Puritanism disguised as science

I’m sitting in the corner of a bar, talking to author Christopher Snowdon and doing something almost unheard of in Britain these days: enjoying a cigarette under cover. Admittedly, it is a pretty open-air kind of ‘under cover’ in a specially adapted part of the Boisdale restaurant and bar near London’s Victoria station; still, the novelty value is not lost on me.

We are here because Snowdon is launching his book this evening, a history of the anti-smoking movement that has been three-and-a-half years in the making. One of the main reasons he wrote it, he tells me, is because ‘I wanted to read it. I went into the library looking for a history of the anti-smoking movement, assuming there would be one, and there wasn’t.’ Instead, he had to wade through many other books on the history of tobacco, picking out snippets here and there and trying to build up a picture of the chequered history of those who want to see the evil weed confined to the ashtray of history.

While Snowdon seems happy to have put the book to bed at last, he also clearly enjoyed the challenge. ‘It’s an ideal subject for a historian. Firstly, because it’s never been done before and it’s rare to find a major contemporary topic that’s never been done before. Secondly, because you’ve got eight million documents online in America thanks to the efforts of various anti-smoking groups. That’s an enormous resource that is virtually untapped. Thirdly, history is all about trusting your sources and, with this issue, you can’t. It’s got to the point where the tobacco companies and their opponents are as bad as each other.’

The result is Velvet Glove, Iron Fist, a book with a full-on, in-your-face title that points squarely to a recurring theme of the anti-smoking crusade: the ‘slippery slope’. Whenever a compromise is made in relation to smoking – when it is restricted in public, for example, or the second-hand smoke thesis becomes more readily accepted – then the very uncompromising zealots behind the anti-smoking campaigns find a new way to demand even more restrictions.

Snowdon points to the debates about the mandatory wearing of motorcycle helmets and car seatbelts in the 1970s as a turning point. Even then, parliamentary debates were concerned not with the potential benefits of wider helmet and seatbelt use – they were regarded as obvious – but with concern that such impositions would be used as an argument for further legislation on unrelated areas of life. Similarly, while Snowdon is clear that active smoking is ‘definitely’ going to increase an individual’s risk of various diseases, one of his main concerns is the way that freedom has become provisional, with the state now justifying all kinds of bans and restraints for ‘our own good’.

You might think that governments have been a little illiberal on tobacco in recent years, but their illiberalism is nothing compared with the reaction of rulers centuries ago. In the first half of the seventeenth century, Snowdon writes, there were ‘draconian laws… to eliminate tobacco use from Sicily to China’. The czar of Russia flogged first offenders and had their nostrils slit; a second tobacco offence would result in execution. In China, the emperor Chongzhen ordered the beheading of tobacco importers. Shah Abbas of Persia punished both importers and users with death, while his son added the touch of executing them by pouring molten lead down their throats.

Yet there were many who also believed in tobacco’s medicinal qualities, and doctors prescribed it for a variety of illnesses from bronchitis to smallpox. The diarist Samuel Pepys apparently made sure he had a packet when the Great Plague hit London in the 1660s and it seems that tobacco was regarded as a vital protection in much the same way that Tamiflu is today.

But it was the psychological effect of nicotine that was always more important. Tolstoy asked ‘Why do gamblers almost all smoke?’, along with ‘prostitutes and madmen’, while women who lead a ‘regular life’ avoid tobacco. Indeed, smoking has long been associated with those who are impulsive and less concerned with what people think of them.

Tobacco is also popular with soldiers. Soothing, yet stimulating, it is just the ticket for those faced with the possibility of brutal death and horrifying injury. Snowdon quotes the US general John Pershing, who was asked what was the key to winning the First World War. ‘I answer tobacco as much as bullets’, he said, before urgently cabling Washington: ‘We must have thousands of tons of it without delay.’ By one reckoning, 95 per cent of the military used tobacco in some form during the First World War.

Nicotine – named after the sixteenth-century French diplomat Jean Nicot who popularised tobacco in northern Europe – is a quite peculiar substance, as Snowdon explains in his book. In small doses, it provides a stimulating rush, but in larger doses the effect is soothing and relaxing. Cigarettes are the perfect delivery system for nicotine, providing an instant ‘hit’ – one enhanced by the fact that the tobacco in cigarettes is cured to make the smoke more readily absorbed by the lungs. No wonder it has been the self-medication of choice for the mentally disturbed.

Quite apart from despotic rulers, there have long been people desperate to outlaw smoking. Often, they have been offended by the smoke and smell, but the reaction against tobacco has also been the focus for all sorts of reactionary arguments. Samuel Solly, writing in the Lancet in 1857, declared that he knew of ‘no single vice which does so much harm as smoking’ and suggested that those ‘troubled in mind’ should be ‘submitting to the rod, and rising strengthened from the chastisement’.

