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“the cigarette habit”, by jc mulhall, 1895 Excerpt 1 (cigarette smoking, inhalation, irritation, pleasure) As a member of this (the American Laryngological Association) and the Climatological Association, and as one who has smoked cigarettes for twenty-five years, I feel that I may speak with a certain amount of authority on this subject. “You, a throat doctor, and smoke cigarettes!” is a phrase that has finally wearied my ears; and, bubbling with mild wrath, “I rise to explain.” The pleasure and the penalty of this vice have never been rationally described, to my knowledge, other than by myself. This I did in a paper published in the St. Louis Courier of Medicine some eight years ago, and so little notice was given it that what I now say will be practically new. A word as to the tobacco habit in general. Mankind pursues various methods in using it: by chewing it, by dipping, by cigar or pipe, by snuffing, and by cigarettes. There is a reason why each one pursues a particular plan. Early associations have much to do with the selection of the plan; but, apart from this, each method has its own particular pleasure. The man who both chews and smokes derives a different kind of satisfaction from each method, and he would derive a still different kind did he take snuff. Cigarette smokers may be divided into those who inhale the smoke and those who do not. The latter class is a very small one and the pleasure is the same, in a milder degree, as that of the cigar and pipe smoker, wherein the smoke chamber is the mouth. But all real devotees of the cigarette inhale. . . . Inhalation explains the pleasure of cigarette smoking. If the cigarette smoker did not feel the smoke in his larynx and windpipe, his pleasure would be gone. Every old cigarette inhaler will tell you this fact: that if he perchance smokes a brand of cigarette very much milder than that to which he has been accustomed, he will at once reject it, simply for the reason that larynx and trachea have been accustomed to a certain degree of irritation. The larynx and trachea have, so to speak, acquired a habit which rejects any unusual departure. For the same reason the inhaler rejects a brand of cigarettes much stronger than that to which he is accustomed, nor will he inhale the smoke of a cigar—vastly more irritating than that of any cigarette. The inhaler may change his cigarette for one more pleasing to his sense of flavor, provided always, however, that it satisfies his accustomed degree of laryngeal and tracheal irritation. The pleasure in cigarette smoking, therefore, as compared with other tobacco habits, may be said to be a pleasurable irritation of the laryngeal and tracheal sensory branches of the pneumogastric nerve.
“the cigarette habit”, by jc mulhall, 1895 Excerpt 2 (actions of nicotine) Another question frequently hurled at me in all these years has been, “What satisfaction can you get out of those weak little things?” The question means nicotine satisfaction. I once more rise to explain. One absorbs nicotine in accordance with the amount of absorbent surface in contact with the column of smoke. In ordinary smoking the mouth alone is the smoke chamber; but when one inhales, one must add to the mouth the mucous membrane of the larynx, windpipe, and larger bronchi. There is, hence, roughly speaking, three times as much surface for the absorption of nicotine; and consequently, though a cigar contains vastly more nicotine, three fourths of it is wasted, so far as the question of nicotine intoxication is concerned, as compared with the cigarette. Moreover, the cigarette smoker consumes two or three while the cigar smoker consumes one. The puny cigarette is, therefore, not so weak as it appears, and with this explanation begins to appear worthy of the newspaper term “deadly.” Again, the cigar smoker, as compared with the cigarette smoker, is an infrequent consumer. We know that, with most drugs, if we divide an ordinary dose into ten equal parts and give one part every ten minutes until the ten parts are taken, we get a more powerful effect than if the whole were given at one dose. So it is with cigarettes. The dose of nicotine is smaller, but the doses are much more frequently repeated. I can smoke one large, strong cigar in the ordinary manner without evidence of nicotine intoxication, but I can not smoke three cigarettes inhaled, in succession, without nausea or vertigo or a rapid pulse. The evil effects of cigarette smoking may be divided into the local and constitutional. . . . So far as the constitutional effects are concerned, I wish to state, as one who has carefully watched this question for fifteen years, that they are absolutely the same as those of tobacco used in any other form. The evil symptoms are always those of nicotine poisoning—not those of any other drug. The only chemist of high standing who, to my knowledge, has analyzed cigarettes is Dr. Ledaux, who last winter presented to the Section in Jurisprudence of the New York Academy of Medicine a report of the analysis of several popular brands of cigarettes. The dealers from whom he obtained the samples expressed their hope to him that he might find all kinds of narcotics in them. They explained that handling them was a nuisance to them; that all the profit accrued to the cigarette trust. He found absolutely no evidence of any other drug but nicotine in the tobacco, and in the paper a harmless quantity of cellulose.
