/
Once one masters this habit, he will find an accession of high spirits, energy, appetite and sexual potency, with recession of coughing, Dr. Johnson pointed out. However, before we can expect the public at large to accept this idea, doctors must set the example, he said.
About 80 per cent of us are smokers, he estimated, and we behave collectively like an addict. Radical cure of tobacco smoking lies in its prevention and tobacco smoking is no more difficult to prevent than opium smoking. Our duty is plain.
The economic aspect also enters in. Tobacco is an immense industry, and large sections of our population depend upon it for their existence. It is evident that millions of people would suffer economically if a vast segment of our population ceased smoking.
Our government too has a financial stake in the industry. According to the New York World Telegram, taxes collected by the federal government from this industry amount to about $1,600,000,000 annually, ‘while the states collect an additional 488 million yearly.
However, as Dr. E. Cuyler Hammond of the American Cancer Society pertinently pointed out, there should be much more to this question than economics, since our government also has a stake in the welfare of our people, and in this instance the stake is the more than 20,000 deaths from lung cancer a year with an ever mounting toll/
While Dr. Hammond failed to mention it, in addition to the 20,000 or more deaths from cancer of the lungs, we must also think of the hundreds of thousands of deaths from heart and circulatory diseases as well as other diseases of a degenerative nature in which smoking plays a part. We are in complete agreement with Dr. Clarence Williams
Lieb, who in his book Safer Smoking mentioned that if he had his way every pack of cigarettes would be inscribed with a skull and crossbones.
That smoking disturbs the fat metabolism and raises the fat level of the blood to a point where it becomes a contributing factor in the development of heart disease has been demonstrated by Dr. John W. Gofman, Professor of Medical Physics at the University of California in Berkeley. In the course of a research project financed by the United States Atomic Energy Commission, Dr. Gofman demonstrated that twenty or more cigarettes increased the fat level of the blood in male subjects sufficiently to raise the overall coronary heart disease death rate by 40 per cent.11
While Dr. Gofman asserted that the process by which giant particles in the blood are increased by smoking and the mechanism by which large fat particles (including cholesterol) contribute to heart and artery affliction are not known, and while he recognised the fact that the lipoprotein elevation resulting from cigarette smoking may not be entirely responsible for the higher incidence of coronary disease mortality, his statement that it must account for an appreciable portion of it was significant.