Ashes to Ashes (83 page)

Far more problematic, however, was the factual basis for the claim that smoking is an aid to mental acuity. To be sure, brain-wave arousal was measurable after small doses of nicotine, suggesting a rise in alertness, and laboratory experiments were showing smokers somewhat better able to remain attentive during the performance of long, boringly repetitive tasks. But in terms of a true heightening of cerebral powers, the evidence indicated that the effects of smoking may be more cosmetic than substantive. Rather than somehow sharpening the smoker’s capacity to concentrate, analyze, or create, nicotine can place its users into a kind of intellectual cage or isolation booth, even a trancelike cocoon, that filters out environmental stimuli like light or noise or subconscious intrusions of memory, allowing little to distract the smoker from
the mental task at hand. Thus, the smoking writer is freed of any diversions save the cigarette and its mindless use—“an innocuous channel for wandering attention,” as psychologist Isidor Chein put it. The practical values of an uncluttered mind, even if not enhanced in brilliance, are manifold. Air traffic controllers, who need to avoid peripheral stimulants and distractions, have long been known to be notoriously heavy smokers, to cite one example. The perception, then, that smoking promotes keener mental faculties may have stemmed from a cloaking of the fact that the smoker’s brain is simply registering and processing
less
information simultaneously, and in that insulated state focuses narrowly. It must be added that, however much of a spur smoking may be to the brain’s activities, all bets are off very soon after the regular smoker stops smoking. To be precise, smoking as an isolated act has not been found to make anyone more mentally alert or less emotionally irritable; rather, not smoking makes the conditioned smoker less alert and attentive—and notably more distractable and irritable. The earnest smoker, therefore, was well advised not to flaunt the benefits, of his habit but to acknowledge, as David Krogh wrote in his book,
Smoking: The Artificial Passion
, “If I don’t smoke, I get upset,” and that he is trapped in a constant cycle of arousal and incipient withdrawal, slaked only by his next cigarette.

One paradox of smoking behavior was particularly intriguing: how, when confronted with a cause of distress that activated the body’s adrenal flow, did a smoker seem to attain relief by reaching for a cigarette, with its initially stimulating effects? Why, that is, use one stimulant to neutralize another?

Stanley Schachter, a Columbia psychologist who undertook research for Philip Morris, reported at the industry’s 1972 Caribbean conference on an interesting experiment conducted by one of his graduate students, Paul Nesbitt. Dividing a group of subjects, male students between eighteen and twenty-six, into subgroups of nonsmokers, low-tar brand smokers, and high-tar smokers, Nesbitt instructed the latter two groups to inhale every thirty seconds while he administered electric shocks of increasing intensity every fifteen seconds for a full cycle of twenty-eight shocks—if his subjects could endure it. The premise of the experiment was that if cigarettes had a true tranquilizing effect, the smoking subjects would be able to absorb more shocks. The results bore out this expectation, and in a dose-response pattern: the more heavily dosed smokers tolerated the most shocks, so that calming seemed to be a direct function of the amount of nicotine absorbed. How so, though?

Nesbitt and Schachter proposed two possible explanations for what would become known in the literature of smoking and health as “Nesbitt’s Paradox” (how can one stimulant blunt the effects of another?). Smoking, they hypothesized, established a base level of arousal in conditioned users, and the additional activation of certain bodily functions caused by the electric shock and the fear of the next one was superimposed over that basic excitation from
smoking, which served to mask some of the cardiovascular and other effects that normally would have been triggered by disturbing events or environmental impingements, such as electric shocks. The stressed smoker will therefore reach for a cigarette and subconsciously attribute some of the arousal symptoms brought on by the frightening or disturbing situation to the similar but less intense physiological effects of smoking, the arousal level of which the smoker has long since become accustomed to—and so is less upset than the nonsmoker by the electric shock. By extension, the investigators went on, smoking served to modulate the intensity of highly emotional states, whether fear, anger, euphoria, or sexual arousal. Smoking can then be perceived as a tranquilizer not
despite
its short-term effects but
because
of them: the known level of excitation, that is, seemed to soften the blow or, at the other end of the emotional spectrum, to serve as ballast for the joyride and keep the passenger from spinning out of orbit.

