Asthma and Smoking: When Cigarettes Were Medicine - podcast episode cover

Asthma and Smoking: When Cigarettes Were Medicine

May 14, 202426 minSeason 13Ep. 9
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Episode description

In 1946, R.J. Reynolds Tobacco Company launched an ad campaign with the slogan, “More doctors smoke Camels than any other cigarette.” Long before Camel cigarettes became the doctor-approved cigarette of choice, at least in advertising, people living with asthma were often instructed to inhale smoke to relieve their symptoms. And that advice was for asthmatic adults – and children. ‘Asthma cigarettes’, as they were called, and related products, weren’t packed full of tobacco, though many did include it; they were, essentially, psychotropic drugs from the nightshade family that people inhaled in hopes of finding respiratory relief. Let's take a look at what kinds of quack – and, to be honest, some not-so-quack – products for asthma before the invention of the modern inhaler.

See omnystudio.com/listener for privacy information.

Transcript

Speaker 1

Welcome to Criminalia, a production of Shondaland Audio in partnership with iHeartRadio.

Speaker 2

In nineteen forty six, R. J. Reynolds Tobacco Company launched an ad campaign with the slogan quote more doctors smoke camels than any other cigarette, long before camel cigarettes became the doctor approved cigarette of choice. At least in advertising, people living with asthma were often instructed to inhale smoke to relieve their symptoms, and that advice was for asthmatic adults and children, and that is definitely not how asthma

is treated today. The popular asthma cigarette, as they were called, and related products weren't packed full of tobacco, though many did include it. They were essentially psychotropic drugs from the night shade family that people inhaled in hopes of respiratory relief. Go to a time in history, a rather long period of time, it turns out, when smoking was recommended to

people as young as six years old. And we'll take a look at what kinds of quack and I actually, to be honest, some not so quack products for asthma that existed before the invention of the inhaler. Welcome to criminalia, I'm Maria, tremarky.

Speaker 1

And I'm a holly fry. Asthma is a chronic disease that affects the airways of your lungs. During an asthma attack, a person's airways becomes swollen and they narrow, Mucus develops in them, and all of this can make it really difficult to breathe. Symptoms of an asthma attack can include coughing, wheezing, shortness of breath, and chest tightness. Attacks can range from a mild nuisance to a life threatening emergency.

Speaker 2

Asthma wasn't always known to be an inflammatory response. It was considered the result of neurosis. It has at times been considered a symptom of demonic possession as well. But no matter what people thought caused it, they sure did try a lot of things to relieve it, and not

often included inhaling smoke, contrary to our modern treatments. We can go all the way back to ancient China around five thousand years ago to find that a Chinese herb called Ephedra seneca was inhaled for relieving asthma discomfort.

Speaker 1

Ancient Greek physician Hippocrates believe that people living with asthma might display a hunched back. He thought that you could tell they had asthma just by looking at them. You can't but that aside. He also was the first person to record his work in trying to understand the correlation that he observed between environment and specific trades and how they seemed to impact respiratory problems. He too recommended inhaling a fedra along with a glass of red wine for

symptomatic relief. Around fifty CE, ancient Roman Pliny the Elder found links between pollen and breathing difficulties, and he too recommended inhaling ephedra as a treatment for those respiratory issues. As an aside, it is actually debated whether or not

Pliny himself may have lived with asthma. It wasn't until around one hundred CE that the Greek physician Aretius of Cappadocia wrote a detailed definition of asthma that was actually fairly similar to the modern understanding of how the disease develops. And then he suggested that drinking a concoction of owl's blood and wine was an effective remedy and preventative.

Speaker 2

It's not Ehedra is a predecessor, though, of today's drug epinephrine, which is a common ingredient in modern quick relief asthma treatments. But while it may have been a valid remedy because of its anti inflammatory properties the fine particles inhaled from smoking, it may not have been the best delivery method for respiratory health. Let's talk about asthma's smoke because things have come a long way in what we know about asthma and what we know can help or worsen its symptoms.

