CIGARETTE SMOKING

THE effects of inhalation of tobaccosmokeon the nervous and vascular systems are considerably favoured by investigators today as a subject for research. Probably the advice to abstain from or at least to limit smoking is given in someinstances without a very sound basis of scientific reason, though information is accumulating which tends to show that smoking can be proved to have an effect upon various functions of the mammalian body. Whethertheseresultsareharmful or not may be anothermatter,but at leastthe physician,by the use of his knowledge, can fortify his position in advising, let us say, the arteriosclerotic subject underthreat of a peripheralvascularaccidentthat the inhalationof tobaccosmokeactually does affect the outlying vascular fields of the body. In this way also we may quote recentwork on the effect of cigarettesmoking on the heart. Harry L. Segal has followed other workers in using the electrocardiographfor testing the effect of nicotine on variousgroupsof people. ' It may be asked if the question is yet settled as to whether nicotineis the harmful constituentof tobaccosmoke, or at least that which is most likely to produce systemiceffect. There seemslittle doubt that it is. Carbon monoxide and other by-products of combustion, either of the tobaccoor of the paper used in cigarettes,have been blamed; but the quantities absorbed appear to be so small that althongh certain of the pyridine derivativesmay causelocal irritant effects, it is not likely that they are significant. Segal remarksthat since we realize that nicotine is the harmful element in the smoking, and since many people find it extremelydifficult to give np smoking, it appearslogical to ask what is the leastharmful way of smoking. This introduces the subject of filters. In this study two filter holders were investigated:one was a special filter containing a silica gel, and the other consistedof an ordinary cigaretteslipped into the holder to act as a nicotine trap. The method used was for the subject to refrain from smoking for one night and on the following day to smoke a eigarettewith or without a holder while sitting in a comfortable chair and with the electrocardiographleads in position, so that tracingscould be taken before and at various periods after he began to smoke. The subjectstestedwere divided into age groups, 17 to 35 years,35 to 50 years,and 50 yearsupwards; in addition to thesetestscertainso-calleddenicotinized brandsof tobaccowere also examined. Before passing to the results we may note that Baumberger's work is quoted as demonstratingthat the nicotine content of cigarette smoke is about 0'57% of the weight of the tobaccoin the cigarette,and 14% to 33% of this nicotine appearsin the smoke; further, that 66'7% of the smoke,and presumablythe nicotine, is retainedin the body when the smokeis simply puffed, while 88'2% is retainedin the body when the smoke is inhaled. Maddock and Coller are also quotedas statingthata quantityof nicotinevarying from 3·33 to 2';')2 milligrammes will be absorbed by the body when one cigaretteis smoked,according as the habit of inhaling is pursuedor not. Segal found that on the whole definite changeswere found in the electrocardiogramin this experiment; there was an increasein the heart rate, and a lowering of the voltage of the T wave was also noted. These effects were producedboth bv standardbrands of tobaccoand by those which are marketedas being denicotinized. The filter holders tested decreased the amount of nicotine in the smoke, but some electrocardiographicchanges were still observed. It may be noted that none of the brands which incorporateda filter in the cigarette was tested; but it seems fair to assumethat similar results would be obtained. All the facts noted occurred