Did cigarettes distributed to WWII GIs kill more men than died in battle?

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Dear Cecil: The 50th anniversary of D-Day leads me to ask a timely question. Many American men began smoking while serving in the armed forces in WWII. The Red Cross even distributed free cigarettes to the troops. Most of these men became addicted to cigarettes, smoked throughout their lives, and now many have died of smoking-related illnesses. I wonder if more men have died from smoking connected with their WWII service than died as battle casualties in that war? Bill Phillips, Seattle, Washington


Illustration by Slug Signorino

Cecil replies:

Great question, I thought when I first read this, and easy to answer. Shows you what I know. I turned first to the Straight Dope archives, but when I got there I discovered the carpenter ants had made mincemeat out of the papyrus. Next I figured I’d tap into the nation’s vast biomedical data apparatus, which consisted of calling everybody I could think of that would possibly know about this. Just to impress you with the thoroughness with which we at the Straight Dope pursue these things, I will tell you that I called the National Cancer Institute, the American Lung Association, the National Heart Lung and Blood Institute, the Veterans Administration, the American Cancer Society, the Center for Addiction and Substance Abuse at Columbia University, the National Center for Health Statistics, the Metropolitan Life Insurance Company, and the federal Office of Smoking and Health.

Result: nothing, although if I were younger and lived in the 404 area code I might have asked the woman at the OSH for a date. One researcher I spoke to did venture that smoking-related deaths among WWII vets could probably be computed, but it would take six months. Plenty fast if you’re funded by the government, I thought, but I’m on deadline.

I retired to the library to see what I could scare up with a little common sense and the World Almanac, supplemented as necessary by the medical journals. I learned that 14.9 million people served in the U.S. armed services during WWII. I then made some simplifying assumptions: (a) all 14.9 million were male (actually around 2 percent were female), and (b) they were statistically reflective of U.S. men as a whole, meaning that 51% smoked (as of 1965, anyway), 19% were former smokers, and the typical smoker had 20 or fewer cigarettes a day. I then applied an estimate from an article entitled “What Are the Odds That Smoking Will Kill You?” (Mattson et al, American Journal of Public Health, April 1987): at age 35, the chances of a moderate smoker (fewer than 25 cigarettes a day) dying of a smoking-related disease by age 65 are 8.7 percent; for a former smoker, 4.2 percent. The youngest WWII vets today are past retirement age, so if Mattson and friends are right, smoking to date has killed at least 780,000. Total U.S. battle deaths during WWII: 292,131.

You realize that from the standpoint of statistical reliability, the preceding is about one jump ahead of a Ouija board and in all likelihood greatly understates the actual smoking-related death toll. (Cecil offers this caveat after having consulted further with the National Cancer Institute.) Individual daily smoking consumption is probably higher than reported in surveys; what’s more, smoking-related deaths climb sharply after age 65. One study (Peto et al, Lancet, May 1992) suggests that a staggering 20 percent of all deaths in developed countries are attributable to tobacco. Applying this to WWII vets, we come up with nearly three million smoking deaths, ten times the number of combat deaths. But that number is still low, since men smoke more than the population as a whole. So take a stab — four million smoking deaths? Five million?

Sure, your skeptics will say cancer victims are older, and die when they’ve only got a few good years left under the best of circumstances, whereas soldiers are cut down in the first blush of youth. But we’re talking a difference of an order of magnitude. I say we definitely should have heavied up on the Doublemint and nixed the Lucky Strike.

Cecil Adams

Send questions to Cecil via cecil@straightdope.com.