While some investigators have confirmed Nesbitt’s results and others have not, the explanation of the paradox underscores the overriding point about the apparent usefulness of cigarettes to those hooked on them: they serve most of all as a mood stabilizer, lifting their users from the dumps, keeping them from going off the deep end or getting lost in untethered bliss. Unlike more starkly mind- or mood-altering drugs taken for recreational use or out of bottomless desperation to escape life’s grinding realities, cigarettes are used as a form of self-therapy to stay normal.

If the reasons young people take up smoking vary, starting with the lure of forbidden fruit, and their numbers would doubtless be smaller were they not under the delusion they will live forever, psychologists have helped public-health advocates understand why the lethal habit persists among tens of millions of adults who should know better. And indeed, they do; surveys have long shown that between half and 90 percent of smokers say they resent being in thrall to what they acknowledge as an addiction and would like to quit, at least in theory—if it were not so difficult to escape their bondage. Their fears of withdrawal symptoms are surpassed in many cases, furthermore, by the dread of assault from life’s countless vicissitudes, which they have convinced themselves they could not cope with if denied a cigarette at the next stressful moment. Smokers are thus classic rationalizers and hiders from fact when unwelcome word arrives about the perils of the one thing they think lets them cope with life. They are the very model of the type described by Leon Festinger in his 1957 treatise,
A Theory of Cognitive Dissonance
—people who act in ways that deny knowledge of the consequences of hurtful or self-destructive acts.

Yet for all the conflict they endure over their dependency, most smokers deeply resent the ever more widely held suspicion by smoke-free society that they suffer from flawed characters or emotional instability because they persist
in what they shouldn’t. The more articulate of them reply with two basic arguments. First, since life is so full of travail, with joy so rare and fleeting, heartbreak all too frequent, and monotony the common lot, what difference does it make if smoking shortens our time on earth, so long as it also intensifies its quality and makes it more tolerable? And if this coping device is just the chimera of addiction, so be it. Second, admit it or not, everyone adopts such coping mechanisms to survive, but the smoker’s choice is just more evident—and less destructive or antisocial than many others. Some nonsmokers cope by taking out their frustrations on others, mocking them or nagging them, bullying or beating or even killing them. Some overeat or undereat; in a world that seems otherwise unmanageable to them, they cope perversely by acting to distort the shape of their own bodies. Some attend to their work monomaniacally, hiding out from the other demands of loveless lives. Some use hard drugs to escape the hell of their existence. Smokers rationalize, almost parenthetically, that if cigarettes were all that bad, no reputable company would market them and no government would permit their use; ergo, all you nonsmoking busy-bodies, go tend to your own weed-infested gardens.

IV

IN
terms of social action undertaken to curb the rising toll from smoking, a stalemate prevailed throughout the ’Seventies. All that government had done about this immensely popular and economically important product was to require a tepid warning label on cigarette packages and in advertisements as well as, in the latter case, disclosure of the toxic yields. True, the cigarette companies were making available less potent versions of their accused product, but the swing-over by consumers to these often less flavorful brands was slow and their therapeutic effects were far from certain. The likely impairment to the public health went on hardly abated: millions quit the habit, but other millions took their place—and tobacco profits soared.

One relatively small appendage of the American government, however, did bestir itself in the 1970s. It was the most curious—critics called it the most misguided—and surely most expensive government effort yet: a decade-long attempt by the National Cancer Institute (NCI) to develop a truly less hazardous cigarette for those millions who could or would not quit the often killing habit. Humane considerations dictated such an effort, its champions said, noting that the industry itself could not be trusted to perfect such a product lest the attenuated brands prove a painless way station on the road to quitting altogether. To tobacco controllers, developing a “safer” cigarette seemed like breeding a one-fanged rattlesnake, still deadly. But the pragmatists prevailed, and the industry quietly exulted.

