The recent controversy around the health risks of vaping is but a small piece in a long history of the tobacco industry in the United States.
The history of regulatory fights over tobacco products goes back to the earliest days of the U.S., University of Virginia assistant professor Sarah Milov writes in her new book "The Cigarette: A Political History."
Like traditional cigarettes, electronic cigarettes weren’t regulated when they hit the market. Plus, vaping is much more inconspicuous than smoking.
E-cigarette companies benefit from the contradictory definitions of the product — and whether their intended purpose is reducing harm or recreation. These companies argue that they’re “responsible corporate citizens” while selling cotton candy-flavored e-liquid at the same time, she says.
In the late ‘60s, after years of successful anti-smoking advertising, major tobacco companies agreed to a ban on television ads, Milov writes. But companies saved all of the money they would have spent on TV ads and spent it on billboards, magazines and corporate sponsorships.
Milov says she sees a similar willingness to give in to certain regulations when it’s clear public opinion has flipped on a product from e-cigarette companies.
“They agreed to a certain kind of ban in a way that showed their corporate respectability, that they were doing the right thing,” she says, “There might be something to learn from that when we see, for example, Juul agreeing to certain kinds of marketing bans.”
Big Tobacco’s rise in power starts decades earlier following World War I, when farmers in the U.S. found themselves drowning in surplus during a period of agricultural depression, she writes. During the New Deal, the government instituted a program to manage the surplus that included strict rules for growing tobacco.
Following World War II, tobacco farmers who again feared a post-war depression started a trade association called Tobacco Associates.
State legislators allowed Tobacco Associates to require farmers to tax themselves, Milov says. Their tax dollars went into a fund that was used to promote U.S.-grown tobacco around the world.
“Tobacco Associates promotes the virtues of American cigarette tobacco in all the countries that receive Marshall Plan aid,” she says.
Roughly a third of the plan’s total food aid — $2 billion of the $13 billion plan for European reconstruction — went to the procurement of tobacco, she writes.
The group also successfully promoted American flue-cured tobacco under the Food for Peace program during the 1950s and 1960s with notable success, Milov says, particularly in Japan.
At the time of the Marshall Plan, powerful Southern Democrats in Congress gave growers political influence.
American tobacco played a role in the financial reconstruction in Europe and other countries that were hungry to restart their own tobacco industries so they could collect tax revenue on selling cigarettes, she writes.
In 1964, the U.S. surgeon general released its first Smoking and Health report recognizing the link between smoking and lung cancer as well as cardiovascular disease. The report seemed to lead some people to quit, but smoking rates were back up in 1965.
This report wasn’t enough to turn Americans against smoking, Milov says.
“It wasn't science alone that convinced Americans to stop smoking,” she says. “It was the activism of organized nonsmokers that made it very difficult to smoke in public places.”
Activists who believed nonsmokers shouldn’t be forced to inhale tobacco smoke convinced companies to condemn smoking to protect profit margins. They argued that smoke breaks detract from productivity using “compelling” cost estimates, she says.
Businesses also instituted smoking restrictions in the workplace in fear nonsmokers could sue them for fostering an unsafe work environment.
Smoking regulations began by separating smokers and nonsmokers but such rules are harder to enforce than banning smoking altogether, Milov says.
“Complete smoking bans end up being pretty effective in helping people stop smoking,” she says, “which is something many smokers wanted to do anyway.”
By making a business case for banning smoking, activists “made smokers unacceptable as well,” she says. The class bias of the nonsmokers' rights movement is still present today: Nonsmokers tend to be more educated, wealthier and more likely to work than smokers.
Nonsmokers activists succeeded at what they called “making smoking socially unacceptable,” she says, but one thing they didn’t see coming was the technological advancements of the 21st century — e-cigarettes.
A study published Wednesday in the New England Journal of Medicine compares vaping-related lung injuries to severe chemical burns, based on lung tissue samples from 17 patients with illnesses linked to the use of electronic cigarettes.
More than 1,000 such cases are being investigated by the Centers for Disease Control and Prevention and state health departments across the country. The Trump administration has moved to ban the sale of most flavored e-cigarettes, but vaping is still largely unregulated.
The ties between e-cigarette companies and the tobacco industry are clear: The new CEO of Juul, the vaping company targeted in several federal investigations, has two decades of experience in Big Tobacco.
Milov calls the rise of e-cigarettes “a predictable result of the quest to make smoking socially unacceptable.”
“I think for people in public health, what is so troubling about the rise of vaping is that vaping has created a new culture of acceptability, particularly for young people, that they'd worked so hard to eradicate with cigarettes,” Milov says.
