Skip to main content

How Smoking Became a Global Pandemic

Harvard professor discusses the advertising-driven global growth of cigarettes

Boyarsky lecture -- Allan Brandt

Harvard Professor Allan Brandt traces the decline of smoking in the US and its rise around the world. Photo by Les Todd/Duke Photography

Despite concerted public health campaigns, cigarette smoking remains a global pandemic that kills thousands around the world, Allan Brandt told listeners Wednesday night at the 2015 Boyarsky Lecture in Law, Medicine, and Ethics. 

The lecture at the Nasher Museum of Art focused on the rise of tobacco consumption and the role of advertising in fueling that growth. Brandt explored the ways advertising campaigns transformed a deadly product into a commodity associated with pleasure.

“How could something that was very bad for you, and was even understood very clearly at the time, be so in fact exciting and interesting and advertised in such bold ways?” Brandt said.

Brandt is the Amalie Moses Kass Professor of the History of Medicine at Harvard University and author of “The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product that Defined America.”

In his talk, “The Global Tobacco Pandemic: Historical and Ethical Reflections on the Persistence of Smoking in the 21st Century,” Brandt described how 20th century cigarette ad campaigns found creative ways to undercut scientific findings about the harm caused by smoking. Adds for Camel cigarettes, for instance, suggested that doctors smoke that brand. 

Smoking was initially more popular among men, he added, until Chesterfield and other cigarette companies began targeting women, leading to large increases among that group.

In the 20th century, approximately a hundred million people died because of tobacco-related diseases, Brandt said. But the threat is not behind us, he said. Citing World Health Organization estimates, Brandt said that if smoking rates do not change, roughly a billion people will have died from tobacco-related causes by the year 2100.

Brandt said cigarette companies exploited and manipulated doubt, uncertainty and ignorance to promote smoking. Rather than explicitly release data, for instance, cigarette companies would emphasize the process of research.

Nevertheless, by 2004, there was a substantial decline in smoking in the U.S.  In response, the tobacco industry targeted foreign markets, upping their exports to countries such as China and Thailand, leading to a large increase in sales, Brandt said. World Health Organization recommendations for overseas advertising bans and warning labels on cigarettes sold overseas have been rejected by the tobacco industry, he added.

New, unregulated technologies such as electronic cigarettes may also contribute to the persistence of smoking, Brandt said. In the past month, 18 percent of 12th graders in the United States have used an electronic cigarette, he noted.

Brandt concluded by challenging the audience to continue to think creatively about how to reduce smoking worldwide.

“Why don’t we have the capacity to stop the massive pandemic in plain sight?” Brandt said. “And how should we be thinking in powerful, ethical, legal, and historical ways about what we can do to reduce the scope of this epidemic in these next days?”