Speaker 1

Today, we know that inhaling particles from smoke is considered a big asthma trigger, and people living with a condition are instructed to avoid smoking and secondhand smoke, as well as poor air quality such as the kind you would see in a wildfire smoke, or even vehicle exhaust. All

smoke contains carbon monoxide, carbon dioxide, and particulate matter. Depending on what's burning, smoke can also contain different chemicals like aldehydes, acid gases, sulfur dioxide, nitrogen oxides, polycylic aromatic hydrocarbons, benzene, toluene, styrene, metals, and dioxids. All of these are bad for the human body,

whether you have asthma or not. The United States Environmental Protection Agency DeFi air pollution as quote any visible or invisible particles or gas found in the air that is not part of the natural composition of air. Even the smallest airborne particles can be respiratory irritants, whether you intentionally inhale them or not.

Speaker 2

An asthma attack can occur when something irritates your airways, but triggers do vary from person to person. One super common trigger, though, is smoke. Inhaling smoke is unhealthy for everyone. It irritates the lining of the airways, and it's associated

with more severe asthma symptoms. It often also means more doctor visits and more frequent hospital admissions, and it's linked to not just an accelerated decline in your lung function, it also makes your body respond poorly to commonly used asthma treatments.

Speaker 1

Okay, so what's the takeaway. It's pretty obvious, but asthma and smoke just do not mix. We're going to take a break here for a word from our sponsors, and when we're back, we'll talk about all kinds of methods and products that people used to inhale in the hopes that they would find a way to manage asthma symptoms.

Speaker 2

Welcome back to criminalia. There is no cure for asthma. However, to help control asthma symptoms and avoid attacks, there are a few rules of thumb.

Speaker 1

Modern medicine has treatments that can help alleviate asthma symptoms without needing to have a lighter on hand. But just as there's no cure, there's also no one size fits all. Treatment options include medications that are inhaled. Some can be taken as a pill. These inhaled medicines, though do not contain smoke. There are two general types of asthma medications.

Quick relief dre ugs such as a beta agonist like albuterol, are used to control the symptoms of an asthma attack that's in progress by opening the airways, and long term options including inhaled or systemic corticosteroids can help you have fewer and milder attacks in the long run.

Speaker 2

It was English physician and astronomer John Mudge who created the very first inhaler of sorts in seventeen seventy eight, which he based on a Pewter tankard. Its design allowed the user to breathe in an opium based vapor through a tube. The earliest known reference of smoking opium for respiratory relief dates back to eleven hundred BCE in China, and for a very long period of time, incense burners and pipes were the most prominent form for that type

of opiate based respiratory drug delivery. People also began to use ceramic pots to inhale herb or chemical infused vapors. In eighteen eighty five, the first portable nebulizer hit the market. Dry powder inhalers also became popular around that same time. They worked by squeezing a rubber ball, and users could force a medicinal powder through a sieve to convert it

into a vapor. One dry powder in haler on the market claimed it could cure asthma in ten minutes or less, but really, to no one's surprise, it could not.

Speaker 1

The major breakthrough in asthma treatment came in the nineteen fifties when the first portable meter dose in haler was invented by George Maison, the president of Riker Laboratories. Its design used glass vials and valves that were originally designed for perfume models to effectively deliver a puff of medicine to the lungs, and it set the stage for new asthma technology, including breath actuated inhler's, spacer devices and dosage counters.

Meter dose in Haler's are now the most common device used for treating asthma.

Speaker 2

But we're kind of getting ahead of ourselves with all this jazz about modern inhalers. Let's jump back to smoking remedies and start with one called fumigation. The Ebers Papyrus is an ancient Egyptian compilation of medical texts that dates back to about fifteen fifty BCE, making it one of the oldest known medical works. It contains asthma remedies prescribed by ancient Egyptian healers, and herbal treatments were the most common.

These remedies included drying herbs, specifically black henbane, heating them on a hot stone, and then placing a jar with a hole over it. The user would inhale the smoke through the stalk of a reed that was placed into that hole. The smoke allegedly offered mild breathing relief for those who are curious. Other cures cited included quote the droppings of camels and crocodiles, though we are totally unsure how that remedy was administered and please let it not have been inhalation.

