The rise and fall of tobacco as a botanical medicine.

• European herbalists and physicians of the 16th century were instrumental in promoting the use and world-wide spread of tobacco as a botanical medicine. • Initial opposition to the excessive use of tobacco was based on the concept that patients continued to use it long after the ailment was cured. Continuous use of tobacco simply for the pleasure of smoking was considered immoral, and provided the first wave of opposition to tobacco, especially by Puritans in England and America. • Over time, skepticism on the value of tobacco as a universal remedy was transformed into the contemporary medical opinion that chronic use is deleterious to health. • Scholars and biomedical researchers studying botanical medications should learn from the history of tobacco the importance of distinguishing true medical benefits from abuse. A forgotten and valuable chapter in the history of tobacco concerns its role as a botanical medicine. For three hundred years following its importation into Europe, tobacco came to be considered a universal remedy highly prescribed by physicians. In the early history of tobacco, the literature on its medicinal benefits was voluminous. Nonetheless, bitter opposition to its use for non-medicinal purposes began to arise. There was little doubt of its medicinal efficacy at first, but with time, as the concepts and practice of medicine changed, the tide of medical opinion turned against it. Medical support for the therapeutic use of tobacco reached its nadir during the mid-nineteenth century, when it was dropped from most medical pharmacoepiae. Medical opinion on the health hazards of recreational smoking required another 100 years to arrive at the contemporary opinion that cigarette smoking is the single most important preventable environmental factor contributing to illness, disability and death in the U. S. [ABSTRACT FROM AUTHOR]

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