The invention of mass marketing led to cigarettes being emblazoned in advertising and film, deeply tied to modern notions of glamour and sex appeal. It is hard to find a photo of Humphrey Bogart or Lauren Bacall without a cigarette. No product has been so heavily promoted or has become so deeply entrenched in American consciousness. And no product has received such sustained scientific scrutiny. The development of new medical knowledge demonstrating the dire harms of smoking ultimately shaped the evolution of evidence-based medicine. In response, the tobacco industry engineered a campaign of scientific disinformation seeking to delay, disrupt, and suppress these studies. Using a massive archive of previously secret documents, historian Allan Brandt shows how the industry pioneered these campaigns, particularly using special interest lobbying and largesse to elude regulation. But even as the cultural dominance of the cigarette has waned and consumption has fallen dramatically in the U.S., Big Tobacco remains securely positioned to expand into new global markets. The implications for the future are vast: 100 million people died of smoking-related diseases in the 20th century; in the next 100 years, we expect 1 billion deaths worldwide.
Around-the-clock tobacco talks, multibillion-dollar lawsuits against the major cigarette companies, and legislative wrangling over how much to tax a pack of cigarettes-these are some of the most recent episodes in the war against the tobacco companies. The Cigarette Papers shows what started it all: revelations that tobacco companies had long known the grave dangers of smoking, and did nothing about it.
In May 1994 a box containing 4,000 pages of internal tobacco industry documents arrived at the office of Professor Stanton Glantz at the University of California, San Francisco. The anonymous source of these "cigarette papers" was identified only as "Mr. Butts." These documents provide a shocking inside account of the activities of one tobacco company, Brown & Williamson, over more than thirty years. Quoting extensively from the documents themselves and analyzing what they reveal, The Cigarette Papers shows what the tobacco companies have known and galvanizes us to take action.
The 1980s have. seen a remarkable degree of public and professional acceptance of cigarette smoking as the most widespread and devastating form of drug dependence. More medical schools now give required courses about drug dependence. Prestigious journals publish reports of investiga- tions on the subject of nicotine dependence, and more conferences and workshops are held each year on various aspects of nicotine dependence. All this is in sharp contrast to the earlier prevailing atmosphere of dis- interest, ignorance, or professional disdain. These changes created an obvious place for a textbook oriented pri- marily toward the needs of clinicians working with patients who have nicotine dependence. Thus, in preparation of this book, most aspects of the management of nicotine dependence are incorporated, in order to address concerns of physicians in training and other health care profes- sionals across the world. The final product, which I believe to be com- prehensive and clinically relevant throughout, is a text that I hope will be of equal use to psychologists, social workers, nurses, counselors, and physicians in all specialties. An encyclopedic treatise was deliberately avoided because that approach can be cumbersome in size, readability, and cost, and for that reason, readers will find little mention of data involv- ing animal research, nicotine-related politics, nicotine product advertising, medical consequences of smoking, psychotherapeutic techniques, and the extent of the problem.
Smoking and tobacco have received much attention in the literature throughout this century, particularly in the last 30 years. The causal role of smoking in a large number of fatal diseases has been established. Concern about the ill effects of smoking has led to anti-smoking campaigns revolving around primary prevention and smoking cessation. This book focuses on the literature directed to those who cannot or will not quit smoking and offers an informed risk reduction approach aimed directly at the chronic smoker. A large number of smoking interventions are represented as well as the characteristics of smokers and the outcome of the respective interventions. The importance of continued research on controlled or reduced smoking as opposed to that of smoking cessation is outlined and methodological flaws are offered to alert future researchers. This literature will be an invaluable resource to health professionals, therapists, and others involved in the issue of health and the hazards of continued smoking.
Nicotine is almost universally believed to be the major factor that motivates smoking and impedes cessation. Authorities such as the Surgeon General of the USA and the Royal College of Physicians in the UK have declared that nicotine is as addictive as heroin and cocaine. This book is a critique of the nicotine addiction hypothesis, based on a critical review of the research literature that purports to prove that nicotine is as addictive drug. The review is based on a re-examination of more than 700 articles and books on this subject, including animal and human experimental studies, effects of nicotine replacement therapies', and many other relevant sources. This review concludes that on present evidence, there is every reason to reject the generally accepted theory that nicotine has a major role in cigarette smoking. A critical examination of the criteria for drug addiction demonstrates that none of these criteria is met by nicotine, and that it is much more likely that nicotine in fact limits rather than facilitates smoking.
A recent report from the United States Surgeon General shows that some school-based tobacco use prevention programmes have proved successful in discouraging first use of tobacco among children. Dissemination of these programmes, however, has been minimal. Taking a health researcher's perspective, the authors of this volume discuss the history, status and needs of school-based tobacco use prevention//cessation research. Issues addressed include how to implement such programmes and the major theoretical and methodological issues involved. Details of the Project Toward No Tobacco Use (TNT) are also covered.
The tobacco controversy is usually portrayed as a battle between selfless defenders of public health and greedy merchants of death. In "For Your Own Good, " award-winning journalist Jacob Sullum argues that such a view conceals the true nature of the crusade for a smoke-free society. As Sullum demonstrates, this struggle is not about the behavior of corporations; it's about the behavior of individuals. It is an attempt by one group of people to impose their tastes and preferences on another.
