[Skip to Content]
[Skip to Content Landing]
Citations 0
. . .In Perspective
March 25, 1998

Tobacco Epidemiology and the Challenge of Multiple Etiologies

Author Affiliations

From the Department of Social Medicine, Harvard Medical School, Boston, Mass; and the Department of the History of Science, Harvard University, Cambridge, Mass.


Edited by Annette Flanagin, RN, MA, Associate Senior Editor.

JAMA. 1998;279(12):969. doi:10.1001/jama.279.12.969

In the late 19th century, as tobacco consumption began a dramatic increase, medical debate about its health consequences intensified. Since the publication of King James' Counterblaste to Tobacco in 1604, physicians and other observers had debated whether tobacco smoking helped or harmed a person's health.1 This debate took on a different form in the late 19th century. Following the development of bacteriology, physicians concentrated on identifying the specific etiologies of pathological processes. Armed with Koch's postulates and sophisticated laboratory techniques, they deciphered the causes of many infectious diseases. But when physicians applied these new methods to the old problem of tobacco use, they immediately ran into trouble.