Close, but No Cigar - 20 August 1999

Because there is a quite new warrior in the battle between the tobacco companies and the government, one or two people have been writing in to wonder so when did the whole to-do, the medical enquiry into cigarette smoking, begin to inflame the country.

Most Americans (and I mean doctors, as well as their tobacco tycoon victims) will send you back to the Surgeon General's now famous report of 1964. I cannot find any expert who goes back beyond that date, but I remember an occasion (in view of what was to come it is an unforgettable occasion) as early as 1952, when I first heard the bell toll on cigarette smokers.

I remember a press conference called here in New York City, on York Avenue at 68th Street, where rises majestically the New York Hospital - Cornell University Medical Center - one of the most impressive, and I think successful modern buildings in this city - great white columnar piles, the longest leaded windows all capped with the signature of a small Gothic arch - suggesting in an otherwise severe modern building that what goes on there is mainly to keep people alive, but with an acknowledgement of divine help.

The date - I swear - 1952. The conference was called by one Dr S Cuyler Hammond (I've sweated for half a day through world almanacs, books of fact, encyclopaedias, medical cyclopaedias, and his name does not exist).

Well, it did. And a very nice man he was. And an alarmed one. It appears he had been put in charge (I think two years earlier) of a project of the American Cancer Society, to look into the medical history of thousands of cigarette smokers (along with a control group of non-smokers who had died of lung cancer). He had planned to report the results, of course, at the end of five years. But here he was only two years after the study had begun because the early results had been so positive and disturbing that he felt compelled to publish them in the public interest. (Subsequent studies, of course, in Britain, Scandinavia, the United States, brought overwhelming evidence that cigarette smokers had between five and 10 times more risk of lung cancer and emphysema than non-smokers.)

Dr Hammond's press conference caused a brief stir at the time. I wrote three or four pieces about it for my paper, and when I went down to Florida to stay with an old friend in his winter cottage, he had the overseas weekly edition of my paper. He was a droll old New Englander - a tiny grasshopper of a man, and he was 95 at the time.

After lunch the first day, when I lit up a cigarette, he asked me what I thought I was doing. He flourished the Guardian and pointed to my piece. "Haven't you read this?" he cried. "No," I said, "I wrote it." He liked that. He himself at that moment lit up a cigarette, an act he'd been performing from dawn to midnight for at least 70 years. "How about you," I asked "my little sermon didn't seem to do you any good - no?" "Well," he said, "it scared me. I called up my doctor and I went to see him." What, I asked him, would happen to me if I stopped smoking right now. He pondered awhile - scribbled a few figures on a sheet of paper. "Well, he said, "you could extend your life probably by about six weeks." I went home and I thought the thing through. And I said - the hell with it. He died five years later, at 100 I think, of just being 100.

When Dr Hammond's talk was over I got together with one of my oldest Yale friends - by that time a distinguished eye surgeon. He told me - I don't swear to any other authority - I ought to look into the cigarette paper. "Only one company in the entire country," he said "makes the paper, so the pressure to say nothing will be terrific." But his point was that the paper contained, had to contain, an arsenical compound that made the paper burn slowly. So maybe the paper was the villain. Well, nothing ever came of the cigarette paper issue that I know about.

I tell you all this partly to set the record of public concern back where it belongs - in the early 50s, not the 60s, but mainly because of a passing thought which I'm sure has occurred to many of you in the past 40-odd years. What - in all the stew and argument and final damning truth about cigarettes and cancer - what about cigars?

In the past few years, a new fad has taken hold that makes an answer to the question all the more pressing. Cigar clubs have mushroomed all over the country. They are very much the creation of young, upscale, fashionable people - sprigs of the plutocracy interested in power (business, Hollywood, politics), the fashion industry, in anything that is - as we say - on the cutting edge. Young movie stars, computer Wall Streeters on the rise, advertising men and women - people who are chic and cool and thoroughly materialistic. Down all the years, and through all the studies in many countries about cigarettes I had never seen a clinical trial about cigar smoking.