"For Your Own Good" shows that long before Philip Morris or R. J. Reynolds existed, tobacco's opponents condemned smoking as disgusting, immoral, addictive, unhealthy, and inconsiderate. In recent decades, they have used scientific evidence that smoking is hazardous to enlist the state in their crusade, arguing that the government has an obligation to discourage behavior that might lead to disease or injury. Given this country's tradition of limited government, however, Americans tend to be skeptical of this argument. Sullum justifies their misgivings, noting that achieving a "smoke-free society" in a nation where tens of millions choose to smoke is necessarily an exercise in tyranny. It therefore comes as no surprise that tobacco's opponents resort to censorship, punitive taxes, violations of property rights, and other coercive tactics. Sullum argues that such uses of state power are illegitimate and dangerous, threatening the freedom of anyone who dares to trade longevity for pleasure.
In response to this charge, tobacco's opponents have offered various rationales designed to overcome suspicions of paternalism. They have portrayed tobacco advertising as an insidious force that seduces people into acting against their interests. They have said that smoking imposes costs on society that need to be recouped through special taxes. They have claimed that secondhand smoke poses a grave threat to bystanders, so smoking should be confined to the home. They have accused the tobacco companies of hiding the truth about the hazards and addictiveness of smoking, preventing their customers from making informed decisions. They have described nicotine addiction as a compulsive and possibly contagious illness, fitting nicely with the public health mission to control disease. Often these arguments are combined with appeals to protect children, as when former FDA commissioner David A. Kessler called smoking "a pediatric disease."
Sullum refutes each of these claims and shows that the anti-smoking crusade in fact rests on two complementary beliefs: that the government should stamp out the use of hazardous drugs and that it should deter activities that impair "the public health." He argues that the dangerous implications of these ideas extend far beyond tobacco.
"I accepted the certainty of my untimely death with gallows humor and a calculator. I'd read somewhere that each cigarette you smoke knocks seven minutes off your time on the planet. To amuse myself, I did the math: 153,000 cigarettes = two years of my life, up in smoke." Julia Hansen first lit up at nineteen. Twenty years later, she was editing books about health -- and smoking a pack or two a day. She denied her son fast food, but smoked in the house and car; curtailed his video games, but lit up at his soccer matches. Despite repeated attempts to quit, she always crawled back to her beloved menthol lights. Smoking had become a metaphorical chain around her neck, shackling her to an early death. Haunted by a nightmarish vision of her future -- her son at her deathbed, begging her not to leave him -- Hansen devised a drastic quit method. She bought a 72-foot length of chain that was "unwieldy as a corpse" and locked herself to a radiator in her dining room. What followed: seven days of cold-turkey misery, comic absurdity, and revelation as Hansen stepped from behind her wall of smoke to face her addiction to nicotine -- and some painful truths. Clanking around her house like Marley's ghost, white-knuckling cravings, and struggling to understand tobacco's unyielding grip on her, Hansen confronted her life in smoke: fractured relationships, lifelong battles with alcohol and depression, and a profound sense of emptiness. On day 1, the chain was her addiction to nicotine, each link a story about cigarettes and self-loathing. By day 7, it had revealed its ringing, rattling truth -- that every smoker has a story, and it always centers on clinging to a comfort that can kill you. In the end, Hansen's story was painfully simple: She smoked to survive her life. And then, to save it, she quit. Fierce and funny, honest and utterly absorbing, A Life in Smoke is Julia Hansen's evocative and inspiring account of the extreme measures she took to quit smoking -- decidedly not recommended by the medical profession.
In the critically acclaimed Five Men Who Broke My Heart, Manhattan journalist Susan Shapiro revisited five self-destructive romances. In her hilarious, illuminating new memoir, Lighting Up, she rejects five self-destructive substances. This difficult quest for clean living starts with Shapiro's shocking revelation that, at forty, her lengthiest, most emotionally satisfying relationship has been with cigarettes.A two-pack-a-day smoker since the age of thirteen, Susan Shapiro quickly discovers that it's impossible to be a writer, a nonsmoker, sane, and slender in the same year. The last time she tried to quit, she gained twenty-three pounds, couldn't concentrate on work, and wanted to kill herself and her husband, Aaron, a TV comedy writer who hates her penchant for puffing away. Yet just as she's about to choose her vice over her marriage vows, she stumbles upon a secret weapon. Dr. Winters, "the James Bond of psychotherapy," is a brilliant but unorthodox addiction specialist, a
former chain-smoker himself. Working his weird magic on her psyche, he unravels the roots of her twenty-seven-year compulsion, the same dangerous dependency that has haunted her doctor father, her grandfather, and a pair of eccentric aunts from opposite sides of the family, along with Freud and nearly one in four Americans. Dr. Winters teaches her how to embrace suffering, then proclaims that her months of panic, depression, insecurity, vulnerability, and wild mood swings win her the award for "the worst nicotine withdrawal in the history of the world." Shapiro finally does kick the habit-while losing weight and finding career and connubial bliss-only to discover that the second she's let go of her long-term crutch, she's already replaced it with another fixation. After banishing cigarettes, alcohol, dope, gum, and bread from her day-to-day existence, she conquers all her demons and survives deprivation overload. But relying religiously on Dr. Winters, she soon realizes that the only obsession she has left
to quit is him. . . . Never has the battle to stem substance abuse been captured with such wit, sophisticated insight, and candor. Lighting Up is so compulsively readable, it's addictive.