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The Lasting Wounds

World War I took the lives of nearly 10 million soldiers and 7 million civilians, 320,000 Americans died in the War. Although the physical wounds would heal, for many the emotional trauma would never end. And in less than 20 years, many of the men who had been given cigarettes by the American Red Cross and other charities and had become inveterate smokers began dying of a heretofore rare disease: lung cancer.

Post-War Legacy

The Nation Made

Before the guns had fallen silent and the ink had dried on the Armistice of 11 November 1918, tobacco companies were capitalizing on the valor of America’s war heroes. Patriotic imagery had been interwoven into cigarette advertisements throughout the war. Now the cigarette was being heralded as the “little white badge of courage” and juxtaposed to awards and medals. A symbol of American determination, bravado, and vitality, this source of comfort on the battlefield was now the welcome-home gift offered to the returning troops.

“At Walter Reed Hospital, a soldier who is missing a foot lights a cigarette for a soldier who is missing both arms”

Image credit: Library of Congress
http://www.loc.gov/pictures/item/93501326/

Circa 1919

“Cigarette time. An ARC [American Red Cross] worker distributing cigarettes and tobacco to wounded. This man chose Lucky Strikes”

Image credit: Library of Congress
http://www.loc.gov/pictures/item/2017674134/
June 1918

“Fame”

Pall Mall Advertisement
Life

March 13, 1919

“General Pershing and Marshal Foch…”

Image credit: New York Public Library
https://digitalcollections.nypl.org/
items/730ed530-860c-0131-66ca
-58d385a7bbd0

1917-1918

“The Three Generals”

Old Virginia Cheroots advertisement
Lorillard’s Magazine, vol. 2, no. 2, page 5
Circa 1918

“Lorillard’s Magazine”

Complete issue of magazine distributed by the P. Lorillard Tobacco Company
Circa 1918

Making the Connection

Alton Ochsner, MD

Dr. Ochsner’s efforts to link lung cancer in World War I veterans to cigarette smoking (1:41)

Told by Alan Blum, MD
1:41

“The story’s been told many times. Dr. Ochsner was called down by his pathology professor, Dr. William Dock at Washington University in St. Louis, to show him a case, and he was told, ‘This is lung cancer, and you should take a look at it because you may never see another case like it again.’ Less than twenty years later, as a thoracic surgeon, he found himself pulling out cancerous lungs left and right, and he noticed that all of these had been veterans in World War I, all these were men, and men who had taken up smoking or had been smoking prior to World War I, when groups like the American Red Cross and ladies’ auxiliaries of medical institutions sent cartons of cigarettes to the boys overseas.”

Alton Ochsner, 1896-1981

Photographic images from journal article, “Alton Ochsner, MD, 1896-1981: He cleared the air,” by Alan Blum, MD
New York State Journal of Medicine,
vol. 83, no. 13, pages 1250-51

December 1983

“Primary Pulmonary Malignancy: Treatment by Total Pneumonectomy; Analysis of 79 Collected Cases and Presentation of 7 Personal Cases”

Journal article about the link between lung cancer and smoking by Alton Ochsner, MD, and Michael DeBakey, MD
Surgery, Gynecology, and Obstetrics,
vol. 68, pages 435-51

February 15, 1939

“Alton Ochsner, MD, 1896-1981: Anti-Smoking Pioneer”

Journal article about the career and legacy of Alton Ochsner, MD, by Alan Blum, MD
The Ochsner Journal,
vol. 1, no. 3, pages 102
-06

July 1, 1999

“Looking back…1915”

Journal article about The Medical Journal of Australia‘s supportive position on smoking during WWI
The Medical Journal of Australia, vol. 1, no. 5, pages 226-27

March 5, 1983

Friend or Foe?

 “Smoking and the military”

Journal article by Gregory H. Blake, MD
New York State Journal of Medicine, vol. 85, no. 7, pages 354-56
July 1985

Further Reading:

“Everywhere the Soldier Will Be”: Wartime Tobacco Promotion in the US Military”
Elizabeth A. Smith and Ruth E. Malone
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724442/

Smokeless Tobacco Use in the United States Military: A Systematic Review
Hannah E. Bergman, Yvonne M. Hunt, and Erik Augustson
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337533/

The Health Consequences of Smoking – 50 Years of Progress: “Tobacco Control Efforts in the Department of Defense”
https://www.surgeongeneral.gov/library/reports/50-years-of-progress/sgr50-chap-14-app14-1.pdf

Cigarettes remained a staple of military life long after World War I. Beginning in World War II, they were included in soldiers’ rations and became crucial assets to win over and barter with local civilian populations.  Nor did the military object to cigarette makers Philip Morris and R.J. Reynolds shipping a steady supply of cigarettes to the troops in Vietnam—and as recently as Desert Storm. Few Veterans Administration hospitals banned smoking until the 1990s, and Congress did not end the sale of cigarettes in V.A. hospitals until 1991. Only when reports in the 1980s suggested that combat readiness was diminished by smoking did the military begin to take the issue to heart.

 “It’s the most welcome gift you can send him…”

Camel advertisement
The Saturday Evening Post, page 73
March 6, 1943

 “Doctor of Medicine…and Morale”

Camel advertisement
Life, back cover
May 15, 1944

 “First on Land and Sea!”

Camel advertisement
Time, back cover
September 22, 1941

 “Philip Morris salutes America!”

Poster welcoming home members of the U.S. Armed Forces from Operation Desert Storm
Circa 1991

 “You can now send Tax-Free cigarettes to Servicemen in Vietnam”

Philip Morris mail order form for financial contributions for cigarettes to send to American soldiers
Circa 1965-1972

“The Smoker’s World”

Special issue of The Examiner, vol. 5, no. 2
A publication of the Dwight David Eisenhower Army Medical Center at Fort Gordon, Georgia
Overseen by John W. “Rick” Richards, Jr., MD
February 8, 1980

John W. ‘Rick’ Richards Jr., MD, co-founder of Doctors Ought to Care (DOC), shares observations on tobacco in the military during his service as a captain and major in US Army medical facilities in the 1980s. Dr. Richards also cites the work of Dr. Greg Blake in motivating the military to address smoking. (7:44)

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