Marijuana is legally available in 17 states for medicinal use and in 24 states for medical and recreational use. Its medicinal and recreational use is still illegal under federal law, but that is changing soon. Under the “Schedule” of drugs with restricted use drawn up by the federal government, marijuana is a “Schedule 1” entity, thereby identifying it as an addicting or abused drug along with heroin, fentanyl, mescaline, peyote, and lysergic acid diethylamide (LSD). The restrictions placed on the manufacture (or cultivation), distribution, and use of these drugs and organic materials (e.g., marijuana, peyote, mescaline, etc.) was allegedly motivated by scientific evidence that they were generally harmful and had no valid medical applications.
The inclusion of marijuana in this forbidden class has long been controversial, and many familiar with its history in the United States have insisted that its listing as a Schedule 1 entity had racial and economic, rather than medical or scientific, bases. Unlike alcohol and tobacco, unequivocally addicting and toxic materials, marijuana was early on viewed as a euphoria-inducing agent favored by black and Latino unskilled laborers. Prejudices targeting these minority groups extended beyond restricting their economic opportunities and included bans on their housing options, educational facilities, and drug choices. Marijuana was an early and obvious area for concern because of its appeal outside the minority communities with which it was most commonly associated. Additionally, it posed a threat to the multibillion dollar tobacco industry. For decades, tobacco lobbyists would vilify marijuana and extol the virtues of tobacco.
The federal government is expected to reclassify marijuana and chemicals derived from it as Schedule 3 entities. This means that it will be available throughout the United States with a prescription issued by an authorized medical provider, even in states that have not already passed laws legalizing it for medical or recreational use. Those lobbying for its decriminalization have argued that it is not addicting; it improves the appetite in people with progressive weight loss, such as those with anorexia and AIDS; it helps manage chronic pain; and it relieves anxiety, depression, and a variety of other psychological problems that have been unresponsive to conventional medicines.
The principal argument over the past half-century for restricting access to marijuana was that its legalization would merely add another mind-altering, euphoria-inducing, easily-abused material to that already available to the general public. There was also a widespread prejudice that marijuana was responsible for ‘antisocial behavior,’ and access to this material could undermine the morality of vulnerable ‘white youths.’ This prejudice was fleshed out in the infamous 1936 movie/public service announcement entitled Reefer Madness in which young, white men and women who had smoked even one marijuana cigarette [aka, reefer] were abruptly addicted and committed a variety of horrendous acts, including rape, murder, and suicide. Men and women smoking these ‘joints’ became licentious, hyperactive, irrational, and delusional.
In contrast to the behaviors claimed to develop with marijuana use, tobacco use was generally depicted at the beginning of the twentieth century as not only benign, but actually a sign of maturity and sophistication. Actors were encouraged or paid to smoke tobacco on camera. Cigarette companies sponsored popular television shows and educated consumers to the alleged health benefits of smoking tobacco. Desi Arnaz of “I Love Lucy” fame appeared as a chain smoker in the television series at the insistence of his sponsors and learned ‘the hard way’ that cigarette smoking causes cancer, lung cancer causing his death when he was 69. Humphrey Bogart was a chain smoker on and off the screen and died of throat cancer at 57. Actresses in the 1930s and 1940s were also encouraged to smoke tobacco to help manage their weight. Studio executives favored slightly built women with ‘wasp’ waists. The widespread adoption of cigarette smoking by women lagged about a decade behind that of men in the general population. This was reflected in a decline in lung cancer deaths in women that lagged a decade behind the decline in men’s lung cancer deaths once the government started spreading the alarm that tobacco smoking killed people.
There was longstanding evidence that tobacco was a toxic material, but there was also a well-funded and longstanding tobacco lobby directing state and federal lawmakers to ignore the health impact of smoking and chewing tobacco. The cigarette industry funded bogus studies that invariably, but inaccurately, concluded that cigarettes and other tobacco products caused no harm. Marijuana was depicted as an addicting hallucinogenic, whereas tobacco was promoted as a benign anxiolytic. People promoting and distributing tobacco made millions. Those possessing or distributing marijuana got jail time.
As a consequence of the decades-long misinformation campaigns funded by the tobacco industry, millions of Americans died or became disabled. Despite the misery knowingly inflicted by cigarette manufacturers, distributors, and advertising agencies, no one was ever held responsible for the harm inflicted on Americans.
The relaxation of laws regulating marijuana sales and use is obviously long overdue. The widespread availability of tobacco products is still a major public health problem. As the median age of Americans increases, our public health system shall be obliged to pay for the management of cancers, cardiovascular disease, chronic lung diseases, and innumerable other consequences of the highly lucrative campaigns of past years to promote tobacco use. The cost to the tobacco industry has been negligible.
Although the production of tobacco in the United States over the past twenty years has dropped by nearly 50 percent, this is primarily because production has shifted overseas to less costly venues, including China. Nonetheless, more than 260 million pounds of tobacco were produced in North Carolina alone during 2023. The production and distribution of this toxic material continues unrestricted. Perhaps the government officials responsible for overseeing the public health are still being distracted by the largesse funneled to them from tobacco profits. Perhaps they have difficulty seeing the problems posed by the widespread use of tobacco products because they are spending too much time in those legendary ‘smoke-filled backrooms’ where national policy is crafted out of the view of their constituents.
Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan. He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the U.S., as well as in England, Germany, and France.
