Wednesday, June 1, 2016

1950: The decline of asthma cigarettes and powder

Figure 10 --
The Medihaler was introduced in 1957.
It was easy and fast acting. 
The end for asthma cigarettes was a slow process. Trying to convince elderly asthmatics who had benefited by inhaling medicated smoke for years that there were better options was not easy.

Even as better products were introduced to the market, asthmatics didn't want to give up something that worked for them. It's no different than today's asthmatics fussing over the end of popular medicines like Chromolyn, epinephrine and theophylline.

Asthma cigarettes continued to be popular even after the discovery of epinephrine in 1900 and as the solutions of epinephrine and atropine became options for home use with the invention of the mass-producible electric nebulizer in the 1930s, asthmatics still lit up the powders.

Sales of asthma cigarettes and powders stayed consistent because they provided breathing relief, were less expensive than those other options, and were available without a prescription.  Plus the nebulizers available were bulky and fragile, as well as expensive. Plus, I would imagine, the hallucinogenic effect provided by smoking drugs was also nice, and perhaps even addicting.

Yet while asthma cigarettes were the preferred choice due to convenience and cost, that all changed in 1957 with the invention of the inhaler, and the release of the Medihaler-Iso and the Medihaler Epi.  These inhalers provided instant relief, were relatively inexpensive, and easily carried in pockets and purses.

As sales for asthma inhalers sales went north, sales of asthma cigarette went south.  Yet despite the decline in sales, there were still people who did not want to give up the cigarettes.  This was compounded by the fact that the cigarettes were available over the counter, while the inhaler was only available by prescription.

Yet it was all over for lovers of asthma cigarettes in 1980.  Slowly rising among the desires of mankind was the desire for recreational drugs.  There had already been efforts to clean up the streets of drugs such as marijuana and cocaine, and since those drugs were difficult to come by, kids would often result to purchasing asthma cigarettes.  Yet they did not purchase them because they had asthma, but because they wanted to get high. (9)

So studies were conducted to confirm whether or not asthma cigarettes really worked, and whether they should be taken off the shelves for good.

It must be noted here that there were many other options for asthma, most of them far better than inhaling smoke.  There were medicines such as alupent and albuterol as fast acting relief medicines, and theophylline and beclomethasone as asthma preventative medicines.

Plus there was atropine, sold in large brown bottles to keep the sun from spoiling the product.  It was stored in the refrigerator to prevent the contents from breaking down.  It was drawn up by syringe, about 0.5cc, and mixed with 0.3cc of normal saline in a nebulizer, and inhaled.

There was also another new product recently added to pharmacy shelves, and this was the synthetic version of atropine called ipatropium bromide (Atrovent).  It was available either as an inhaler or solution, and was much easier and much safer to inhale than any asthma cigarette.

Since atropine provided the same relief as asthma cigarettes, minus the hallucinogenic effect, there really was no further need for over-the-counter asthma cigarettes.

H.L. Elliot and J.L. Reid described in a 1980 article published in the British Journal of Clinical Pharmacy a study that concluded asthma cigarettes made of "herbal preparations containing Atropine-like alkaloids" were just as effective as using ipatropium bromide (Atrovent).

Dr. R. Schiffman's Asthma powder (3)
The researchers concluded that "an overdose of asthma cigarettes is manifestly capable of producing pharmacological effects (hallucinations, delerium, tachycardia)."

They also concluded that the dose of inhaled medication from cigarettes getting to the lungs was "variable and unpredictable."

Likewise, they noted that "In view of increasing evidence of abuse, there appears to be good reason to restrict availability of these preparations. Although a herbal cigarette might possibly be recommended for the asthmatic who insists on continuing to smoke," a majority of asthmatics would get just as much benefit with fewer side effects by using their Atrovent inhaler. (10) By 1985 asthma cigarettes were removed from the shelves of all U.S. Stores.  Yet while being generally extinct in western nations, they are still available in some third world nations.

  1. Jackson, Mark, "Asthma: The Biography," 
  2. H.L. Elliot and J.L. Reid, "The Clinical Pharmacology of a Herbal Asthma Cigarette"British Journal of Clinical Pharmacy (1980, 10, 480-490) 
  3. Picture used with permission from
  4. Jackson, Mark, "'Divine Stramonium': The Rise and Fall of Smoking for Asthma,"  Med Hist., 2010 April; 54(2): 171–194.
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