Book Excerpt: "The Cigarette: A Political History"
By Sarah Milov
For three days in June 1975, hundreds of public-health experts, doctors, civil servants, and activists from around the world converged in New York City for the Third World Conference on Smoking and Health. This conference was larger and more diverse than the previous two, in New York (1967) and London (1971). Most importantly, it included a new, decisive figure: the nonsmoker. During the 1970s, it was in his or her name that the most significant regulation of tobacco would occur. At a panel dedicated to the subject of “Non-Smokers’ Rights,” Glenn Goldberg, a lawyer for Action on Smoking and Health (ASH), placed the legal and social movement for non-smokers’ rights in the context of the rights revolutions reshaping Americans’ sense of self, citizenship, and the obligations of the state.
“Black Americans, Spanish-surnamed Americans, American Indians, American women, American homosexuals have all utilized legal action and legal process to obtain and preserve their fair share of government protection and largess,” he explained. “At long last, and most encouragingly, America’s nonsmoking majority is using the law to protect their lungs, to preserve their health, to save their very lives, from the forced inhalation of other people’s tobacco smoke.”
But rights-based liberalism of the 1970s was a tangle of paradoxes, and rights for nonsmokers were no exception. Once nonsmokers had laid claim to a set of inviolable rights, smokers insisted that their own rights were under threat. Even as activists spoke movingly of their pain and discomfort in smoky situations, rights were a language open to nonsmokers and smokers alike as they jostled for control of public space. White middle-class activists had learned from the civil rights movement’s democratization of public space. “Everyone has the right to attend to daily business, to participate in public affairs, and to seek recreation and entertainment without being subjected to constant, unnecessary health hazards and discomfort,” explained a 1976 pamphlet produced by the California Group Against Smoking Pollution (GASP) Legal Fund.
Yet nonsmokers’ rights activists rarely considered the ways in which public-smoking restrictions fell unevenly upon Americans who were more likely to find themselves reliant upon public facilities: racial minorities and the poor. Like other middle-class citizen movements of the decade, GASP argued from a position of victimhood without reckoning with the ways in which its advocacy reflected its members own racial and class privileges. Despite its pretense toward universalism (“everyone has a right to breathe air unpolluted by tobacco smoke”), nonsmokers’ rights talk reflected a thin vision of collective life. Of course, tobacco interests represented an even thinner slice of America. Woman-led, aspirationally universalistic, and insistent upon the democratization of public space, the nonsmokers’ rights movement was a foil to the patriarchal, particularistic, and opaque regime that had dominated tobacco politics.
Two complimentary movements succeeded in portraying the nonsmoker as a figure in need of protection and endowed with rights: ASH, which pursued an elite strategy of legal change, and GASP, which was a decentralized, chapter-based, citizen-led social movement. Although their strategies were not centrally coordinated, each picked up where the other left off. To invent the nonsmoker, ASH relied on the efforts of lawyers in specific legal forums. But GASP insisted nonsmokers were everywhere—they just needed to make themselves known. Despite a shared penchant for irreverent acronyms, GASP and ASH embodied two different organizing traditions. Where ASH thrived in the courtroom, GASP came to life in library meeting rooms, church basements, and family rooms across the country. GASP was a grassroots effort led largely by women, not staffed by elite operators from the Washington legal scene.
GASP was formed in Clara Gouin’s living room in College Park, Maryland, in January 1971. Gouin was a housewife and the mother of two daughters, the youngest of whom had an allergy to smoke. The child’s reaction to cigarettes was so severe that it prevented the family from going out to eat. Even worse than being restricted in public was the expectation that nonsmokers had to accommodate smoking guests in their own homes. Ashtrays in the homes of nonsmokers were monuments to smokers’ supremacy. “What doormats we nonsmokers were!” Gouin recalled thinking as she lay awake one night contemplating nonsmokers’ powerlessness. The friends with whom she commiserated—about the burn marks on furniture and carpets, the added chore of airing out one’s coats and washing one’s hair immediately after returning from a night out—agreed. And Gouin also knew the gravest costs of smoking. She was mourning the loss of her father, a longtime smoker, to lung cancer.
