In The Cigarette Century, Allan M. Brandt has written a meticulously researched and passionately argued history of smoking in America. A professor of medical history at Harvard, he makes the strongest possible case for repressive international controls to "reduce the harms of smoking" in the interest of public health. According to Brandt, if tobacco consumption continues at its current rate, there could be 1 billion deaths from tobacco-related disease in this century—10 times the number of tobacco-related deaths in the 20th. In his view, this is a public-health catastrophe that dwarfs the dangers of infectious disease.
Brandt's alarm is made all the more persuasive byhis impressive command of the vast tobacco archive; millions of pages of tobacco litigation are now available online, and tobacco literature makes up the largest collection at the New York Public Library. His competence extends to the medical science of epidemiology, whose development in the 20th century provided statistics for diseases such as lung cancer, and the modern advertising industry, with its sophisticated innovations in consumer psychology: For example, Joe Camel's power over children's imaginations has been said to be greater than that of Mickey Mouse. Possessed of this scholarly authority, Brandt is able to argue with great force and clarity against a powerfully American libertarian instinct that seeks to make cigarette smoking a matter of individual choice and personal responsibility. If he fails to persuade, it is because he barely acknowledges the pleasure and benefits of cigarettes, despite the risks.
Doctors have known for centuries that smoking is bad for your health (except when, as always fashionable, some thought it was the panacea). However, it was only with the surgeon general's report in 1964 that cigarette smoking was proven to be a cause of cancer and subsequently stigmatized by medical and insurance institutions allied with government. To many, it is a mystery that 20 percent of adults in America continue to smoke despite decades of warnings. (The percentage might be larger if it included all the people who "don't smoke" but bum cigarettes.) Smokers put their longevity and their health at risk, at great expense and inconvenience to themselves. But tobacco has its benign advantages and seductive charms: It kills boredom, promotes sociability, controls anxiety, offers consolation, and, when elegantly done, as in movies or advertisements, it can be seen to be an activity of Promethean beauty, an elegant juggling of fire, ash, and smoke.
In the United States in particular, tobaccco has long been identified with freedom, first by the early Virginia settlers and more recently, brilliantly, by the Marlboro man; the cowboy smoker incarnates the American dream of escaping, if only for the time of a cigarette, from the incessant demands of tedious work and domestic reality. In the 19th century, the "freedom to smoke" was loudly demanded by bourgeois liberal culture, essentially by men, who argued for the right to have spaces to smoke free of women's moralizing intrusion. In the 20th century, as America made a shift from class-based to mass consumption, women drew the connection between the right to vote and the right to smoke publicly, which they won simultaneously. For hundreds of years, until recently, tobacco was a sort of totem substance in this country, like cheese in France or pasta in Italy: "Tobacco," it was proudly proclaimed, "is American!"
But today we know that smoking significantly increases the risk of dying early—by 23 years on average, according to some estimates. And so, against the libertarian claim that we have an inalienable freedom to smoke, Brandt invokesboth the cataclysmic dangers to public health that smoking represents and the criminal conduct of the cigarette industry—namely, its habit of lying on behalf of cigarettes over the last 80 years. He describes in rich detail the progressive discovery of the precise effects of smoking and the fierce resistance by the tobacco companies to the public disclosure of these effects. Brandt avers:
Tobacco use is aggressively promoted and marketed; a vast majority of smokers throughout the world begin as children; smokers become addicted to nicotine, a powerful drug; this addiction is reinforced by marketing, promotion, and powerful cultural symbols, and non-smokers (again, especially children) are harmed by the tobacco smoke of adults (who become addicted as children).
In his view, the cultural resources of advertising and promotion inexorably persuade young people of smoking's allure; hooked by nicotine, they go on to harm their own children with their smoke and, by their example, to initiate the next generation of smokers. The chain is unbroken from child smoker to child smoker. Given all this, Brandt argues, cigarettes ought to be severely controlled, on an international scale, for our own good, since smokers cannot claim that they are autonomous individuals exercising their right to perform a voluntary behavior.
Brandt is massively persuasive in representing the risks that cigarettes and tobacco pose to public health. And he is correct to suggest that even in today's censorious climate, our culture still valorizes smoking in many ways: One study found that 60 percent of leading actors light up in all movies, and another, conducted in 2001, found thatmore than 85 percent of recent films contained tobacco use. But The Cigarette Century is ultimately limited by its failure to account for the blessings as well as the curse of tobacco. Smoking, it is well-known, kills appetite, mitigating the risks of obesity. And recent studies indicate that it may prevent Parkinson's and delay the onset of Alzheimer's disease.
What is more, Brandt's work never addresses the question ofwhether it is ever possible freely to accept the risk of smoking cigarettes, to choose an addiction. Surely every person I have known has been addicted to something in their life and has been unable to quit for some period of time. Addiction is one of the risks people run in order to enjoy adult pleasures. Adult pleasures, as distinguished from childish pleasures, are usually not sweet and often taste bad the first time you try them, and other times as well. They can be harmful if overindulged or used for a long time, and they easily become addictive. It is one of the pleasures and terrors of growing up that one has to struggle to understand the mixed blessings of adult pleasure. Traditionally, adolescents have used tobacco for that purpose. Habits, said Nietzsche, are the best thing in life, as long as you change them regularly. If everyone has an addiction to something or other, at some time in their life, the question might be: Would you rather have your child addicted to cigarettes or alcohol? Cigarettes or marijuana? Cigarettes or sex? Cigarettes or mountain climbing? Under the compulsive regime that Brandt is advocating, it might not be possible to choose our addiction freely.
In response, Brandt would claim that no one would choose to smoke if they knew the whole truth, if they were not befuddled by the cynical seductions of corporate interests and the pressure of cultural constraints. But what if one chose addiction for the negative pleasure, precisely because it feels slightly bad at every puff, even if one knows full well that the habit is killing, and won't let go easily? Suppose you were to smoke because you love the small shock when the nicotine enters the veins; like a cold, brisk gust, it hurts a little but focuses the mind. It's the risk you come to love, the small heroism of defying the odds. There is a name for that kind of negative aesthetic pleasure: It's technically known as the sublime.
It could be argued against Brandt that rather than instituting an international regime of tobacco control—a "global governance"—as he recommends, we should learn once again in America to respect the freedom to smoke, realizing that among the commonly indulged adult pleasures, it is one that may be less debilitating and unproductive, more generally satisfying and useful, than others all too readily available.