HISTORIANS HAVE OFTEN CAST the story of cigarettes in 20th-century America in epochal terms. Smoking, as that narrative goes, insidiously afflicted public health and life expectancy decade after decade through the 1960s, after which it was gradually banished by the light of science. The stories within this narrative are familiar: elite conspiracies against the public; the struggle for truth in science and policy; popular consumer products secretly delivering dependence and death.

We know those stories well. But in her new book, The Cigarette: A Political History, Sarah Milov tells a different story — or, more accurately, several different ones. She delivers not a singular epic, but descriptions of historical episodes that function like well-observed, interconnected short stories, each untangling a unique aspect of the tobacco industry’s embeddedness in the United States’s political economy. By the end, the clear outlines of the old epic’s heroes and villains are considerably hazier.

As with any good short story writer, Milov’s strength is her rhetorical restraint. The cigarette is the MacGuffin that unifies these tales but it remains uninterpreted in itself. The most she says in this respect is: “Tobacco forces us to strip away sentimentalities about the twentieth century.” Describing the politics of the cigarette in successive eras, she engages deeply in analyses of political economy, and yet the economy of her prose is not unlike that of Flannery O’Connor, who wrote of the short story: “A story is a way to say something that can’t be said any other way, and it takes every word in the story to say what the meaning is.”

Milov’s first story draws on the milieu of another Southern writer, Robert Penn Warren, whose first novel, Night Rider, describes the wild and violent world of early 20th-century tobacco production. Milov explains how that world was eventually tamed. For many decades, discord reigned in the growing regions of the South as farmers tried to resist the power of the American Tobacco Company, a monopoly as powerful in its sphere as Standard Oil or US Steel were in theirs. The trust was eventually busted, creating the ancestors of the tobacco companies we know today.

But, as Milov explains, tobacco farmers understood that only a “pantomime of competition” existed among the companies. Buyers dominated the market through an auction house system — prices varied wildly by the minute, farmers had almost no bargaining power, and profits were made in backroom deals. In response, the farmers organized, creating associations to withhold tobacco from the companies until producers received a fair price. Growers who didn’t get in line faced the wrath of their neighbors, though lawsuits were more common than “night riders” actually burning fields.

In the first decades of the century, writes Milov, these networks of growers became more sophisticated and genteel, allying themselves with farm bureaus, university agricultural extensions, and crusading publications like Progressive Farmer in what she calls “well-worn networks of agricultural associationalism.” These networks initially prospered before ultimately being rejected as ineffective in the 1930s by the farmers themselves. The relationships they created were nonetheless key to establishing the tobacco regime of the New Deal era — a quota system that, remarkably, lasted until 2004. Essentially, the right to grow tobacco became a new form of virtual “property” that was generated based on the acreage farmed in the 1930s. Milov shows how the establishment of these quotas was outsourced to local elites, who exhibited the racism and favoritism one might expect. The result “was not a representative farmer democracy; it was a fusion of administrative oligarchy and economic populism.”

Like other recent scholarship on racial and economic inequality, these chapters of The Cigarette do not so much emphasize the exclusion of the powerless as highlight the synthetic creation of the white middle class in the United States. The quotas were a bureaucratic artifact. And yet, over time, they came to be viewed as the patrimony of a mythical construct: the American farmer-citizen, whose image the tobacco industry and its allies consciously and assiduously massaged through the emerging art of public relations. “Farmers were instructed to think of themselves as citizens, family patriarchs, church-members, and community stewards, and not as recipients of government aid,” writes Milov. The Farm Bureau encouraged members to consider the superiority of rural virtues, but, this said, Farm Bureau members were not alone in assimilating government largesse into a sense of earned property. Indeed, at the very same time, suburban Americans likewise began to understand single-family homes, purchased with federally subsidized mortgages, as the birthright of the middle class. These same organizations militated in favor of Jim Crow and against welfare programs that would have benefited African Americans, while at the same time supporting price controls that effectively sustained a “welfare state for rural white people.” Eventually, rather than themselves doing the hard work of farming, a majority of quota owners made their money by renting their rights to others.