The origins of the College Park GASP were humble. Using $50 of her allotted “grocery money,” Gouin procured the first batch of buttons that would become a standard symbol in the national nonsmokers’ movement: “GASP—Nonsmokers Have Rights Too.” Six of Gouin’s nonsmoking friends—“mostly mothers, and a few working secretaries”—met in her living room and launched their first action: banishing smoking from their own homes by removing ashtrays and putting up no-smoking signs. Several weeks later the first issue of GASP’s newsletter, The Ventilator, was published thanks to the Prince George’s Tuberculosis and Respiratory Disease Association (TB&RD), which allowed Gouin to use its mimeograph machine. The Tuberculosis and Respiratory Disease Association (later known as the Lung Association) would prove instrumental in another crucial way: it mailed The Ventilator to members in surrounding counties and shared it with 200 state and local affiliates across the United States. Piggybacking on the association’s national scope and reputation, Gouin’s GASP quickly reached an enormous and diverse audience.
Although GASP’s earliest chapters thrived in college towns and liberal enclaves like College Park, Berkeley, and the Bay Area, nonsmoker activism was embraced beyond circles of bohemians, lefties, and university professors. GASP chapters were fully decentralized: there was no central institutional presence in College Park or Washington, D.C. GASP chapters thrived in Michigan, Georgia, Arizona, Kansas, and New York. A GASP member in Flint, Michigan, threated to sue the Pontiac General Hospital for assigning her husband, who was recovering from a heart attack, to a hospital room shared with two smokers. Her husband was eventually given a private room—at “no extra $,” the Berkeley GASP News happily relayed. Newsletters kept nonsmoking activists abreast of innovative activities all over the country, inspiring activism closer to home. For example, in 1974, readers of The Ventilator learned that Willi’s Wunderland Restaurant in Davenport, New York, and Harrah’s Theater Restaurants in Lake Tahoe had begun offering nonsmoking sections to patrons. This was not a nonsmokers’ version of the Negro Motorist Green Book. It was intended to inspire Maryland’s nonsmokers to become more visible, to “voice their opinions” to local restaurant owners, to demand more nonsmoking accommodations. Adorned with hand-drawn cartoons (Gouin was a talented cartoonist), newsletters conveyed usable local information (“Smokefree Chinese Cuisine in Cambridge!”), a sense of the nonsmokers’ national presence, and the righteousness and camaraderie of the cause.
Legal and grassroots movements worked synergistically to produce a nonsmoker identity. What we might call identity politics was understood in the vocabulary of “liberation”—a term that at once suggested a history of oppression and the world-historical significance of group expression. GASP’s 1973 Nonsmokers’ Liberation Guide—“a manual of revolutionary tactics and strategies to secure the breathing rights of nonsmokers everywhere”—exemplified the tendency of the movement to deploy the rhetoric of revolution within the safe confines of suburban liberalism. In ten pages, the pamphlet elaborated the personal, community, and legal tactics available to nonsmokers, as well as the “grand strategy” of their cause. Nonsmokers were encouraged to make their presence known through signs at work, by making requests of private businesses and municipal buildings, and by lodging complaints when requests went unheeded. GASP suggested that individuals whose work or standing in the community required that they speak publicly—an indication of the professional backgrounds of many nonsmoking activists—“request no-smoking whenever you give a presentation,” “propose a no-smoking policy or resolution,” or pass around a “polite and reasonable request” to attendees.
While these actions may have brought relief for nonsmokers, a middle class professional announcing a code of conduct in a meeting was hardly the stuff of revolution. Suggestions for legal and community action, while focused on policy change, sprang from the fundamental belief that education, reflection, and the proper administration of pressure on political officials would yield smoking restrictions. The liberation guide possessed no analysis of power—no indictment of the political system that produced and subsidized tobacco, no meditation on the cigarette as metaphor for the poisons and pleasures of consumerism, no reflection on the possibility that sanctions for indoor smoking might fall unevenly on the racially and economically marginal. With buoyant middle-class entitlement, GASP seized the sound and symbolism of liberation. The Liberation Guide was a mirror image of the contemporaneous Virginia Slims “You’ve Come a Long Way, Baby” advertisements. As Philip Morris conquered cool, GASP liberated the bourgeoisie.
Many GASP activists were Democrats, but Nixon’s metaphor of the silent majority spoke to the sense of long-suffering resentment on the part of respectable citizens. “Approximately two-thirds of adults are non- smokers!” proclaimed a 1973 pamphlet produced by the College Park GASP. “It is time for the silent majority to voice their objections to being made the involuntary victims of tobacco smoke.” To overcome nonsmokers’ silence, GASP encouraged members to “become visual”—to adorn themselves, their property, and, if possible, other people’s belongings. One of the first actions of Gouin’s GASP chapter was a letter-writing campaign to 700 physicians in southern Maryland with a request to put up no- smoking signs in their waiting rooms. Most doctors did not reply, but fifty offices proclaimed themselves smoke-free. GASP chapters in places as distinct as Berkeley and Wichita sold buttons, bumper stickers, and posters with slogans like “Your Cigarette is Killing Me,” “Yes, I Mind if You Smoke,” and “Kissing a Smoker is Like Licking an Ashtray.” These items were less valuable as a source of revenue (prices ranged from 25¢ to $1) than as a definitive declaration of nonsmokers’ prerogative.