“the cigarette habit”, by jc mulhall, 1895 Excerpt 3 (actions of nicotine, tolerance, effects on youth, peer pressure) The only narcotic present (in cigarettes) is nicotine, and this is an evil or not according to a great many different circumstances. That chief circumstance when, without exception, it is always productive of great harm, is youth. Every medical man will admit, theoretically, that this should be a fact, and the few who, like myself, have made practical observations will tell you that they never saw a child (I mean by this term those who have not reached puberty) who used tobacco habitually whose health was not in some manner badly impaired. What else would one expect the tender, growing nervous organism to do but wilt under the steady daily influence of a drug like nicotine? In adolescence—and practically this may be said to be from puberty until eighteen in females and twenty-one in males—the evil is not so great, but is still a great one; for, though the nervous crisis of puberty has been passed, the nervous system is still rapidly developing. The nerves are more resistant than in childhood, but, on the other hand, greater demands are correspondingly made upon them, either by the higher phases of education in one class or by the actual daily struggle for existence in the other. That the use of tobacco is a serious handicap in adolescence is proved by the investigations of others than myself. At several of our great universities it has been found by exact and scientific investigation that the percentage of winners in intellectual and athletic contests is considerably higher in the total abstainers from tobacco. Sammy, the best known newsboy of St. Louis, who by his wit and energy at the age of fourteen has accumulated quite a bank account, at my instigation made a series of unbiased observations concerning the newsboys of St. Louis. He found, among things being equal, that the selling capacity of the boy who used no tobacco was much greater than that of the boy who used tobacco either by chewing or by smoking. . . . The boy at first uses only the mouth as a smoke chamber, and as a cigarette is so mild he absorbs but a minute quantity of nicotine, insufficient for nausea. He gradually becomes able to consume more cigarettes, and quickly acquires nicotine tolerance. He is not allowed to pursue this method long. Invariably some other boy teaches him to inhale. At first it causes violent cough and many would never repeat the attempt, but the taunts of the other boy are heard, and with the bravado of boyhood he perseveres. The larynx and windpipe soon tolerate the smoke, then demand it, and the boy is a full-fledged cigarette fiend.
“the cigarette habit”, by jc mulhall, 1895 Excerpt 4 (smoking by women and youth, effects of advertising, role of the press) The mildness of the cigarette explains also its spreading use among young women, especially the leisure-class young ladies. As a rule they do not inhale, for at the first attempt the violent cough ensuing quenches ambition in this direction, and, unlike the youth or the boy, she is seldom encouraged to persevere. The fear of a tobacco-tainted breath also curbs her habit. In young ladies who smoke cigarettes very moderately and who do not inhale, I have never seen evidences of nicotine poisoning. Their immoderate use, even without inhalation, may, of course, afford sufficient nicotine to disturb the health. Apart from this, however, I join hands with the ladies of the W.C.T.U., who in New England have established anti-cigarette leagues among young ladies reformed of the habit, because of the pernicious example these young ladies may set to the youth and childhood which surround them. Twenty years ago in this country this habit existed, but was unusual, probably because each consumer was compelled to make his own cigarettes. But since the American manufacturer with his advertising genius has scattered them over this country, ready made and very cheap, the habit has grown enormously. Nervous diseases and insanity are rapidly increasing in the American people we are assured by our own neurologists. Our nation was already noted as furnishing proportionately more neuroasthenics than any other. If to such an inheritance American youth then adds the nerve-destroying nicotine habit which the cigarette so materially assists in spreading, there is grave reason to hope that the cry of reform may be echoed and re echoed throughout our glorious country. There is no such instructor of the public as the press, and I trust that our newspapers will publish broadcast (sic) such information as this and kindred essays may give them on what is fast becoming a national vice in American youth—the cigarette habit. Source: Mulhall JC. The cigarette habit. NY Med J 1895 (30 Nov):686–8. (From transactions of the 17th annual congress of the American Laryngological Association)
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