I was listening to NPR (as we do when we’re in the car), where KQED Forum was doing a segment on the rise of tobacco smoking in young people. Smoking, as a social behavior, is staging a comeback.
This kind of floored me. I have personal reasons to detest smoking: both my parents were smokers when I was small, and I have the second-hand smoke damage to prove it. My father quit after the Surgeon General’s report came out–that is a saga in itself–and had chronic bronchitis and COPD for the rest of his life. My mother, who never quit, died from tobacco-related causes. And of course I saw all the anti-smoking PSAs (many of the ads that I remember well were discussed on Forum) including the one with the woman discussing how she started smoking–while smoking via the hole in her throat.
I kind of thought that this was a battle that was slowly being won, and a behavior that was emphatically in the rear view mirror. But as I listened to the panelists I began to formulate a question: is this because we don’t remember how bad smoking was, and therefore can assume that it wasn’t that bad at all?
I am old enough to remember walking in to a wall of smoke in restaurants and bars. I don’t miss that. Airplanes had smoking and non-smoking sections, but don’t kid yourself–if anyone was smoking on a plane, everyone was breathing it. My first serious boyfriend was a smoker, and while I loved him a lot, I had to get used to the taste (“kissing a smoker is like licking an ashtray” has considerable truth to it). But if you haven’t had that experience, how can you know? Especially in the face of forces like the tobacco industry which have been trying to play down the dangers of nicotine for 100 years.
Certainly smoking used to be positioned as glamorous. If you look at old movies (and I love me some old movies) smoking had a gestural language. It looked cool. It could look romantic (Paul Henreid lighting two cigarettes and giving one to Bette Davis in Now, Voyager comes to mind). It could look tough. It could look louche–gangsters with cigarettes either clamped in the corners of their mouths, or dangling from their lower lips as if kept there by the power of sin. And apparently smoking is making a comeback in film and TV, telegraphing cool and chic.
It occurred to me that we have the same problem with anti-vax people. They don’t remember what the “childhood diseases” were like. I mean, I do. I had measles. It wasn’t bad enough that I felt absolutely horrible; it was accompanied by my mother’s terror that I would die or be struck blind. That leaves an impression. I also remember (dimly) the anxiety during polio season, before the Salk and then the Sabin vaccines became available. But in the years since vaccination became commonplace and these diseases receded into the rearview; measles, at least, became a sort of sitcom punchline, a funny disease that makes you break out in spots. Ho Ho.
Does this mean that periodically humans have to be reminded of how bad things can get before we permit ourselves to move forward? Or worse, that a portion of humanity will valorize the before times as better because they tangle things they don’t like in the current reality (say, racial or gender equality, and having to take thought to the environment before doing whatever they damned well please) with things that are unrelated but part of that current reality (like vaccines). I often write in historical settings, but I don’t for a moment believe that things were better then, at least not for the vast number of people who died early, and very often hungry and ill-treated. The tendency of some people, to assert that Things Were Better, or More Glamorous, or something, back when we took our chances with polio or lit one cigarette from the remnant of the last, bewilders me. I know how sophisticated Bette Davis looked with a cigarette in her hand, but I don’t mistake that for harmlessness.
I recall that, back in my youth, we used to mock the laws about spitting on the sidewalk. That seemed ridiculous even to those of us who didn’t actually do any spitting, since we assumed it was just another law designed to be used against people who weren’t really doing anything wrong. And then at some point I realize that those laws dated back to the years when tuberculosis (“consumption”) was rampant. TB is an airborne disease and spitting was one of the ways that it spread. It’s also bacterial, so the development of antibiotics provided a cure. It’s still around and there are drug-resistant strains, but it does not effect most people in the U.S., so it’s not a matter of much concern anymore.
Which is to say that I think you are right: when we solve a health-related problem, society often forgets how significant it was. I’ve known people my age with polio. Friends of mine used to work with deaf-blind kids whose condition was caused by the fact that their mothers got rubella when they were pregnant (there were waves of such conditions that corresponded to waves of rubella). And my mother died of emphysema, having not quit smoking three packs a day until she reached the point of needing oxygen.
But I’m old and most people around now haven’t had those experiences, so they assume the problems aren’t real. I also frequently notice major misinterpretations of things now treated as history that are part of my lived experience.
I don’t know the solution, except that it’s important for those of us who do remember history to point these things out frequently.
Elsewhere, a conversation came up about Berton Roueche’s “Annals of Medicine,” a series that ran in the New Yorker for decades. Roueche followed public health investigators in New York City and later across the country (many of his cases were later used as the basis for episodes of House, M.D.. That is where I picked up my fascination with medical history and my fervent belief that public health interventions have been responsible for saving us all from pretty dire health issues. Maybe one way to get people (kids, I suspect; their parents are probably beyond help) to take these things seriously is to introduce something like “Annals of Medicine” to elementary or middle school science curricula. At least it might make the horrors of the past a little more real in light of their applicability to the present.
Medical history is quite fascinating (as you know) and I imagine it would not be hard to get kids excited about it, especially if the curriculum played up the gory parts. It also occurs to me that someone with the requisite skills and appeal to the younger generation doing TikTok shorts or longer videos on YouTube might work well.
I resist the urge to knock cigarettes out of people’s mouths on a daily basis, though I do often have a coughing fit (not always feigned) when I walk by smokers on the street.