The term tobaccosis in this essay denotes, collectively, all diseases resulting from the smoking, chewing, and snuffing of tobacco and from the breathing of tobacco smoke.
They include cancers of the mouth, nasopharynx, larynx, trachea, bronchi, lungs, esophagus, stomach, liver, pancreas, kidney, bladder, prostate, and cervix, as well as leukemia. They also include atherosclerosis of the cardiovascular system - coronary heart disease (with ischemia and infarction), cardiomyopathy, aortic and other aneurysms, cerebrovascular hemorrhages and blockages; renal failure and peripheral vascular disease; emphysema and chronic obstructive pulmonary diseases; peptic ulcer disease and regional ileitis; cirrhosis of the liver; immunological deficiencies and failures of endocrine and metabolic functions; and fetal diseases and perinatal disabilities.
Tobaccosis is the foremost plague of the twentieth century and thus joins the most fearsome plagues that devastated humanity during this millennium such as the Black Death, smallpox, malaria, yellow fever, Asiatic cholera, and tuberculosis. But unlike microparasitic plagues, whose victims experienced pathognomonic disease manifestations within days or weeks of exposure, tobaccosis is an extraordinarily insidious disease entity of long latency resulting from exposure to tobacco for many years or decades and manifested by increased occurrence of any of a broad spectrum of neoplastic and degenerative diseases ordinarily associated with advanced age. Thus, the powerfully malignant nature and magnitude of the tobaccosis pandemic went largely undetected during the first four centuries of its global march; and it is only late in the fifth century of the post-Columbian world’s exposure to tobacco that the extent of tobacco’s depredations is being fully revealed. Because of its leadership in the production, marketing, and use of tobacco, the United States has borne much of the brunt of the tobaccosis pandemic. Hence, this historical account deals mainly with the U.S. experience.