I Have a Question
September 1986

“I Have a Question,” Ensign, Sept. 1986, 59–61

A century and a half ago, the Prophet Joseph Smith learned from the Lord that tobacco was not good for us. Since then, medical science has determined the same thing. How has society responded to this information?

Dr. James Mason, director of the Center for Disease Control, Atlanta, Georgia. The revelation known today as section 89 of the Doctrine and Covenants was received on 27 February 1833. Few revelations have come under more scrutiny than this “word of wisdom,” and few have served as well to vindicate Joseph Smith’s calling as a prophet. The counsel he received that day in 1833 has since received increasing support from scientific and medical research, much of it only in the past few decades. The Lord’s admonition to refrain from tobacco is but one example.

For the past twenty-two years, the Surgeon General of the United States has identified cigarette smoking as the single most important cause of disease and premature death. Tobacco kills thirteen times as many Americans as hard drugs do, and eight times as many as automobile accidents. The worldwide cost in lives now approaches 2.5 million lives per year, with about 360,000 deaths annually in the United States. Over a billion people now consume almost a trillion cigarettes per year, an average of more than half a pack per day.

Lung cancer alone claims 129,000 lives per year; coronary heart disease kills another 170,000 annually. Some smokers contract cancer of the larnyx, mouth, esophagus, bladder, and pancreas; some suffer with chronic bronchitis, pulmonary emphysema, peptic ulcer, allergies, thrombosis, reduced fertility, and peripheral vascular disease. Smokers can even be affected by the medicines they take to get well, because the desired pharmacological effects of some drugs can be altered by the chemical residue of tobacco in their bodies.

The United States Public Health Service calls Americans’ addiction to tobacco “the most widespread example of drug dependence in our country.” Nicotine is an addictive drug, and the American Lung Association and other agencies state that smoking meets all the criteria of addiction. The fact that nine out of every ten American smokers say they want to “kick the habit” provides additional evidence of the addictive qualities of tobacco.

The Lord has told us that “tobacco is not for the body, neither for the belly, and is not good for man.” (D&C 89:8.) In spite of this and other warnings, the rate of smoking is increasing in many countries where the citizens can least afford tobacco products and smoking’s adverse effect on their health. The people of these countries are already confronted with high infant and child mortality rates, short adult life span, and limited health care facilities. Family incomes are low and often do not cover basic requirements for food and clothing. Even so, smoking is on the increase in eastern bloc countries, Canada, and Egypt, where more young people than adults smoke. In some schools surveyed in Santiago, Chile, two-thirds of the children smoked.

Statistics in other countries, including the United States, Great Britain, Norway, and Sweden, are more positive and show a decrease in smoking activities, particularly in the age of starting to smoke and the incidence of smoking. An analysis of cigarette smoking in the United States from 1981 to 1983 shows gradual reductions in smoking. According to an American Cancer Society study, the number of men who smoke dropped from 48.4 percent in 1959 to 26.15 percent in 1982. The percentage of women smokers declined, too, from 27.2 to 21.1 percent during the same period. However, women in general, and young Caucasian women in particular, comprise a higher percentage of smokers than ever before because their consumption of tobacco is not falling as rapidly as in other groups. Women 18 to 22 years old currently have a higher smoking rate than men—34.9 percent versus 34 percent. If present trends continue, smoking rates for men and women will be identical in the United States by 1990.

That trend alarms many researchers who have found that in the past few decades, women have taken up smoking almost with a vengeance. As a result, the average life expectancy advantage women have had over men is gradually being eroded. Over the past thirty-two years, there has been a 315 percent increase in the lung cancer death rate among women, and lung cancer is expected to surpass breast cancer as the leading cancer killer of American women. It has already done so in five states.

Smoking by mothers of unborn children is even more serious because it places their offspring at risk. Nicotine, numerous toxic chemicals, and radioactive polonium all interfere with fetal development, since the fetus can receive these substances through the mother’s blood. Smokers give birth to underweight babies twice as often as other women. And because birth weight is a key factor in infant mortality, tobacco use by a mother can threaten her baby’s life. Furthermore, Americans pay more than $152 million a year for intensive care services to underweight babies of smoking mothers. To add to these grim statistics, birth defects, including mental retardation, abnormal facial features, and heart defects may occur in infants of women who smoke two or more packs of cigarettes per day during pregnancy. Each year more than 3 million babies are born thus afflicted, and the number is growing as more women become smokers.

The tragic and needless deaths, disease, and untoward effects on the unborn that occur as a result of tobacco witness to the truth of the Word of Wisdom.

Even those who don’t smoke are at risk in a smoking environment. For example, children of smoking parents experience much higher rates of respiratory illness, including colds, pneumonia, and bronchitis. They can also suffer lifelong effects; evidence shows that passive smoking in childhood (inhaling the smoke of others’ tobacco products) delays physical and intellectual development.

