There is very little doubt that tobacco is a strongly protective agent against infection from disease. Its germicidal qualities are well-known and recognized. It is now recognized by medical writers that the mouth is one of the principal, if not the principal channel of infection for many infective diseases. The cavities of the teeth are the breeding places of hosts of pathogenic bacteria, of which there are about 100 different varieties arising from decaying food and other sources. These destructive agents, many of them highly pathogenic, easily find their way from the mouth through various channels to the inside of the body. Many infective organisms floating in the air are drawn into the mouth in the act of respiration and this is a common method of falling a victim to contagion.

The effect of tobacco juice on the bacteria of the human mouth was investigated by Dr. W. D. Fullerton and is reported by him in the Cleveland Med. Journal 1912, page 585.

In his experiments Fullerton used tobacco juice obtained from the human mouth by chewing plug tobacco. He also used a solution of smoke obtained from a well seasoned pipe. These were first thoroughly sterilized in order to obtain a pure natural mixture of tobacco and saliva. Cultures of well-known species of bacteria were made using every laboratory precaution so as to obtain accurate results. Specimens of these bacterial cultures were then submitted to the action of the tobacco juice. It was found that exposure for one hour killed or rendered innocuous 15 to 98 per cent of the bacteria; exposure for 24 hours acted similarly on from 84 to 100%. Dr. Fullerton gives his opinion, from his results, that it seems that a pipeful of tobacco was more toxic to bacteria than one chew; but chewing tends to loosen retained food particles, foci of bacteria, etc., and much of this is ejected from the mouth. Fullerton’s work agreed very well with the results obtained by other workers in the same line of investigation. In Miller’s Micro-organisms of the Human Mouth, p. 246, it is stated that the organisms of the mouth lead only a miserable existence in a mixture of an infusion of tobacco, sugar and saliva; and that the smoke of the last one-third or the first one-fourth of a Colorado Claro cigar sterilized ten cubic centimeters of beef extract solution which had been richly inoculated with bacteria from decayed teeth. Arnold, Lancet (London, 1907) reports similar experiences with some of the most virulent types of infective bacteria.

Both nicotine and its derivative pyridine as well as the tarry oils resulting from tobacco distillation are strong and effective disinfectants; and formaldehyde, one of the most powerful germicides known, is so formed. Trillat, Annales de l’Institut Pasteur (Paris), Vol. 19, p. 722, shows that 100 grams of pipe tobacco will yield .063 grams and 100 grams weight of cigar .118 grams of formaldehyde. Also that a dilution of 1⁄1000 formaldehyde is germicidal to all bacteria although it has very little deleterious effects on man.

As far as can be ascertained there has not been very much investigation for the purpose of demonstrating the actual results of clinical experience regarding the antiseptic qualities of tobacco in the case of smokers, but facts, so far as they have been recorded, bear out the experiments. Rideal Disinfection and Preservation of Food (London and New York, 1903) states that the investigations of Tessarini showed that tobacco smoke passed over the organisms of human cholera and pneumonia killed them in from 10 to 30 minutes. He also states that the Cigar Manufacturers Association of Hamburg reported that in the cholera epidemic of 1892 in that city, only 8 out of 5,000 employes in the cigar factories there were attacked by the disease and that, there were only 4 deaths. Professor Wenck, of the Imperial Institute of Berlin, has published an account of this cholera epidemic (see Laucett francaise, Paris, 1912, p. 1425). His conclusions favor the preservative action of tobacco. It was clearly shown that slightly moist tobacco was a fatal germicide for the cholera bacillus; all microbes die in it in 24 hours. The examination of cigars made in Hamburg during the epidemic showed that they were absolutely free from bacilli. Wenck asserts also that cholera microbes die in ½ hour, 1 hour, and 2 hours after having been placed in contact with the smoke of Brazilian, Sumatran and Havana tobacco. The fumes of tobacco will besides kill in five minutes the cholera microbes obtained from saliva. Fullerton already quoted examined a small number of mouths (74) in the Johns Hopkins Hospital at Baltimore. Of those who did not use tobacco in any form a larger percentage showed signs of dental caries and decay of an advanced stage than in the case of tobacco users. Similarly in the case of women who never used tobacco; and, although there was a much greater care and cleansing of the teeth, yet the percentage of decay and disease was higher than in the case of men using tobacco. Fullerton says, “The smoking or chewing of tobacco is decidedly germicidal. Chewing, by exercising the teeth, helps nutrition and eliminates pathological agencies both by destroying them in situ and by removing them in the expectoration.” Rideal (already quoted) mentions that Dr. Burney, the senior medical officer of Greenwich Hospital, London, asserts that the tobacco smoking inmates of that institution enjoyed comparative immunity from epidemics.