Speaker 1

Moving along on our history timeline, next, we have inhaling pipes the smoke of stramonium, a plant from the same family as belladonna and that you may also know as gymsen weed and other similar herbs like black henbane, indian hemp, tobacco, and cannabis were all on the list of plants to inhale for asthma symptom relief. Dried and crushed plant material was stuffed into a hollow pipe and inhaling. The smoke was believed to be calming and that it could ease

mildly labored breathing. In fact, you can find ancient healers prescribing smoking pipes for asthma symptom relief at least as far back as one hundred BCE. In addition to the problem of irritating your airways with smoke particles, some of these plants, including stramonium and black henbane, are toxic and they may cause hallucinations or neurological problems. Hold on to that because we're going to talk more about those ingredients in a moment.

Speaker 2

So what could be better than a pipe stuffed with plants we know have toxic and hallucinigenic properties, enter cigars stuffed full of toxic and hallucinogenic herbs. In eighteen oh two, a Scottish born physician slash general named James Anderson was in India regarding the cultivation of silk when he first learned that people there inhaled smoke as a treatment for asthma. He shared that knowledge with his patients, and he wasn't the only one who'd caught the wave. A craze blue

through Europe and then the United States. It seemed everyone was suddenly smoking stramonium, sometimes mixed with tobacco, rolled into cigars or stuffed into pipes and inhaled for breathing relief and maybe some interesting visions depending on those unregulated ingredients and how much of them you smoked.

Speaker 1

Another option, and this was a really inexpensive option for asthma relief, was inhaling the smoke from burning paper that contained potassium nitrate and stramonium. It worked as simply as this, you'd ignite the paper with a match and then breathe it in. Some asthmatics using this method may have used a paper funnel to direct the smoke to their airways. Directions for use seem to vary. This is obviously the

lowest tech option you can imagine. Today, experts know that inhaling the smoke of potassium nitrate will not relieve respiratory symptoms, and it's actually known to irritate the bronchial mucous membrane, the opposite effect of how you'd want to common asthma attack. Potassium nitrate is also now considered to be quote probably carcinogenic by the International Agency for Research on Cancer.

Speaker 2

And then there was something known as asthma powders, which were made with stramonium. It really does seem like we've found our main character here in this episode, and you could buy a can of that at your local store. These products were used by placing a bit of powder on a piece of plane paper, igniting it, and inhaling the fumes. In this instance too, Sometimes pay per funnels were used to ensure you were directing the smoke straight

into your airways. Powders were a really common asthma remedy from roughly the eighteen seventies all the way till the nineteen fifties.

Speaker 1

And then people with asthma and other respiratory conditions were introduced to the asthma cigarette and it was a hit. But before we talk about how enormously popular it was, we're going to take a break for a word from our sponsors, and when we return, we will talk about how people smoked asthma cigarettes far into the twentieth century.

Speaker 2

Welcome back to Criminalia. Asthma cigarettes were super popular products, but let's not forget what was in them. Let's talk about stromone and other potentially toxic plant ingredients that people were inhaling thinking they would help.

Speaker 1

Asthma cigarettes were not only popular, they were also endorsed by well known and trusted names. Two leading nineteenth century writers, for instance, are on that list, the English physician Henry Hyde Salter, who was himself asthmatic, and the French physician Armand Trousseau. And this was also a product that was endorsed by the famous French novelist Marcel Proust, who on the evening of Saturday August thirty first, nineteen oh one, wrote to his mother recounting his struggle with a severe

asthma attack the previous day. From his letter, we quote misery of miseries or mystery of mysteries. My asthma obliged me to walk all doubled up and light anti asthma cigarettes at every tobacconist's I passed and what's worse, I haven't been able to go to bed till midnight after

endless fumigation. He had had periodic attacks since he was nine years old, in addition to bouts of hay fever, and he was familiar with his treatment options, and he had tried a lot of them, including prescribed opium, caffeine, iodine, and morphine. The latter had been injected by his father, doctor Adrienne Proust. His nose had been cauterized, a procedure used in the early twentieth century to help manage allergies.

He had also been prescribed a milk diet at one point, and he occasionally visited health resorts such as Evian le Bin on the shores of Lake Geneva. However, Proust's best liked treatment for his symptoms involved the inhalation of smoke from asthma cigarettes.

