The Physical Effects
of Smoking
PRELIMINARY EXPERIMENTAL
STUDIES
By
GEORGE J. FISHER, M.D., M.P.E.
and
ELMER BERRY, B.S., M.P.E.
ASSOCIATION PRESS
NEW YORK: 347 MADISON AVENUE
1922
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The Physical Effects
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FOREWORDAbout four years ago I was giving a course of lectures on physical training and hygiene subjects at the Summer School of the Young Men's Christian Associations of the West at Estes Park, Colorado. In the course of one of my addresses I was asked several questions regarding the physical effects of smoking. I found the questions very difficult to answer, because there was so little reliable data available. Most of the material on this subject is based upon opinion and not upon research and is, therefore, not reliable. The fact that students who smoke in colleges are poorer in their studies than those who do not is not proof necessarily that smoking produces poor scholarship. There may be many other factors involved. I am sure there are. The same may be true of the delinquent boy who smokes. He is not necessarily delinquent because he smokes; he may smoke because he is delinquent. The fact of the matter is, very little research has been attempted. Upon making a statement of this character at the aforesaid place, I was approached by Mr. A. A. Hyde of Wichita, Kansas, a well-known philanthropist, who asked whether some experiments of a scientific character could not be made really to determine, at least to some extent, what effect smoking had upon the heart and nervous system. He volunteered to stand the expense of such experiments. A little later I came across a study made by Prof. Lombard, who stated that in making experiments upon himself he had discovered that the smoking of a single cigar had caused a rise in the heart rate. Following this Mr. B. D. Brink of Boston made an experiment on an individual and found the same result. These experiments of course were too limited to be of value, but they gave direction to my thinking. In the summer of 1912, Mr. Elmer Berry and Mr. G. B. Affleck, of the faculty of the Eastern Young Men's Christian Association Summer School, made some physical tests of students attending the school, but we found our technique so faulty that we believed the results to be inaccurate and worthless. I then requested Prof. Berry to elaborate the method, stating that I would take care of the expense, but did not reveal the name of the individual who was furnishing the funds. Mr. Berry and I worked out a method which we believed isolated the factor of smoking in its physical results, so that we could determine the physical effects. Mr. Berry describes this method elsewhere. After the first experiments, we were led to take up subsequent ones. We are still continuing the work of experimentation. We hope to include tests to determine the effects of smoking upon endurance and upon mental concentration. Our method may be open to considerable criticism. We have, however, tried to be honest in our attempts to get at actual facts. We are perfectly dispassionate in the matter. We have not tried in them to establish any preconceived idea of the effects of smoking. We are hunting for the truth. We would like to know what to say to young men, when they inquire of us what effect smoking will have upon them if they indulge themselves. Smoking has become an almost universal habit. It seems to be growing in extent. Furthermore, many men smoke a great many cigars in a day. A large number buy them by the box. We should surely know what the effects are of a habit which is so universal. If there are no bad effects then we need not, on physiological grounds, be concerned. On the other hand, if smoking is injurious we should surely know of it. This is the attitude taken throughout these tests. Both smokers and non-smokers were used in the experiments. In the first and last tests the students who directed the experiments were smokers. In the other tests they were non-smokers, so that any psychological influence was neutralized. The results of the experiments were a surprise to all of us who had any part in them. I did not imagine that the smoking of a single cigar would have such demonstrable effect, especially in such general movements as are used in baseball pitching. We do not, by any means, claim that these experiments are conclusive. They are not published as such. They are simply announced for what they are worth. They are presented as tentative and preliminary, and with the hope that others will repeat the experiments and announce their results. Two things we would have the reader keep in mind. First, that these tests were made upon an exceptional group of men, mostly physical directors in more than the average physical condition and between the ages generally of 21 and 25 years. Perhaps if boys in the late teens had been used for experiment, or men of maturer years, the results would have been greater in degree. Perhaps, too, if men who were inveterate smokers had been tested, the evils would have been shown to be greater. Furthermore, the room in which the experiments were made was well ventilated, which is unlike most of the conditions under which men smoke, and which if they had obtained might have accentuated the results. In the second place, the results obtained were consistent in each of the four tests. This consistency is a considerable factor in emphasizing the results. It compels us to believe that smoking does affect the heart rate; does interfere with its return to the normal, delaying the process; and does affect the neuro-muscular control. However, we wish the reader to come to his own conclusion after reviewing the tests. If it is evident that the smoking of a single cigar interferes with an individual's efficiency, we believe that many men knowing this will greatly modify their habits - in fact, will give up smoking, which many have indulged in because they believed it to be physically beneficial; in fact doctors have prescribed smoking because they have believed the results to be of value. We believe these experiments will stimulate many others to repeat them. This is our hope. We believe also that the results discovered should cause smokers to inquire carefully into their own experience and act accordingly. George J. Fisher, M.D.