Where today it is children who are often the focus of anti-smoking campaigns, in the past it was women, who were deemed particularly vulnerable to the deleterious effects of tobacco. In 1920, the US Surgeon General advised women to avoid smoking as ‘a woman’s nervous system is more highly organised than a man’s’. Others were concerned that if women took to smoking it would undermine the Anglo-Saxon racial stock. As one senator’s wife declared in 1925, smoking amongst women would inevitably lead to ‘physical bankruptcy and race degeneracy’.

If there is a theme running through Snowdon’s book, it is of anti-smoking campaigns driven by Puritanical fervour clashing with the individual right to enjoy smoking unhindered. The big change was the discovery – first made properly by Fritz Lickint in 1929 in Germany and confirmed by his compatriot Franz Muller – that lung cancer cases were almost always smokers. Such ‘Nazi’ science was utterly ignored by the rest of the world, but it only confirmed Hitler’s hatred of smoking (despite his two-packs-a-day habit in his youth).

In Britain during the same period, the voice in the wilderness railing against smoking was Lennox Johnston, a Glasgow doctor. Johnston was a man zealously convinced of the dangers of tobacco, becoming a prolific letter writer and experimenter (often on himself). After bashing his head against a medical brick wall for years, he finally had a study published in the Lancet in 1942 – to zero acclaim. It was to his utter frustration that when the time came for properly funded research into the matter, the money was given to Austin Bradford Hill and his assistant, Richard Doll, whose famous survey of doctors and smoking became the first confirmation outside of Germany of the link between smoking and lung cancer.

While Hill and Doll’s conclusions have been confirmed time and again, it is the link between ‘passive’ smoking and ill-health that has driven the debate in recent years. Anti-tobacco campaigns largely failed to make much headway when they simply called for prohibition or for a smoke-free atmosphere. As long as smoking only involved potential harm to the smoker himself, the irritation felt by some non-smokers was never considered enough to justify intervention and the restriction of people’s smoking habits.

Then, changing the focus from harm-to-smokers to the alleged dangers of second-hand smoke for everyone proved crucial in building momentum for a variety of smoking bans. Yet, as Snowdon writes, the evidence of second-hand harm has always been flimsy. In other areas, doctors and researchers have been quick to dismiss studies that have found links between, for example, abortion and breast cancer, on the correct grounds that the increased risk found – 70 per cent – was simply too small to be captured by the blunt instrument of epidemiology. However, much smaller increases in risk have been used as proof that passive smoking causes lung cancer.

Snowdon shows through a comprehensive survey of the passive smoking evidence that very few of the studies conducted to date have shown a statistically significant link between passive smoking and ill health. But that has not prevented some borderline insane claims being made that second-hand smoke is, if anything, even deadlier than the stuff sucked into the lungs of smokers themselves.

The fact that such studies have led to prohibitive legislation should be of concern to everyone, even those who dislike smoking. As he lights a second cigarette, Snowdon tells me: ‘Essentially, the argument is: smoking is bad and therefore anything you can do to reduce smoking is fair game. There’s very little accountability for the people who’ve been pumping out this information over the past 20 years.’

Having promoted a fast-and-loose approach to scientific evidence, the anti-smoking lobby thinks anything goes when it comes to restricting smoking. ‘The argument has been expanded to other areas because of the slippery slope’, says Snowdon. ‘The epidemiological effects in passive smoking studies are so tiny that if you accept the studies around passive smoking then you have to accept almost any study.’ The result of that would be an assault on a variety of personal choices, from binge drinking (and even ‘passive drinking’) to eating bacon sandwiches. With ever-expanding legislation and billion-dollar lawsuits, the anti-smoking campaign has become the template for junk-science lobbying and courtroom carpetbagging on a whole raft of issues.

While epidemics of ‘ill health’ are invented, real problems are often ignored. Shockingly, in 2007, only five per cent of the US National Cancer Institute’s funding was spent on studying lung cancer, despite the fact that it causes one-in-three cancer deaths in America. As far as the medical establishment is concerned, it seems that finding a treatment for lung cancer has taken a back seat to interventionist, smoker-bashing health campaigns. According to Cancer Research UK, just seven per cent of those with lung cancer will survive for five years after their diagnosis. If you’ve got lung cancer, the message is: it’s your own fault.

Snowdon is once more in demand and dashes off to sign books. I light up again. Funny how pursuing what should be nothing more than a bad habit can seem like a single, raised finger to those who want to restrict our personal freedom and micromanage our lives.

Rob Lyons is deputy editor of spiked.

Velvet Glove, Iron Fist: A History of Anti-smoking by Cristopher Snowdon is published by Little Dice. (Buy this book from Amazon(UK).)