The most persistent proponent of the concept was the world’s most vocal investigator in the field. Twenty years after his breakthrough paper in 1950 on the higher prevalence of lung cancer among smokers, Ernst Wynder crusaded everywhere he went, declaring that cigarettes were a scourge the medical community had for too long taken lightly. Working in tight quarters with a small budget at Sloan-Kettering with Dietrich Hoffmann, the world’s leading authority on the chemistry of tobacco, Wynder turned out a series of studies firmly establishing the link between smoking and cancer at many body sites besides the lung (among them, the larynx, esophagus, kidney, pancreas, and bladder). And the more the pair had measured the degree of toxicity of individual compounds among the thousands present in smoke, the more difficult the task of meaningfully modifying cigarettes looked. There were just too many potentially deadly substances to try to filter them out selectively, while modification of the product by diluting the tar and nicotine brought with it other potential perils, especially linked to the flavorants added to compensate for the loss of taste. Licorice, the most widely used casing, was 25 percent glycyrrhizin, a salt found to turn carcinogenic when burned; the same was true of cocoa powder, another popular cigarette flavoring. And when tobacco plants were doused with nitrate sprays to reduce cancer-breeding hydrocarbons like benzpyrene, the additive turned out to enhance the presence of nitrosamines, a tobacco-specific compound that was found to be highly carcinogenic in tests of laboratory animals.

Wynder, a sophisticated cosmopolite possessed of a patrician manner easily confused with condescension, was a well-read, well-connected scientist-entrepreneur, driven to make his mark. He once told Hoffmann, “I’ve had the two best things you can hope for in life, a German education and American opportunity,” and he used the latter to the hilt. At Sloan-Kettering, he won the backing of the institute’s medical director, Dr. Cornelius Rhoads, who was so taken with Wynder’s work that he volunteered to have his own back painted with tobacco tar distillate, as in the mouse-skin bioassays Wynder had developed, to see if the spot turned tumorigenic (an allergic reaction cut short the experiment).

But Rhoads’s successor, Frank Horsfall, conceding at most a minor link between smoking and disease, urged Wynder to tone down his antitobacco statements, tightened his budget, and demeaned his research until Wynder demanded and won a special review committee to endorse the ongoing value of his work. Horsfall kept after him, nevertheless, until after one 5 percent budget slash too many, Wynder had had enough. He used all his persuasive skills and far-flung contacts to build his own research establishment, the American Health Foundation (AHF), begun in 1969 with four employees (including the indispensable Hoffmann). Wynder proved a prolific fund-raiser, winning major backing from industrialist-philanthropist Norton Simon and the Dana and
Kellogg family foundations. In time, his health enterprise grew into a highly respected research institute with a staff of some 240 and offices in the stylish Ford Foundation headquarters in midtown Manhattan and on a small campus in Westchester, and turned out a series of useful publications including the scholarly journal
Preventive Medicine
, of which Wynder himself served as founding editor. AHF explored many fields, but it never stopped studying smoking and remained the world’s leading private repository of knowledge on the subject.

Still, Wynder was viewed as a slightly disreputable operator by some scientists, most of whom specialized in a single discipline while Wynder was co-authoring some 400 articles on smoking that suggested an astonishing breadth of competence. His very versatility and virtuosity invited much skepticism and envy. One leading pathologist expert on the smoking issue granted Wynder a certain technical soundness but sniped, “He’s as much a scientist as a bomber pilot is.” Part of Wynder’s uneasy standing was the single-mindedness of his pursuit in a field that many researchers found simplistic and merely a behavioral problem. Often Wynder shrilly preached to the already converted or the purposely unhealing and disclosed bitterness when little heeded. At times, he conducted himself with a flair not entirely in keeping with the conservative mores of his profession. A bachelor, he zipped about in an open sports car, squired many pretty women, including well-known film actresses, frequented smart spots from Beverly Hills to the Hamptons, bought an apartment at New York’s UN Plaza complex, and employed a gourmet chef for his entertaining. All of this did not endear him to the scientific establishment, but over time, admiration for Wynder grew, along with his influence. Recalled Frank J. Rauscher, Jr., a microbiologist who served as a top NCI officer in the ’Seventies, “He’s a hard S.O.B.—he’s good, he thinks he’s good, and he’ll tell you he’s good. But there’s nothing phony about Ernie Wynder and his flag-waving on smoking and health. He succeeded because he was needed.”