Speaker 2

Unlike asthma cigars, you didn't have to really grown. You could very conveniently buy a box of pre rolled cigarettes. Many preparations have inhaled asthma remedies contained a short list of possible ingredients. It's usually a combination of stramonium, which is toxic, lobilia also toxic, potassium hydroxide, which is a caustic chemical known to damage the upper respiratory tract when inhaled, and tobacco, a carcinogen that can cause damage not only

to your lungs but to your whole body. An early recipe for asthma cigarettes dating to the late eighteen hundreds called for quote eight parts stramonium leaves, eight parts green tea leaves, six parts slobilia leaves, and two parts plantain leaves. In other recipes you'd often find tobacco, cannabis, and even some seriously bad stuff like arsenic. It was really a

potpourri of potentially toxic plant materials in there. At that time, the perceived efficacy of asthma cigarette ingredients was linked to what was believed to be their anti sposmotic properties. They were thought to have a calming effect on your airways, but they were also known to cause quote grateful forgetfulness and a balmy oblivion like opiates. So there's that.

Speaker 1

Nothing about these remedies is scandalous, at least not for the medical knowledge at the times the treatments were being used. This wasn't a case of a guy hawking dubious breathing therapies at a traveling medicine show, but there was no shortage of advertisements with all kinds of claims regarding asthma relief.

In the eighteen eighties. Joy's Cigarettes claimed in one of their ads that their product offered quote immediate relief in case of asthma, wheezing, and winter cough, and that their cigarettes were quote recommended by the most eminent physicians and medical authors, agreeable to use, certain in their effects and harmless in their actions. They may be safely smoked by ladies and children.

Speaker 2

Doctor Blosser's medical cigarettes claimed to relieve quote sudden violent asthma attacks quickly by warm vapor which penetrate clogged breathing passages, loosen phlegm, relieve congestion, and soothe irritated membranes. We won't hold our breath on that claim.

Speaker 1

In eighteen ninety, an advertisement for Doctor Battie's asthma cigarettes claimed Doctor Battie's brand would quote effectively treat asthma, hay fever, foul breath, all diseases of the throat, head colds, canker saws, and bronchial irritations. Note it also warned against allowing kids younger than six years old to use them. Potter's asthma cigarettes claimed that they were quote for the relief of asthma attacks and other spasmodic affectations of the respiratory tract.

No one, as you may have noticed, advertised what exactly you would be inhaling if you tried these products.

Speaker 2

We know most of these asthma cigarettes contained stramonium as their active ingredient, and they were considered top of the line asthma therapy before the first asthma in haler hit the market in nineteen fifty seven, and they perhaps surprisingly remained readily available until the mid twentieth century, when they

were phased out amid growing evidence of recreational abuse. Their ingredients could cause hallucinations as well as problems such as disorientation, respiratory distress, heart conditions, delusions, seizures, coma, and a high enough dose their active ingredients could be fatal.

Speaker 1

Let's talk about what asthma cigarettes brought to the table. No, First, let's talk about those two ingredients that keep coming up stramonium and black hen beane. Atropine is the thing that makes stramonium and black hen beane potent, and it also makes them toxic. It's a white alkaloid discovered in eighteen thirty three and then isolated in eighteen sixty seven, and it's the key within those plants to asthma relief, specifically

opening airways. By eighteen seventy nine, with Europeans and America skins hooked asthma cigarette manufacturers used, it seemed any combination of plants containing atropine. An example ingredients list for these so called medicated cigarettes contained quote stramonium leaves containing alkaloids zer point two five percent in finished product, chestnut leaves, tea leaves, gum, benzoin colon nuts. Clinical studies conducted during

the nineteen forties. In nineteen fifties, so decades after these became popular continued to emphasize the therapeutic value of asthma cigarettes, wrote researcher h. Herkzheimer in nineteen fifty nine. So after the introduction of the first modern inhaler, quote, atropine administered locally in cigarette smoke or wet aerosols increases the vital capacity and gives a feeling of relief in cases of mild or moderate chronic asthma and emphysema.

