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The writer gave up smoking tobacco about a year ago because of the bad effects the habit seemed to have on his heart and eyes. He has since read a good deal on the subject, pro and con, but found the existing literature quite unsatisfactory. There is a tremendous need of scientifically ascertained facts. Scarcely any definite experimental data are available. We hail with all the more pleasure a volume entitled The Physical Effects of Smoking. Preliminary Experimental Studies, By George J. Fisher, M.D., and Elmer Berry, B.S. (New York: Association Press; 1917), which gives the result of four experiments made under strictly scientific conditions and in a careful and unbiased spirit. Two of these experiments were conducted by moderate smokers-one of whom has since given up the habit because of the results secured-and two by non-smokers. All of them were normal, healthy, athletic fellows, between the ages of 21 and 25, who for the most part expected no results, were as far as possible kept in ignorance of the progress of the experiment, and were decidedly surprised at its final results. These results are arranged in chronological order, with full tabulated records, and a final summary. The conclusions may be briefly stated as follows: Smoking raises the heart rate and blood pressure, markedly delays the return of the heart rate to normal after exercise, and impairs the neuro-muscular control as indicated by delicate finger exercises and gross muscular co-ordinations. There is no escape from the firm, steady, scientific insistence of the figures. If they are accurate, our young men should be made aware of the truth. As the editors say in their General Summary (p. 175), if such results are produced on healthy vigorous young men in prime condition by moderate smoking, what is the effect of the widespread use of tobacco upon the manhood of our land? The significance of these results should not be lightly tossed aside. An increased heart rate of only 5 beats per minute means that a man's heart does 2074 kilogram-meters (approximately 15,000 foot pounds) more work per day. In fifty years this means 272,471,000 foot pounds of unnecessary work. Does that mean, other things being equal, five years less of life? Does it mean less margin of safety, less recuperative power, more danger in case of extreme need, in the crises of disease or accident? But if the blood pressure is also raised, even these figures do not represent the whole truth, for the unnecessary work of the heart is even greater. What connection is there between this increasing pressure and arteriosclerosis? Can smoking be one of the great causes of this increasing malady among our middle-aged business men? These questions should be definitely studied at the earliest possible opportunity, together with such others as: Is it true, as these experiments indicate, that the body does not become habituated or immune to the harmful effects of tobacco ? What are the actual comparative effects of smoking on boys, young men, and middle-aged men? What are the relative effects of cigarettes, cigars, and pipes? Does smoking have any definite effect upon the mental and psychic processes? The work done by Dr. Fisher and Mr. Berry should be repeated by other observers and the results checked. In dealing with such a deep-rooted human habit as smoking, facts are needed, not theories, sentiments, or prejudices. If smoking is harmful, as these studies indicate it to be, we cannot establish the fact soon enough. - The Fortnightly Review, Volume 25 [1918]

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