“Tobacco use passed into Europe in the late sixteenth century after initial encounters between Europeans and native North and South Americans [1]. Tobacco was seen often as a medicine. Several well known European physicians extolled the virtues of tobacco as a medicinal herb [1] and tobacco enemas were recommended for treatment of cholera and to loosen the bowels [2]. Ironically, one of among some twenty ailments purportedly amenable to tobacco was cancer [2]. For the next two centuries modest changes in cultivation, largely in the American colonies, provided increasing supplies of tobacco to Europe although it should be noted that consumption was taken largely in the form of chewing plugs [2], snuffed, or smoked in pipes [3]. It was not until the late 1860’s that a sudden change in consumption occurred. In fact the change was startling. According to Tilley [4], in 1869 about 2 million cigarettes were being manufactured in the United States and it was uncommon to see someone smoking in public. Some ten years later with the advent of new curing methodologies, the introduction of the Bonsack cigarette-making machine, and as the cigarette fashion took hold, 300 million units were produced. Indeed, the Bonsak machine could produce some 100,000 cigarettes a day, the equivalent of the work of 30–40 labourers. These machines marked an innovative turning point for the tobacco industry [5]. The production level initiated by the automated machines was reflected in the consumption trend as tobacco sales between the late nineteenth century until the end of the first World War underwent a major shift as 50% of sales were accounted now by cigarettes rather than pipe tobacco [6]. With this remarkable shift to cigarettes and the concurrent increase in smoke inhalation compared to snuffed or chewed tobacco, deaths due to lung cancer showed dramatic increases [7].” (Scott, J E)

Scott, J E The Pulmonary Surfactant: Impact of Tobacco Smoke and Related Compounds on Surfactant and Lung Development Tob Induc Dis. 2004; 2(1): 1.