On September 25, 1878 readers of The Times in London could have read a letter written by physician Charles R. Drysdale, proclaiming tobacco use to be “one of the most evident of all the retrograde influences of our time.” To support his claim, he highlighted symptoms experienced by those who are exposed to the poisons contained within cigarettes, including nausea, vertigo, heart palpitations, tooth staining, gum swelling, weakness, miscarriage, and in some cases even blindness.

To readers in 2025 of course this list doesn’t sound all that surprising. We’d even add to it without much thought. But in 1878, it would still be another eighty-six years until the Surgeon General of the United States released a report that came to a similar conclusion, and a shift in smoking habits began. At the time, forty-one percent of American adults smoked, tobacco companies were still using misleading ads that claimed the enthusiastic support of the medical community for their products, and people were dropping dead of lung cancer at alarming rates.

The percentage of American tobacco smokers dropped to somewhere in the neighborhood of thirty percent by the time I was a kid growing up with the pervasive odor of cigarette smoke in public spaces, much the way my children now experience second-hand marijuana smoke every time they’re in the parking lot of the grocery store. A sharp decline finally began to occur in the 2000s, and currently about eleven percent of American adults smoke (or vape) tobacco products.

Europe trended downward as well, though not nearly so quickly or dramatically, and they’ve settled out at about twenty-six percent, now 147 years after Dr. Drysdale told them all it was bad for them. He wasn’t the first person, or even physician, to express doubts about the wisdom of smoking tobacco, but like those speaking into the void ahead of him, Drysdale’s words didn’t have much impact.

Perhaps he’d have had better luck if he’d had the ability to launch a targeted social media campaign. Then he could have really grabbed people’s attention with a catchy headline, a disturbing picture, and an oh-so-clickable link offering the secrets to good health after ten minutes of scrolling through bullet-pointed promises to share the information that big pharma doesn’t want you to know, a lengthy self-promoting video, and a chance to order some supplements and sign up for a costly personalized health program.

At least I assume that must work, because I am bombarded with these kinds of pitches. All. The. Time.

The reason for this, I think, is that I have pretty thoroughly entered into a clear advertising demographic. I recently celebrated a birthday in which I went from being a forty-something-year-old woman to a slightly older forty-something-year-old woman, and as such, I am apparently exclusively interested in losing weight, sleeping better, getting rid of stubborn belly fat, reducing stress, improving posture, eliminating joint pain, increasing energy, overcoming mental fatigue, balancing gut bacteria, and abolishing foot pain. That’s the list from just one quick scroll through.

I don’t tend to click on such gimmicks, but of course, though not exclusively, I am kind of interested in those things. Because I’m a forty-something-year-old woman.

Just reading the headlines, I have come to understand that I’m supposed to walk more unless I’ve been told to walk more and if that’s the case, it’s the worse advice ever. There are certainly lists of supplements that I should be taking that all overlap with the lists of supplements I should be sure to avoid. Obviously I should not be eating sugar or flour, but also I shouldn’t be counting calories or following an elimination diet.

There are three foods every woman my age should be eating, though I don’t know what they are. There are also three foods every woman my age should never eat. I don’t know what they are, either. A few minutes a day of certain exercises will return me to the fitness levels of a much younger me. But not those exercises. Those exercises are super harmful and will definitely work against me. Also I should drink red wine and black coffee, but consume no alcohol and avoid caffeine.

It’s a confusing world out there in the sea of health information. It makes me almost understand how Dr. Drysdale’s good medical advice, at least a century before most people were ready to hear it, might not have received much notice among the noise.

There could be some social media campaigns out there right now that are pushing out sound medical advice. Maybe eighty-six years from now, someone with more medical prowess will embrace it, and the population as a whole will start to be healthier for it. Until then, I’m pretty convinced that as a forty-something-year-old woman, I probably shouldn’t smoke tobacco.