details of cigarette consumption have been documented in detail in prior reports [USDHHS 1989, 1994]
and will not be repeated here). Men in substantial
numbers either switched from other tobacco forms or
took up smoking, and women in smaller but visible
numbers began taking up tobacco use—in the form of
cigarette smoking—for the first time, even as the frequently women-led antitobacco efforts continued. By
the 1930s, cigarettes accounted for more than one-half
of all tobacco consumption (Schudson 1984).
In response to these trends, the WCTU campaigned for strict enforcement of laws forbidding the
sale of tobacco to minors, attacked advertising that
claimed or suggested health benefits, and criticized
smoking among women. In 1927, the Department of
Narcotics reported that chapters across the country had
sponsored thousands of antismoking events and strategies. For example, the Portland, Oregon, chapter successfully protested a leading department store’s use
of a female mannequin holding a cigarette. Members
stubbed out 219,560 cigarettes and 39,713 cigars. The
WCTU also lobbied for laws prohibiting smoking in
places where food was displayed for sale and reported
that 21 states had enacted such laws (Schudson 1993).
As the cigarette’s popularity increased, so did
concerns about its health consequences. Serious research of the day sought to link tobacco with a variety
of conditions (Burnham 1989),
but uncovered little new
ground (Tate 1999), while sobering results were often
lost amid a welter of overblown charges. For example,
the common observation at the time that cigarette
smokers seemed more dependent on their habits than
other tobacco users, now explained by increased blood
nicotine levels (Tate 1999), led one writer in 1912 to
warn that users would naturally progress from tobacco
to alcohol to morphine (Sinclair 1962). Similar unsubstantiated charges have often made better headlines
than the results of serious scientific studies over the
years. In 1930, one doctor claimed that 60 percent of
all babies born to mothers who smoked died before
reaching the age of two (Sinclair 1962). Smoking was
said to depress intelligence and academic achievement
(Troyer and Markle 1983). One historian writing in
1931 recalled a widely distributed antismoking poster
that wordlessly voiced these concerns by showing a
woman who had a cigarette in her mouth and was
holding a baby; the poster bore “no words—the mere
presentment, it was hoped, would have a deterrent
effect” (Corti 1931, p. 266).
That image of mother and child projected an antismoking message that, typical of its time, contained
both a moral and a medical objection to smoking. Historian Allan M. Brandt has observed that antitobacco
crusaders early in the century “saw no tension in seeing the cigarette as ungodly and unhealthy; they
equated moral dangers and health risks” (Brandt 1990,
p. 159).
A 1925 WCTU pamphlet held that because the
brain’s higher functions develop last, youthful smokers would have “impaired morals, weak will, lack of
religious and spiritual development, and a shocking
incapacity for unselfishness and consideration of the
rights of others” (p. 9). One of the moral dangers that
remained a theme in anticigarette propaganda was the
danger smoking posed to thrift, as cigarettes were a
needless expense, especially among the poor (Brown
1920).
Although anticigarette crusaders had medical
objections to smoking, they did not have any medical
consensus behind them. Medical opinion was generally noncommittal. Most physicians counseled that
tobacco in moderation was not harmful (Hygeia 1928;
Tobey 1930; Johnson 1932). Media reports even located
medical research that suggested that smoking had
health benefits. During World War I, army surgeons
praised cigarettes for providing the wounded relaxation and relief from pain (New York Times 1918);
a Paris
physician claimed that tobacco use might prevent the
development of microbial infections (New York Times
1923); and a famous mountain climber said that smoking helped breathing at high altitudes (New York Times
1922).
Without a strong medical component, the objection against tobacco use was scarcely distinguished
from any number of other protest targets of the reform
movement early in the century. Lacking as strong an
opponent as, for example, the alcohol temperance
movement, tobacco use continued unabated. In the
instance of cigarettes, use proliferated.
The Attraction of Cigarettes
Throughout its boom period, from the 1920s until the mid-1960s, cigarette smoking was generally
regarded as a consumer activity rather than as a medical problem. In its commercial essence, the cigarette
is simply a “package,” as a Philip Morris Companies
Inc. memorandum has suggested, for a “product”
(Cipollone v. Liggett Group, Inc., 505 U.S. 504, 112 S. Ct.
