The Biologic Effects of Tobacco

This small volume consists essentially of six review articles and one essay. The first article, by Alvin I. Kosak, deals with the chemistry of tobacco smoke. This is a well-written and carefully documented section which emphasizes the need for more uniformity in experimental methods in the field and indicates a lack of knowledge in the important phase of aerosol retention. The chapter on pharmacology by Charles J. Kensler deals principally with the action of nicotine, although the possibility of other components of smoke being important is admitted. In the chapter on the cardiovascular system, Ellen McDevitt and Irving S. Wright conclude that the "use of tobacco by susceptible persons will result in the development and continued activity of thromboangiitis obliterans." They also state that although there is no evidence that tobacco is an etiologic factor in several other vascular diseases, including coronary artery disease, its continued use unfavorably influences the clinical course. The section on neoplastic diseases by Ernest L. Wynder presents the author's much publicized results and those of other workers interpreted to show the role of tobacco smoking in the causation of lung cancer. The review on the gastrointestinal tract by Robert C. Batterman "indicates only that our knowledge of the influence of use of tobacco upon the gastrointestinal tract is fragmentary." Doctor Batterman deplores the lack of scientific evidence available as to the relationship between tobacco smoking and the gastrointestinal tract. In the section on allergy, Francis C. Lowell concludes that skin sensitivity to tobacco is present in approximately one-third of the smoking population and less in nonsmokers, but true allergic manifestations to tobacco or tobacco smoke, such as dermatitis, asthma, or rhinitis are uncommon or rare. There is insufficient evidence to warrant the conclusion that vascular disease is caused by allergy to tobacco. The final chapter is on "Cause and Effect" by E. Cuyler Hammond. This deals with the statistical approach to epidemiological research. Although this book contains numerous references to the literature on the various aspects covered, this alone is insufficient reason for publishing it. The material presented might be interesting as a point of departure for one planning to work in the field, but the paucity and weakness of conclusions based on scientific evidence suggest that this is a premature effort.