Ninth: In the United Kingdom, where these diseases are decreasing, there has been no material increase in the use of tobacco, and the per capita consumption is less than one-third that of the United States. [Sidenote: Increase of Smoking] In 1880 the annual per capita consumption of tobacco in the United States was about 5 lbs., while in 1914 it had risen to more than 7 lbs. In the United Kingdom the per capita consumption is about 2 lbs., and there has been no material increase in recent years. The cigaret bill, in particular, has grown enormously, having more than doubled in the past five years, while there has been a slight increase in the consumption of cigars, smoking tobacco, chewing tobacco and snuff, as shown in the following table:[56] ------------------------------------------------------------------------ Fiscal | | | Tobacco, | Year | Cigars | Cigarets | Chewing and | Snuff | | | Smoking | --------+----------------+----------------+---------------+------------- 1910 | 8,213,356,504 | 7,884,748,515 | 436,608,898 | 31,969,111 1911 | 8,474,962,786 | 9,254,351,722 | 380,794,673 | 28,146,833 1912 | 8,350,119,103 | 11,239,536,803 | 393,785,146 | 30,079,482 1913 | 8,732,815,703 | 14,294,895,471 | 404,362,620 | 33,209,468 1914 | 8,707,625,230 | 16,427,086,016 | 412,505,213 | 32,766,741 |----------------+----------------+---------------+------------- Total | 42,478,879,326 | 59,100,618,527 | 2,028,056,550 | 156,171,635 ------------------------------------------------------------------------ Tenth: The poetic effusions of the lovers of the weed are no safer guide than the exaggerated and intemperate denouncements of people who have idiosyncrasies against tobacco and simply hate it. Eleventh: Those who now smoke should have a thorough physical examination to determine the condition of the heart and blood vessels. This examination should be repeated at least annually, in order to detect any adverse influence on the circulation. _REFERENCES_ [38] _The Toxic Factor in Tobacco_, The Lancet (London), 1912, I, p. 944. [39] French Department of Agriculture, Compt. Rend. Acad. de Science, CLI, p. 23. [40] Garner, W. W.: _The Relation of Nicotin to the Burning Quality of Tobacco_, U. S. Department of Agriculture, Bureau of Plant Industry, Bulletin No. 141, Sept. 30, 1909, p. 15; _A New Method for the Determination of Nicotin in Tobacco_, U. S. Department of Agriculture, Bureau of Plant Industry, Bulletin No. 102, July 6, 1907, p. 12. [41] Lehmann, K. B.: _Untersuchungen über das Tabakrauchen_, Munchen, med. Wchnschr., 1908, LV, pp. 723-25; _The Physiological Action of Tobacco Smoke_, Med. Rec., 1908, LXXIII, pp. 738, 739. [42] _The Toxic Factor in Tobacco_, The Lancet (London), 1912, II, pp. 944-947.