2608 [1992], cited in Lynch and Bonnie 1994, p. 60). In
fact, the cigarette is by far the most commercially successful package for the product—tobacco, itself a
delivery device for nicotine—yet devised. Such thinking fits well with the notion that consumption is an
act of imagination—that is, that one buys not the product but rather the attributes for which the product is
merely the vehicle (Fox and Lears 1983).
34 Chapter 2
Reducing Tobacco Use
Each vehicle for nicotine delivery has different
social propensities. The unique qualities of the cigarette
as a tobacco form were critical in its role as the agent
through which tobacco use was made both available
and acceptable to all social classes. Put simply, cigarettes not only made tobacco cheaper (through automated production) but also easier to use. This utility
stemmed from several distinctive features that separated cigarettes from other modes of tobacco use and
fueled the spread of the smoking habit.
The first distinctive feature of the cigarette is its
mildness. This attribute, along with its inexpensive
unit cost, made the cigarette especially appealing to
boys. Before the cigarette became popular, adolescent
males were likely to first try smoking by using cigars,
a practice that required a degree of skill to draw in but
not inhale the strong smoke. The unpleasant side
effects resulting from failing this tobacco rite of passage were largely avoided when new smokers tried
cigarettes, which used a milder form of tobacco that
was meant to be inhaled. Many of the legislative efforts during the 1890s and after were directed not at
tobacco use generally but at cigarettes exclusively because they were so accessible to boys and young men
and because they were inhaled (Outlook 1901). A 1907
Wisconsin court decision used this issue of adolescent
accessibility to justify a regulatory distinction between
cigarettes and other forms of tobacco. The cigarette,
the decision stated, was able “. . . to remove the protection which nature placed in the way of acquiring
habits of use of the more vigorous tobacco commonly
used in cigars. Before the day of the cigarette, mastery of the tobacco habit was obstructed by agonies of
nausea usually sufficient to postpone it to a period of
at least reasonable maturity” (State v. Goodrich, 113
N.W. 388, p. 390 [Wis. 1907]).
Mildness was especially characteristic of cigarettes smoked after the 1870s, when cigarette tobacco
was made milder by being flue-cured rather than firecured. Moreover, the stronger Turkish tobaccos that
were popular in the early 20th century became unavailable with the interruption of trade during World War I;
thus, blended American tobaccos came into wider use,
making the cigarette an even milder product than before (Tennant 1950).
The inhalability of the milder tobaccos used in
cigarettes is the source of a second important distinction between cigarettes and other forms of tobacco.
Because the smoke of pipes, cigars, and dark tobacco
is relatively alkaline, its nicotine dose is absorbed
through the linings of the mouth and nose. Flue-cured
“blond” or light-colored tobacco, from which American cigarettes are normally blended, produces slightly
acidic tobacco smoke; the nicotine dose thus must be
inhaled to be absorbed. Drawn into the lungs through
cigarette smoking, nicotine is absorbed into the systemic circulation more quickly than in other forms of
smoking—hence the greater potential for nicotine
addiction (Lynch and Bonnie 1994).
A third distinctive feature of the cigarette is its
relative convenience and disposability. This mild and
quickly consumed tobacco product seemed to contemporaries “peculiarly adaptable to the temperament of
the American people in an age when things are done
hurriedly and yet with greater efficiency than at any
previous time” (Young 1916, p. 119). The New York
Times editorialized in 1925 that the cigarette was “short,
snappy, easily attempted, easily completed or just as
easily discarded before completion—the cigarette is the
symbol of a machine age in which the ultimate cogs
and wheels and levers are human nerves” (New York
Times 1925, p. 24). Facility of use was further augmented by the introduction of the safety match just
before World War I (Burnham 1989).
In short, cigarettes had a “natural adaptability”
to the rhythms of urban life (Tennant 1950, p. 142).
Cigarettes fit more easily than other forms of tobacco
into brief moments of relaxation, they were more
readily used while working, and they were more easily managed without the use of one’s hands. Cigarettes helped combat the tedium of industrial work.