If the influence of tobacco discolors the New Deal, it similarly stains 20th-century foreign policy initiatives that might otherwise appear admirable. The state had already given its blessing to the tobacco industry when it included cigarettes in the standard C-ration during World War II. In the chapter “Cultivating the Grower,” Milov shows how savvy lobbyists were able to use postwar foreign policy to create overseas markets for surplus American leaf. Employing the same kind of “associational” influence they had used to help shape the New Deal, lobbyists secured federal purchases of tobacco for distribution abroad as part of the Marshall Plan and the Agricultural Trade Development and Assistance Act (later known as “Food for Peace”). Economic and political elites essentially used tobacco as a tool in the global struggle for democracy and against communism. One Virginia congressman said of war-weary Europeans, “Tobacco is something they want, and it will instill a desire to strive for the better things in life which can be obtained under freedom of initiative provided by democratic governments.” Meanwhile, economists lauded the fact that tobacco could generate tax revenue and, almost as importantly, encourage trade in dollars. In short: This American mercantilist moment is profoundly implicated in the global public health impact of tobacco.

Throughout her book, Milov seeks to remind us of when “tobacco was a normal part of American political economy.” If you want to know what the smoke-filled rooms of midcentury America were really like, this is the book to read as well. She reminds us, too, that “the Establishment,” a term once ubiquitous and just as ambiguous, included tobacco’s advocates in government.

The Cigarette changes tone and focus following the 1964 Surgeon General’s report, a key document establishing the link between smoking and cancer. (She smartly opens the book in medias res with the scene of the press conference for the report, which came out on a Saturday so as not to disrupt the stock market.) Many readers will find Milov’s treatment of the anti-smoking movement most relevant for understanding political struggles today.

Having introduced us to an America where cigarettes were a normal part of everyday life, Milov then dramatizes just how unusual were the efforts to combat tobacco. As she explains, the identity of the “nonsmoker” needed to be invented. After all, it seemed deeply counterintuitive at the time to assert opinions about what fellow citizens consumed. Today, the hazards of secondhand smoke are obvious, but not so in the 1950s. Milov shows how the political and cultural movement to protect nonsmokers in fact outpaced the science. To advance their cause, anti-smoking activists borrowed tactics from consumer advocates like Ralph Nader as well as from the countercultural movement. With names like ASH (Action on Smoking and Health) and GASP (Group Against Smoking Pollution), the founders of these groups seem pluckily heroic and even flagrantly eccentric in their zealous pursuit of public interest lawsuits and consciousness-raising sloganeering (“Thank you for not smoking!”). Milov reminds us that even removing the ashtrays from one’s home in the ’60s and ’70s was considered bold.

But the stories of The Cigarette are not told in heroic mode. Though she has an eye for charming details, Milov analyzes the tactics of grassroots groups with the practical spirit of a Saul Alinsky, explaining how they decided, for instance, to target airplanes as sites for nonsmoking campaigns. She shows how the character of anti-smoking campaigns won over white-collar women but alienated blue-collar men (along with their unions) — which brings The Cigarette to the scene of its demise: the workplace.

As Milov tells it, the tale of smoking bans in the workplace began as a dogged fight for citizens’ rights, only to end in bureaucratic policies motivated by corporate costs.

This story starts in 1975 with the remarkable ordeal of Donna Shimp, an AT&T employee with an extreme sensitivity to cigarette smoke. When the office near her home closed, Shimp was transferred to a building laden with smoke. Her efforts to increase air circulation in the office were shut down by other employees. Finally, she resorted to wearing a gas mask. A company doctor insisted Shimp be put on paid sick leave, but her leave ended up lasting months instead of days. Eventually, she was relocated to an even more distant office with fewer smokers, but her respiratory issues persisted. Furthermore, she suspected that management and the employees’ union were conspiring to get her fired. With the help of ASH, Shimp sued. In the case of Shimp v. New Jersey Bell Telephone Co., she won the right to work in a building where employees could only smoke on their lunch breaks. Examining the company’s legal strategy, Milov suspects that Bell Telephone actually wanted the court to force its hand. After all, the ruling only applied to one employee.