Speaker 2

A nineteen eighty study of the popular Potter's brand, which we mentioned earlier, concluded that these in gret dience were all a bunch of ahui and that quote. Although an asthma cigarette contains approximately zero point six milligrams atropine equivalent alkaloids, it is a crude preparation and after smoking, the amount of active drug reaching the bronchial tree is extremely variable

and unpredictable. In addition to that, the level of toxin was found to vary greatly, not just from brand to brand, but cigarette to cigarette. So maybe you had a feeling of relief, or maybe you needed immediate medical attention.

Speaker 1

Despite the possible benefit and possible side effects of inhaling atropine over the counter, inhalation therapies were bound to sound better than doctor prescribed adrenaline shots to anybody that was living with asthma before the nineteen fifties, those injections were one of the very few tools against asthma symptoms that

early twentieth century physicians had. Unlike tobacco based cigarettes, asthma cigarettes were more of a delivery system for herbal remedies that hopeful asthmatics hoped might take the edge off of their discomfort before the invention of albuterol and propellant based inhaler's.

Speaker 2

That is, while the cure for asthma has yet to be discovered, neither has the cause, but experts do know more and more about the condition, including that inhaling smoke, whatever kind of smoke that may be, is more likely to exacerbate respiratory symptoms than calm them. No matter what all of those advertisements may have claimed.

Speaker 1

Asthma cigarette, Yeah, you want a little sip of something that cures what ails you?

Speaker 2

Yes?

Speaker 1

I do.

Speaker 2

I'd rather have that than an asthma cigarette.

Speaker 1

I really love the ingredients lists here, and I particularly love the one that read eight parts stramonium leaves eight parts of green tea leaves, six parts lo be leaves, and two parts plantain leaves. And that was my starting point. I'm not making stramonium martinis, but I am making something delicious. This is one you build in the shaker. I put everything in before I put ice in because I don't

want to over dilute this. Although you will shake it with ice, but first pour in two ounces of green tea, so whatever you have that you've made and cooled, one ounce of lemon juice, one ounce of macha syrup.

Speaker 2

Hey have we used that before?

Speaker 1

No, we haven't. I bought mine online. Some grocery stores carry it. I'm told I haven't found one in my locals, but it was really easy for me to find online and get in the matter of two days. Delicious. I'm gonna use it everything. Then you're gonna add two ounces of bourbon and a half ounce of banana liqueur. Look, bananas are not plantains, and I know that, but they are in the same family, and you don't have a

lot of it in here. Okay. First of all, let me tell you when you put this all together in your shaking tint, it smells like heaven. It smells so good it should be illegal. But then you're gonna add your ice. You're gonna shake, shake it, and then you're just gonna strain it over fresh ice. This is one of my favorite drinks I've made in a long time. This is probably going to show up at the end of season discussion. The bourbon flavor gets subsumed. I don't

know where it goes. It's in there, but it's not there. The banana banana is always tricky. We've talked about it before. It can really drive the bus and kind of take over a drink, and the scent of it is very prominent in this drink. But something about the green tea undercuts it, and you just get this really beautiful. It tastes medicinal. It tastes like you're having green tea, you're lowering your cholesterol. I'm not claiming that it's actually doing that.

I'm just saying it feels like you're doing something healthy.

Speaker 2

Pretend you're breathing better.

Speaker 1

Absolutely spectacularly delicious drink this one. I'm gonna make it a bunch to make this as a mocktail. You're basically gonna do everything normally except instead of bourbon. You will use a black tea, so it'll be essentially like a fabulous iced tea at that point. And then you'll use a half ounce of banana syrup instead of a banana liqueur. And we're gonna call this the Stramonium Special, even though

there's no stremonium in it. I had been wanting to play with macha syrup for a while, and I kept putting it off, and then I was like, I think today's the day. It was. Then I was very happy those green tea leaves in that plantain led to delightful inspiration. If you drink this Stremonium Special, I hope it's delicious.

And we also hope that you join us again next week because we're gonna be right back here to talk more about some wild things people have sold in the name of curatives that aren't really gonna do that they say, and we'll also have another drink. We hope you join us. Criminalia is a production of Shondaland Audio in partnership with iHeartRadio. For more podcasts from Shondaland Audio, please visit the iHeartRadio app, Apple Podcasts, or wherever you listen to your favorite shows.

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