Passive smokers are about three times more likely to die of lung cancer than those not exposed. More than ten studies have linked lung cancer in nonsmoking men and women to their smoking spouses. In fact, passive smoking is estimated to cause more cancer deaths in the United States than all regulated industrial air pollutants combined. This may affect five thousand nonsmokers per year, or one-third of the cases of lung cancer not directly attributed to smoking.

Smoking is not only a deadly habit, but a costly one. The price Americans paid in 1985 for lost productivity and health care was approximately 65 billion dollars. And this does not include the cost of the tobacco itself—another 30 billion dollars!—nor the loss of food and other beneficial products the land could have been used to produce.

In response to tobacco’s terrible cost in lives and health, many governmental and private agencies have launched campaigns attacking smoking. One result is that TV stations now no longer carry advertising for cigarettes and cigars. The year 1982 marked the first decrease in the sale of cigarettes since 1969, and sales declined even further in 1983.

But as sales fall, the advertising budgets of cigarette manufacturers rise. The more than $2.7 billion spent on cigarette advertising in 1983 was mostly to convince young people to smoke. The Lord was aware of these temptations when he warned, “In consequence of evils and designs which do and will exist in the hearts of conspiring men in the last days, I have warned you, and forewarn you, by giving unto you this word of wisdom by revelation.” (D&C 89:4.)

One ironic result of campaigns to reduce smoking has been the marked increase in the use of “smokeless” tobacco. As the sales of cigarettes decline in the wake of negative health publicity, sales of smokeless tobacco are dramatically increasing. The use of “chew” or “snuff” in the United States has increased more than 40 percent in the last two decades, and as many as 22 million Americans may now be users.

There are three kinds of smokeless tobacco: chewing tobacco, dry snuff (usually inhaled), and moist snuff (tucked between the gum and lip). Youth are becoming heavily involved in this form of tobacco use. A study of one thousand high school students in Colorado noted that 22 percent of the male students chewed tobacco or dipped snuff, with 10 percent using it on a regular or daily basis. Even young children are becoming involved; a 1983 study in Louisiana showed that 21 percent of ten-year-olds dipped snuff!

The health hazards of smokeless tobacco have long been known. As early as 1761, John Hill, a British physician and botanist, blamed a cancerous lesion in a patient’s nose on the patient’s “immoderate” use of snuff. Two hundred and twenty-five years later, the Massachusetts Department of Public Health ordered that snuff carry warning labels about its cancer-causing properties. The United States Congress has recently mandated tough warning labels on all smokeless tobacco products and advertising.

Physical symptoms of disease caused by smokeless tobacco include receding gums, disintegration of bone where the wad of tobacco is held in the mouth, and formation on the gums of white patches called leukoplakia. A significant percentage of these leukoplakia patches become cancerous. Researchers in the United States, Canada, Sweden, Great Britain, India, and Denmark have concluded that smokeless tobacco is linked to oral, pharyngeal, and laryngeal cancer. A study in the southern United States showed that short-time snuff users had a fourfold increase in cancer; longtime users had a rate fifty times higher!

The smokeless tobacco industry is gearing up to fight any hint that its products are not good for health. Manufacturers are resisting warning labels. One manufacturer with a $30 million budget promoted its product in conjunction with the 1984 Summer Olympics with the slogan, “Take a pouch instead of a puff,” falsely implying that smokeless tobaccos are a safe alternative to cigarette smoking.

Users who think smokeless tobacco is nonaddictive are wrong; there is just as much addiction with smokeless tobacco as with cigarettes. The only difference is that instead of being inhaled, the poisonous alkaloid is readily absorbed through the lining of the mouth.

There is some good news in all this: we have no reason to believe that addiction to tobacco cannot be overcome. More than 33 million Americans have heeded the warnings and given up smoking since 1964 when the first Surgeon General’s report on the consequences of smoking was issued. No one is so addicted that he or she cannot stop smoking. The Word of Wisdom was “given for a principle with promise, adapted to the capacity of the weak and the weakest of all saints, who are or can be called saints.” (D&C 89:3.)

It is good news that smokers of all ages can experience substantial health benefits from giving up tobacco. Even those who have smoked for as long as fifty years have a great deal to gain by giving up their habit. They feel noticeably better within a year, and they also reduce their chances of having a stroke or heart attack.

The Lord finished his revelation on the Word of Wisdom with a promise to the Saints: “And all saints who remember to keep and do these sayings, walking in obedience to the commandments, shall receive health in their navel and marrow to their bones; And shall find wisdom and great treasures of knowledge, even hidden treasures; And shall run and not be weary, and shall walk and not faint.” (D&C 89:18–20.)