From these opinions and examples it seems quite clear that whatever portions of the decomposition products of tobacco reach the mouth and mix with the saliva, or propagate themselves in the immediate surroundings of the smoker, are likely to have extremely good effects. It would be easy to multiply these opinions but there is no use laboring the argument. There is a matter, however, it will do no harm to mention here. Today it is being gradually recognized by the medical profession that the conditions which lead ultimately to gastric and intestinal ulcer including appendicitis are entirely due to infection. At the 1912 meeting of the British Medical Association this was clearly manifested and some of the leading authorities in England pointed out the importance of the mouth as a focus of infection in such diseases. Now if this is so, it is at once apparent how important tobacco as a mouth disinfectant and germicide becomes; and it may incidentally throw some light (otherwise unexplained) on the fact constantly observed that in persons under 30 years old these diseases are far more common amongst women than in the case of men. The use of tobacco is not asserted as a reason, but it may be.

With regard to other beneficial effects—Clouston, Fullerton and Marvin, state that the moderate use of tobacco has a beneficial effect on the digestive system as in general it causes an increased flow of saliva and gastric juice which helps in the digestion of food; it also stimulates the muscles and mucous membrane of the stomach and intestines. The sedative effects of tobacco on the nerves is a preventative of nervous dyspepsia and is valuable for the promotion of good digestion.

While much has been written on the effects of excessive smoking on the nervous system little has been said of the good effects of moderate smoking. Every smoker realizes that the soothing effects of tobacco on the nerves is perhaps its most valuable property. Clouston’s opinion, already quoted (and none could be better), is that “tobacco exercises a soothing influence when the nervous system is in anyway irritable; it tends to calm and continuous thinking.” Fullerton says, “It gives a composure and feeling of well-being which are beneficial to mind and body.” Of these facts there can be no doubt because they are matters of common daily observation and experience. Most smokers find a solace and quieting influence from their evening smoke after the worries of a troublesome day which no other agent can give them. The effect produced may be partly psychological but that does not matter. Indeed the strenuousness of life in the age in which we live seems to demand such a help and nothing appears to supply the want so efficiently, so pleasantly, and with less harm, than a quiet smoke. It puts the smoker at peace with himself and at peace with others. Bush found in his investigations on the mental effects of tobacco on college students that there was a temporary loss of ten per cent in mental efficiency in certain faculties of the mind. This is probably true enough though his results are not quite conclusive. On the other hand many men find that they can think more clearly and more consecutively when helped by a smoke. Indeed they smoke when they have a knotty problem to solve. The point need not be argued; all smokers will agree with it.

Judged from a psychological standpoint the effects of tobacco are entirely favorable. To the sleepless, the worried, to him who is troubled in mind or vexed in spirit, the pipe or cigar is a never-failing remedy to soothe and cheer. It is the feeling of betterment which it engenders and the spirit of good will which tobacco creates that are responsible for its universal use by men differing widely in grade and condition of life as well as in mental caliber; it reaches the common springs which move humanity; its qualities are those which have made the pipe a symbol of peace and a bond of fellowship and union between man and man from Pole to Pole.

From a general summing up of the opinions which have been quoted the question might finally be asked, “Is tobacco on the whole harmful or beneficial to its users?” The answer seems to be this: “Tobacco to the extent used on the average has some slight injurious effects and some slight beneficial effects on the physical system. It is an excellent preservative agent against contagious and infectious disease. Mentally its effects are overwhelmingly beneficial.” In every particular case a man must judge for himself, taking account of his individual idiosyncrasies and conditions whether the use of tobacco is beneficial to him or otherwise.