I put the question up to several people lately and found the general prejudice to be that cigars are harmless - always have been - because you don't inhale them. Cigars have had an interesting social history standing in America which is sharply different from their social standing in Britain.

The explorers who followed Columbus into the discovery of the New World brought back many oddities to Europe (including the potato and the turkey) and the cigar. It was introduced first into Spain. But the supply of two necessary types of tobacco - the filler and the wrapper - was limited - and cigars were expensive enough for the next two centuries to make it a status symbol, a sign of conspicuous wealth.

In the United States, however, or I should say in the northern colonies - especially Connecticut where the right tobacco was and is grown - cigars were, as early as the 17th Century, a cottage industry and were peddled by housewives from door to door. England was introduced to cigars, about the time of Waterloo, by English soldiers who had fought Napoleon in Spain. But within 10 years the government slapped a massive tax on manufactured tobacco products as distinct from the raw material - so cigar smoking stayed even more conspicuously a declaration of wealth or social pretension.

Throughout the 19th Century in Britain and into the 20s their reputation was always tainted with the notion of showing off. The great little Scot, Keir Hardie, the founder of the British Labour party, used to warn any young man recently elected to parliament and on his way to Westminster - "Have a care! It's the brandy and cigars that corrupt."

Right into my time - I recall the cartoons in Punch during the First World War - any picture of a war profiteer showed him in a long fur coat with an astrakhan collar - and puffing a fat cigar. One gallant figure that defies this stereotype will come to mind - Winston Churchill. During the Second War his cigar was often drawn by caricaturists between the two fingers giving the V for victory sign. But then, he was, in many things, a law unto himself.

In America, first as I say, in New England, cigar smoking was the commonest of pleasures, and early in the 19th Century, the Connecticut supply was vastly enhanced by the setting up in Florida of a cigar industry, because the Florida Keys were only half a day's sail from the Cuban tobacco fields. But in 1868, Cuba was having one of its revolutions, and many Cuban cigar makers beat it to Florida, and the industry moved up the Florida peninsula to Jacksonville, which, even 60 years ago, was producing 400m cigars a year. Heaven alone knows what it must be today, with the ban on Castro's cigars in place during the nearly 40 years since he promised elections, and hasn't had one.

It's hard - I've found - for Europeans to believe that in America, cigarette smoking did not surpass cigar smoking until after the First World War. It had become in 100 years as familiar and classless as the hamburger. It entered the vernacular - at shooting ranges in amusement arcades a fine cigar was often the prize for hitting the bull's eye. Hence, anything in life that was a near miss - a name almost correctly spelled, a putt that just missed the hole - people would say, "Close, but no cigar."

It was between the wars that the popular, universal habit of cigar smoking began to fade and by the late 1950s cigarette smokers - with the new shop window of television - left behind an ever-ageing generation of cigar smokers. So it was only after years, decades, of grim news about cigarettes that somebody had the idea of reviving the cigar as not only a glamorous but a safe alternative. The cigar club fad started, as I say, and I have marvelled ever since at the dashing advertisements of young celebrities all puffing away with nobody saying anything about the harm or harmlessness of the chic alternative. Until last month.

When finally, the most prestigious of all American medical journals - the New England Journal of Medicine published the results of a study. Not a collection of anecdotes about what happened to your Uncle Fred as distinct from your Cousin John. Fifteen hundred regular cigar smokers along with 16,000 non-smokers were watched and reported on for the past 22 years.

The findings are not as bad as the cigarette studies but cigar smokers had 30% more heart disease, almost 50% more emphysema and are at strong risk from an affliction not mentioned in the Surgeon General's report on cigarettes - throat and mouth cancer.

Sigmund Freud, confronted once too often with the question "what does a cigar symbolise?" replied "a cigar is just a cigar." In his case, also a death sentence. He smoked cigars from 6am to midnight and died of throat cancer.

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