Consciousness-raising was another tool for increasing nonsmokers’ sense of grievance. As powerfully expressed by contemporary feminists, consciousness-raising brought the hidden indignities of private experience out into the open, where they could be located in a structural critique of power and patriarchy. In the words of feminist historian Sarah Evans, the practice was premised on the belief that “people change…through a process of talking together, discovering common problems, and thereby understanding the need for collective action.” It was a tool admirably suited to the needs of the nonsmokers’ movement—and not only because many of its earliest participants were women. “For a long time many nonsmokers have felt individually annoyed by smoking, but suffered in silence,” Gouin explained in a 1972 profile. “People are more likely to speak out when they know others feel the same way.” The fact that nonsmokers comprised a majority of the population made speaking out a lower-risk proposition than other activism. But suffering itself ennobled the nonsmokers’ cause, opening up avenues for analogy to the liberation struggles of other op- pressed peoples.
GASP sought to catalyze a transformation in consciousness—to help nonsmokers see themselves as an oppressed category of people. For the middle-class whites who comprised GASP’s ranks, there was surely a romance in understanding anti-tobacco activism as their own freedom struggle. At a freezing rally at the U.S. Capitol held on the occasion of Lincoln’s birthday in February 1975, a tall, gangly nonsmoker dressed as the president proclaimed the event “a nonsmokers’ liberation ceremony.” “We are gathered here today to proclaim the emancipation of a large number of Americans who have been held in involuntary servitude,” the ersatz Abe announced. “They are the millions of nonsmokers, persons who choose not to smoke, but who are, nevertheless, made slaves of the smoke of other people.”72 Presidential impersonation provided an unwittingly apt metaphor for the group’s constituency. Though they perceived smoke as the yoke of slavery, activists for nonsmokers’ rights also sought to occupy a special place of power reserved in American political culture for the organized, educated, and white.
At times, activists spoke the heady language of civil rights and emancipation, drawing comparisons between the nonsmokers’ rights movement and the African-American freedom struggle. Nonsmoking activists “reasoned from race,” to borrow legal historian Serena Mayeri’s evocative phrase, drawing analogies between civil rights for African Americans and civil rights for nonsmokers. Though they were quick to hedge their comparisons, nonsmokers’ rights activists’ use of analogical reasoning frequently flattened the difference between the structural discrimination that African Americans faced and the crimped choices that nonsmokers contended with as consumers. “Although I would not suggest that non- smokers’ rights are trampled on to the same extent as have been the rights of minority groups,” Peter Hanauer, the co-founder of Berkeley’s GASP, told an audience of anti-smoking activists in 1976, “I would suggest certain parallels.” After all, he wondered, “Is there any real difference . . . between saying to a person ‘You can’t eat at this lunch counter’ and saying ‘You can’t eat at this lunch counter if you are concerned about your health or if you want to enjoy your lunch?” For Hanauer, nonsmokers—like African Americans denied public accommodation under Jim Crow—were victims of oppression.
All over the country, men and women like Gouin were forming little platoons to assert control over their environments—and to intervene in the political processes that drew the permissible limits of development, pollution, and noise.76 An ethos of participatory democracy as well as the imperative to keep property values afloat spurred such suburban environ- mentalists to clean up rivers and green spaces, oppose aerial pesticide application, and insist on zoning standards to control development. In the suburbs, the environmentalism of the 1970s was frequently articulated in the language of “quality of life” and with reference to access to amenities such as parks and bike paths. Nonsmoking activists were part of this quality of life constituency. After all, smoky environments prevented thou- sands of families from accessing the kinds of places considered the birth- right of the middle class—restaurants, cafes, and movie theaters. Suburban environmentalists and nonsmoking crusaders shared a consumerist approach to public space: it was theirs to enjoy.
Excerpted from The Cigarette: A Political History by Sarah Milov, published by Harvard University Press. Copyright © 2019 by the President and Fellows of Harvard College. Used by permission. All rights reserved.
This segment aired on October 3, 2019.