smoking habits of such sick people as typical of
the general population?
While cancer research men have been among
the severest critics of the cigarettes-cause-cancer
studies, a similar controversy has raged among
practicing surgeons and cancer specialists.
Some prominent physicians have accepted the
new evidence as conclusive. Dr. Alton Ochsner,
director of the famous Ochsner Clinic of New Or
leans, for example, has categorically stated, "It ap
pears without doubt that the inhalation of ciga
rette smoke exerts a cancinogenic effect upon lung
tissue.”
But others reject this view just as vigorously.
Surgeon William F. Reinhoff, Jr., of Baltimore,
declares, "I have reviewed more than 500 cases
of lung cancer that were inoperable, and I have
found no relation whatsoever to smoking.”
The attacks upon smoking have, of course, not
been restricted to the idea that it might cause
cancer. Yet, as in the case of the cancer studies,
almost all of the other attacks seem to create far
more medical controversy than they clear up. Con
sider, for example, the theory that smoking injures
the heart, and the related theory that it intensifies
heart disease and accelerates its disastrous course.
As with the cancer theory, there are again
grounds for a certain amount of argument.
Some years ago, Drs. Grace Roth, John Mc
Donald and Charles Sheard, of the Mayo Clinic in
Rochester, Minnesota, published in the A.M.A.
Journal a report on experiments they had con
ducted upon six normal human subjects. They
were able to demonstrate that smoking temporarily
speeded the pulse, temporarily raised the blood
pressure and temporarily caused a drop in the
temperature of the extremities. These facts have
been largely confirmed by other researchers.
Antitobacco propagandists made much of this
data. Yet precisely the same effects are brought
about by a host of other agents and conditions.
A man’s pulse rate goes up at the sight of a
well-turned ankle. So, too, does blood pressure.
If you run 100 yards, or if you get good and
angry, your heart will increase its rate of pump
ing and your blood' pressure will mount.
Whether this is good or bad depends, however,
entirely upon circumstances. If it increases your
breathing rate and helps you run faster, that may
be excellent . . . especially if you are being chased
by an angry dog. If it throws you into a frothing
fit, that is, obviously, very bad.
But logically, it seems extreme to indict the
cigarette as a cause of heart disease when its ef
fects on the action of the heart and the blood are
so strikingly similar to the effects of so many
other of the ordinary conditions of daily life.
Another more recent study, once again published
by the A.M.A. Journal, reported upon a far more
extensive investigation by a group of doctors from
Columbia University’s College of Physicians and
Surgeons and from New York’s Presbyterian Hos
pital. Drs. Robert L. Levy, James A. L. Mathers,
Alex A. Mueller and John L. Nicherson wanted to
find out whether smoking was bad for people who
already had heart disease.
They tested persons of different ages, some of
whom suffered from various heart conditions and
some of whom didn’t. They tested young people
and old. They used both ordinary cigarettes and
the denicotinized types.
FACTS THAT THE TESTS REVEALED
They found, first of all, that cigarettes had
widely differing effects on different people—ef
fects that varied without any discernible relation
to whether or not the people had heart disease.
Except in a small minority of susceptible persons,
they found that smoking cigarettes caused only
slight changes in the circulation and did not sig
nificantly increase the work demanded of the
heart.
Among none of their subjects, including even
those with coronary heart disease, did they find
that smoking caused any cardiac pain.
Their viewpoint.? "Most patients with a cardiac
disorder, including those with a disease of the
coronary arteries, can smoke moderately without
apparent harm. In fact, for many, smoking not
only affords pleasure but aids in promoting emo
tional stability.”
That, of course, does not mean that all heart
patients should smoke. Dr. Levy and his group
were careful to point out that smoking should be
forbidden for certain types of heart disease—"con
gestive heart failure, the acute stages of cardiac in
farction and active rheumatic heart disease.”
The antismoking propagandists have another
major line of attack. Smoking, they tell us, short
ens the life-span. The cigarette, they assert, is in
actuality what we used to call it jokingly, a "coffin
nail.” For scientific support they rely mainly
upon a twelve-year-old survey by the late Dr.
Raymond Pearl, of The Johns Hopkins University.
Dr. Pearl did indeed study a very large group
of people—6,813. He reported that two thirds of
all his nonsmokers survived past the sixty-year
mark. Light smokers did almost as well. Sixty-
one per cent survived past sixty. But among
heavy smokers only 46 per cent reached sixty.
But many other statisticians find serious flaws
in Dr. Pearl’s reasoning. He had isolated a single
factor from among many which undoubtedly con
tribute to the slightly earlier death of some
smokers, and the slightly longer survival of some
non-smokers. But others point out that people
who work under high pressure and high tension
often smoke heavily, to permit themselves to work
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