Particularly before workplace smoking restrictions
were widespread, cigarettes could, in the words of one
commentator, “not only help pace out a day—on the
production line, in the typing pool, behind a lunch
counter or waiting on a welfare line—but they could
give you a steady flow of small rewards to keep on
trucking” (Blair 1979, p. 33). Cigarettes organized and
controlled the passage of time; a cigarette, writes Richard Klein, is “a clock” (Klein 1993, p. 24).
After World War I, cigarettes, which were less
costly to use than cigars or pipe tobacco, became part
of a more general “throwaway ethic” reflected in other
consumer developments of the day (Busch 1983). The
disposable razor blade came into widespread use during and after World War I (Schudson 1984); in 1927,
U.S. wristwatch production surpassed pocket watch
production, as the more conveniently consulted wristwatch had won favor among soldiers (Busch 1983).
Changing attitudes about hygiene also stimulated this predilection for convenience and disposability. Between 1909 and 1936, 45 states banned the
common drinking cup used in public facilities such
as railroads; the railroads became the first principal
customers for the paper cup and paper cup dispensers (Busch 1983). Disposable sanitary napkins and
Historical Review 35
Surgeon General's Report
Kleenex tissues also became mass-market items for the
first time in the 1920s (Busch 1983). From a strictly
hygienic perspective, the cigarette appeared to give a
cleaner smoke than the cigar. A Lucky Strike advertisement directly contrasted the neatness of cigarettes
to the messiness of cigars, which require more oral
manipulation: “Spit Is an Ugly Word, but It’s Worse
on the End of Your Cigar” (Tennant 1950, p. 286). This
advertisement also played on an earlier scandal in
which cigar makers were purported to have used spit
to seal the cigar’s leaf wrapper (John C. Burnham, telephone conversation with Richard B. Rothenberg, May
25, 1995). For a generation working in offices and
riding to work in subways, streetcars, and automobiles,
milder smoke was less irritating to others. Both the
strong fumes of cigar and pipe smokers and the
unsightly by-products of snuff and chewing tobacco
users were generally more objectionable than the
smoke and ashes of cigarette smokers. Historian
Cassandra Tate has concluded that one of the lessons
of the first antismoking campaign is that “any successful social reform movement carries within it the seeds
of a backlash” while “incessant warnings can fade into
the ozone of the commonplace” (Tate 1999, p. 155).
An important part of the cigarette’s convenience
was its readiness of use. Some smokers still rolled their
own cigarettes in the 1920s and 1930s, but these consumers were a small segment of the market (Tennant
1950). By far, most smokers during these key decades
of rising cigarette popularity used cigarettes prerolled
by the manufacturer. (Cigars were also prerolled, but
by hand rather than by machine, and thus at considerable expense to the buyer.)
The cigarette’s ready-made
convenience was immediately apparent when compared with, for example, the care required to load a
pipe so that it burned neither too quickly (thereby overheating the bowl) nor too slowly (thereby requiring
frequent relighting). The cigarette was far more easily
lit and drawn than other smoked tobacco products.
One final distinctive feature of the cigarette is
its cultural connotation as a minor moral transgression. Smoking cigarettes is—and has always been—
considered slightly illicit. A practice that “looked so
strange, felt so pleasant, accomplished so little, and
cost so much [although less than cigar or pipe smoking] could not be unopposed” (Tennant 1950, p. 115).
The pleasure it offers is culturally mediated—that is,
part of the pleasure of smoking is the guilt connected
with it. None of the marketing efforts of the tobacco
giants ever fully legitimized the image of smoking—
and there is some suspicion that they never meant to
(Burnham 1993). As one sympathetic cultural observer
has put it, part of the seductive quality of the cigarette
is “beauty [that] has never been understood or represented as unequivocally positive; the smoking of cigarettes, from its inception in the nineteenth century, has
always been associated with distaste, transgression,
and death” (Klein 1993, p. xi). A modern parallel is
the recent cachet of smoking as a sexual fetish, with
images available on the Internet (Hwang 1996, p. 5).
Culturally, in fact, interviews have shown that cigarettes became a generational marker for the transforming generation that had come of age during World War I,
as well as for the reform-minded generation of the Vietnam War era