Regardless, individual struggles like Shimp’s set in motion events that would lead to an entirely different tactic for creating smoke-free workplaces. During her absence from work, Shimp began marshaling evidence that smoking was detrimental to companies’ profits — not just to their employees’ health. She discovered Taylorist productivity studies that convincingly showed that smokers were less efficient workers. Further, the trial revealed that Bell Telephone already understood the extent of harm that smoke could cause its equipment, and thus its bottom line. Over time, these facts proved much more persuasive than legal arguments. After the ruling, Shimp even found a new career helping other employers create smoke-free workplaces. “Where Shimp failed as precedent, Donna Shimp was determined to succeed by persuasion,” Milov writes. “She was, she realized, a perfect consultant: a source of knowledge, strategy, and inspiration for other Americans suffering through smoke at work.” Moved by the logic of scientific management, 38 percent of companies had completely banned smoking by 1990, and 68 percent had some sort of official policy regulating it. Ten years before, only 15 percent of companies had had any such policy.

Milov makes it easy to see the downsides of how our present smoke-free world came about. By the 1990s, “[w]hat has once been a novel expansion of workplace liability […] was now inside the circuitry of corporate risk analysis.” Changes in smoking policies accompanied the decline of unions, who were reluctant to give up workers’ treasured smoke breaks just as they were reluctant to condone policies rewritten outside the collective bargaining process. Companies today enjoy wide latitude to fire workers who smoke, or even to refuse employment to job candidates with smoking spouses. Inevitably, the burdens of this new regime fall on poorer Americans, who are more likely to smoke and less likely successfully to quit. As is too often the case in this country, the needs of those who don’t contribute to the bottom line are ignored.

Readers may or may not agree with Milov’s conclusion that the movement for nonsmokers’ rights, while laudable, “unwittingly catalyzed a conservative political strategy whose far-reaching effects are scarcely fathomable, and all too real.” But her politically infused tales are likely to teach any reader something new about countless aspects of American government (including, for instance, the role of Big Tobacco in creating the American Legislative Exchange Council, or the surprising anti-smoking crusade of Ronald Reagan’s surgeon general). As a work of nonfiction, The Cigarette should be considered alongside other clear-sighted takes on how politics in the United States is actually done (including such works as Marc Reisner’s Cadillac Desert or Michael Grunwald’s The New New Deal).

Ultimately, it was Milov’s style that really captured me. Her ability to deliver single sentences of incisive analysis fulfills Flannery O’Connor’s mandate for the short story, applied masterfully to describe political moments. For instance, in describing American trade representatives assessing the French market for American tobacco, she writes that they realized that “taste was political, not natural. And it was always the result of negotiation.” At the macro level, her work serves to recapture a sense of possibility in historical junctures that have already closed, thus implicitly opening a wider range of future possibilities.

In her essay “The Fiction Writer and His Country,” O’Connor reacted to critics who called for more affirmative stories of America. “Unless we are willing to accept our artists as they are, the answer to the question, ‘Who speaks for America today?’ will have to be: the advertising agencies,” she wrote.

Where the artist is still trusted, he will not be looked to for assurance. Those who believe that art proceeds from a healthy, and not from a diseased, faculty of the mind will take what he shows them as a revelation, not of what we ought to be but of what we are at a given time and under given circumstances: that is, as a limited revelation but revelation nevertheless.

The United States’s most pressing health crises today require exactly such circumstantial revelations about similar objects steeped in layers of significance: the handgun, the prescription pad, the car, and yes, the corporation. Such reflections are long overdue. For the past several decades, discourse around “American health” has devolved into a narrow debate over the mechanics of “the American health-care system” — and more often, into an even more blinkered fight over access to insurance. Yet most public health experts will agree that the greatest gains in American life expectancy in the 20th century were achieved through the demise of smoking. Today, our greatest health challenges arise from inequality and racism, which are squarely beyond the ambit of the formal health-care system. To undo these injustices, Milov shows us we will need to dig for stories with greater stakes than who gets to see the doctor and when.

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Andrew Benedict-Nelson is an author and consultant based in Gardner, Kansas.