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King James professed high concern for the moral degeneracy of his subjects, whom he found softened by new wealth, “which makes us wallow in all sorts of idle delights and soft delicacies,” the worst of them being tobacco smoke, the concoction of “these beastly Indians.” If England was set on taking up the savages’ ways, “[w]hy do we not as well imitate them in walking naked … yea, why do we not deny God and adore the Devil, as they do?” Dismissive of the medicinal claims made for tobacco on the ground that it was always praised when smokers recovered from their illnesses but always exonerated if a man died after smoking, the king reserved his fiercest rhetoric for the closing lines of his assault upon
    a custom loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lung, and the black stinking fume thereof, nearest resembling the horribly Stygian smoke of the pit that is bottomless.
    Not only would James’s fuming countrymen not abjure the pastime, but by 1665 they were fiercely embracing it as a defense against the great plague that devastated London that year. It was near the end of the seventeenth century when smoking first faced the rigorous scrutiny of authentic science, as authorities at the leading school of medicine in Paris began reporting their suspicion that tobacco consumption shortened lives. Early death, though, was still so familiar a companion that the possible destructive effect of tobacco was not a pressing concern. Indeed, the first recorded clinical data on the subject was not published until 1761, when a London physician reporting ten cases of cancer, nine afflicting the nostrils and one the esophagus, among habitual snuff-takers, noted that the hard, black, malignant “polypusses” were indeed cancers “as dreadful and as fatal as any others,” and warned against the overuse of snuff. Fourteen years later, another London physician, Percival Pott, observed the frequent occurrence of cancer of the scrotum in chimney sweeps and theorized that the cause was their constant immersion in soot (and no doubt a scarcity of bathing facilities). But neither snuff nor soot was smoke itself, though the former was a product of tobacco and the latter of combustion, hinting that each had properties deleterious to human tissue.
    Still, the relationship of tobacco to health lay deep in the shadow of ignorance. By the end of the eighteenth century, the most respected physician in the New World and the author of a learned tract on chemistry, Benjamin Rush of Philadelphia, was warning of the effects of tobacco on the mouth, stomach, and nervous system and linking it to drunkenness—this at the same time hewas prescribing profuse bleedings as the preferred treatment for almost all illnesses.
    Little of truly scientific note was added as tobacco use spread in the first half of the nineteenth century, despite the scorn of polemicists like Horace Greeley, founding editor of the New York Tribune , who defined the cigar as “a fire at one end and a fool at the other.” There began to emerge now, however, critiques of smoking that were more medical than moral in their carping. Among the shrewdest and more prescient of them was The Beauties and Deformities of Tobacco-Using , a slender volume issued in Boston in 1853 by a physician named L. B. Coles, who argued without a shred of documentation that tobacco was “a deadly narcotic” that stifled the brain’s reasoning and perceptive powers, impaired the hearing, vision, liver, and lungs, and shortened smokers’ lives by 25 percent. Coles also hypothesized that many tobacco-caused afflictions were not recognized as such because they did their fatal work gradually. The habit so weakened the internal system, he concluded, that the smoker was easy prey to many diseases. Yet the scientific consensus of the time was better represented in the pages of The Lancet , the leading English-language medical journal, which devoted much space in