The way we smoked

Doctors used to be pawns in the tobacco industry's games. Why smoke when you can chew?

by Peter Woodford

These days you won't find many of your fellow doctors huddling among the desperate IV-toting smokers in outdoor hospital 'smoking sections.' This wasn't always the case. Back in the good old days, smoking docs were abundant, and they featured prominently in cigarette advertising.

Temptress tobacco couldn't fool all the doctors � there were anti-smoking rumblings in the medical community as early as the 17th Century when the Mogul Emperor Akbar was advised by his court physician to lay off the hookah. But opposition to smoking didn't truly reach critical mass until the second half of the 20th century, when medical science finally caught up with the deductive abilities of small children and horses to ascertain that breathing in smoke is indeed bad for you.

To look at cigarette ads of yesteryear is to peer into a perverse world where fictional maladies are invented and great health benefits are gained by smoking a certain brand � 'cigarette hangovers,' for instance, which one brand boasted it didn't cause. A 1933 magazine ad noted 21 out of 23 players on the champion New York Giants smoked Camels because "It Takes Healthy Nerves To Win the World Series." But the most bizarre tobacco ads to modern eyes have to be those in the 'doctor-endorsed' subgenre. Many old Phillip Morris ads publicized positive medical research findings, and offered to send reprints to doctors. The journal Laryngoscope published quite a few articles favourable to Phillip Morris's coffin nails in the 1930s, leading one to wonder what were the researchers actually smoking? R J Reynolds ran a now-amusing series of ads featuring doctors smoking. Here's a taster from the not-exactly-sterling science peddled in one of their ads from 1946:

"Throat Specialist report on 30-Day Test of Camel Smokers � Not one single case of throat irritation due to smoking Camels!" Yes, these were findings in a total of 2,470 weekly examinations of hundreds of men and women from coast to coast who smoked only Camels for 30 consecutive days! And the smokers in this test averaged one to two packs of Camels a day! According to a Nationwide Survey: More Doctors Smoke Camels than any other cigarette!"

In July 1998, Bill Clinton, himself a cigar aficionado, issued an executive memorandum in tandem with a State of Minnesota lawsuit calling for public access to scores of tobacco industry documents. These papers offer an interesting insight into evolving public and medical attitudes towards smoking. Among them was a Rothmans memo from 1958, which culled a number of tobacco-friendly medical research findings aiming to disprove the link between cigarette smoking and lung cancer. Eventually tobacco companies would give up flatly denying there was any harm in smoking and retrench to spin the message that smoking, like most things, is fine in moderation. Sympathetic doctors were again used to spread the word. But cigarette companies were facing a better-informed public by this time. This can be seen in a declassified Phillip Morris memo from 1970, which included a form letter for answering complaints about the company's 'moderation in smoking' campaign. In response to expected charges of cynical timing and backpedalling, the letter stated: "... Frankly, until recently, [we] have never found a way of expressing ourselves on the subject without sounding preachy or argumentative."

The very sight of a smoking doc in North America would practically generate scandal, but today's low rate of tobacco use amongst physicians is a 50-year overnight success. In Canada, smoking by occupation data is scant. The last time it was surveyed, the health and teaching professions tied for the lowest smoking rates (17-18% for the whole field � the rate among physicians is almost certainly lower). In the rest of the world, doctor smoking rates vary widely. In Italy, the group 'Sanit" senza fumo' (Health Professionals against Smoking) recently reported that 25.3% of the nation's doctors smoke; a rate that's close to that of the general public. In Romania a recent study showed 50.1% of male and 38.6% percent of female docs smoke. Amongst Japanese doctors 27.1% of men and 6.8% of women are smokers. 9.6% of Finnish MDs smoke. Sweden boasts the lowest physician-smoking rate (5%) of any country where data is available. That claim loses some of its lustre considering that chewing tobacco use is on the rise. Among Swedish MDs, 16% of males and 5% of females chew tobacco. Could it be their neighbour, Copenhagen's bad influence?