Since cigarette smoking is so deadly, and this is so well known, why do more than one in five American adults still do it? Why did my mother, a former editor of this magazine who died of lung cancer last year, do it? Why did I do it as a teenager?
In The Cigarette Century: The Rise, Fall and Deadly Persistence of the Product that Defined America, Allan Brandt, a medical historian at Harvard, reminds us of the answers to these questions. The common explanation is that people start smoking when they are young as a result of peer pressure, or curiosity, or a rebellious desire to seem mature and sophisticated. Repeated exposure to nicotine distorts the brain system responsible for cognition, awareness, and a sense of well-being, so that the smoker comes to crave the chemical. Once hooked, people naturally become fatalistic about the risks, or deny them. Smoking rates are especially high among the poor and the mentally ill, perhaps because they can afford few other consolations and because the mild antidepressant effects of smoking make quitting especially difficult.
But there is another reason why so many people smoke, and this is the central theme of Brandt’s detailed, illuminating book. For most of the twentieth century, few people were aware of how dangerous smoking really was; they were lulled into a false sense of security by a deliberate industry campaign to promote the falsehood that scientists had failed to prove that there was a strong, consistent link between smoking and cancer. For decades, the companies managed to fool not only the public but also the medical community, Congress, the courts, and the press.
Throughout the second half of the twentieth century, practically everyone knew that smoking was risky; what they didn’t know is that it is extremely risky. Smokers who consume more than twenty-five cigarettes a day are fifty times more likely to contract cancer than nonsmokers. According to the American Cancer Society, “about half of all Americans who continue to smoke will die because of the habit.” Diseases related to tobacco account for 20 percent of all deaths in the US each year, and they are now the second leading cause of death in the world.
We all willingly accept some risks, whether in skiing, skydiving, or other forms of recreation, or simply by driving in the rain. However, if half of all skiers died prematurely, losing roughly a third of their natural lifespan—and if people knew it—skiing would be much less popular than it is. Smoking really is that dangerous, and for decades the companies that sold cigarettes knew it. But most ordinary people did not.
Beginning in the 1980s, a number of former smokers suffering from cancer sued the cigarette companies for having misled them about just how dangerous smoking was. For a corporation to withhold accurate health information is not only against the law, it is also a violation of human rights, according to the 1948 Universal Declaration of …