REPRESENTATIVE GRAPH AND TABLE
GENERAL SUMMARYIt is unnecessary to repeat here the definite conclusions reached by each study. The experimenters have returned results remarkable for their uniformity and general consistency, showing that smoking raises the heart rate and blood pressure, that it markedly delays the return of the heart rate to normal after exercise and that it impairs the neuro-muscular control as indicated by delicate finger exercises and gross muscular coordinations. We have repeatedly stated that these results are preliminary and tentative. The results seem hardly believable. On the other hand we are forced to accept them. There is no escape from the firm, steady, scientific insistence of the figures. If these results are true and accurate, it is high time that our young men be aware of the truth. If such results are produced on healthy, vigorous young men in prime condition by moderate smoking, what is the effect of the wide-spread use of tobacco upon the manhood of our land? The significance of these results should not be lightly tossed aside. An increased heart rate of only 5 beats per minute means that a man's heart does 2074 kilogram-meters (approximately 15,000 foot pounds) more work per day. In fifty years this means 272,471,000 foot pounds of unnecessary work. Does that mean, other things being equal, five years less life? Does it mean less margin of safety, less recuperative, more danger in case of extreme need, in the crises of disease or accident? But if the blood pressure is also raised, even these figures do not represent the whole truth, for the unnecessary work of the heart is even greater. What connection is there between this increasing pressure and arteriosclerosis? Can smoking be one of the great causes of this increasing malady among our middle-aged business men? More significant than the actual heart rate is the reduced nervous control of the heart. We know the "smokers heart" of the physician's clinic, but here is definite evidence of the exact effect of minute amounts of smoking. Failure to return to normal after exercise within a reasonable time is sufficient reason for denying athletics and heavy exercise to a would-be athlete. A strong, slow, regularly beating heart which returns quickly to normal after moderate exercise is taken by athletic trainers as one of the surest indications of condition and physical fitness. Here is an influence which quickly and definitely upsets this condition, even in those known to be in prime athletic trim. Athletic trainers have long refused to permit men in training to smoke. They knew clinically that it was bad. Evidently they are eminently justified in their position. One does not mistreat the delicate mainspring of an expensive watch. How much more foolish to subject one's heart to any unnecessary harmful influence. The effect upon neuro-muscular control again emphasizes the trainer's clinical experience. What about the army of skilled mechanics, artisans working on delicate tasks, and surgeons with life and death in their hands? To all of these, clear eyes, steady nerves, and muscles capable of accurate response are absolute essentials. These do not go with smoking. If the neuro-muscular control is affected, what about fatigue? These studies throw no definite light upon that question. It should be definitely studied at the earliest possible opportunity. A remarkable result of these studies is the apparent indication that the body does not become habituated or immune to these effects. Is this true? Non-smokers showed but little more bad effects in these studies than the smokers. But is it possible that our smokers were really too moderate smokers to become immune? This must be determined. Or does the business man who is a heavy smoker really suffer tremendously, without knowing it, in these various ways? In the baseball experiment, the more our men smoked the marked were the results. Here lies a field for further valuable research on a most vital point. What are the actual comparative effects on boys, young men, and middle-aged men? Is it possible that boys are badly affected, young men somewhat so, and mature men free? Some would like to think so; some practice that theory. There is little in these studies to comfort them. Nevertheless the facts should be determined. What are the relative effects of cigarettes, cigars, and pipes? These studies used cigarettes but very little, and the results were not conclusive. It would be well if definite information could be secured. Does smoking have definite effects upon mental and psychic processes? The neuro-muscular apparatus is one machine. It is hardly likely that one side of it is so definitely affected without some effects at least on the other side. Definite experiments ought to attack this phase of the problem. It is evident that a mere beginning has been made upon this tremendous problem. The surface has merely been scratched. Even the work already done should be repeated by other observers and the results checked. We are dealing with a deep-rooted human habit. Facts are needed in discussing it, not theories, sentiments, or prejudices. If smoking is as definitely harmful as these studies have indicated it to be, we cannot establish the fact soon enough. If smoking is not harmful but beneficial, it ought to be possible to prove it. We have presented this work in the hope that it may stimulate others to the collection of definite facts along these lines.
BIBLIOGRAPHYThe following bibliography does not presume to be at all complete. It is here presented
in the hope that it may be helpful. AMERSON, SULLIVAN, S. S. ARNOLD, M. B. BEYER, HENRY G. CORNWALL, EDW. E., M.D. FOSTER, M. L. FRIEDMANN, A. C. H. GARNER, W. W. MORIGUAND, G. AND BOUCHUT, L. RICHARDSON, B. W. OTHER Tobacco-smoking and the Circulation. Journal American Medical Association, Feb. 7, 1914, Vol. 62, No. 6, 461. |
Tom D. Stephenson |
