How The Cowboys' Tobacco Habits Backfired And Left Them With Hidden Diseases

You've probably seen pictures of cowboys using some kind of tobacco product. After all, tobacco and cowboys are like two peas in a pod in Western films and television series, and that's based on real-life cowboys often enjoying tobacco in many forms. Still, whether they were lighting a hand-rolled cigarette or inserting a plug of chewing tobacco, cowboys likely didn't know or care about the dangers related to tobacco usage. In fact, even though physicians in the late 19th century had an idea of the detrimental effects of smoking, they didn't dissuade blue-collar workers like cowboys from smoking regularly. Naturally, their bodies responded to tobacco the same way our bodies do today, so they suffered from various smoking-related ailments.

First up was gum disease, a progressive condition that causes the soft tissues and bone in the mouth to gradually degrade. Smokers are twice as apt to have gum disease as those who abstain from tobacco use. However, during pioneer times, cowboys didn't have a lot of doctors looking out for their mouths. On the contrary, Wild West dentists in the mid-1800s usually just pulled teeth when they became too painful instead of trying to save them. Thus, many people, including cowboys, ended up with few or no teeth as they got older.

Gum disease doesn't just cause teeth to fall out, though. It also opens the door to a decline in the body's immunity. That's why people with gum disease are more likely to be diagnosed with cardiovascular disease and diabetes, on top of having an immune system that's always working overtime. 

In the Wild West, lowered immunity could be life-threatening since contagious diseases like tuberculosis (called consumption at the time, the leading illness that led to cowboy deaths) and typhoid fever were rampant. Infamous Wild West figure and sometimes dentist Doc Holliday, who smoked a pipe voraciously, died in his mid-30s from tuberculosis.

Let's say a cowboy decided to start brushing his teeth to keep them as clean as possible between tobacco chewing and smoking a pipe. He'd probably wind up using a homemade chew stick with a fringe of carved twigs at the end. Or, he might have just shared the communal toothbrush that was available in public areas, a cowboy dental hygiene habit that would disgust us today. As you likely already know, shared toothbrushes introduce more foreign bacteria into users' mouths, which is why you should never use someone else's toothbrush.

Aside from having a gap in their grins, cowboys who smoked tobacco slowly damaged their lung function and may have faced lung cancer, although records are too scarce to support that diagnosis definitively. Regardless, many cowboys likely developed a chronic cough. To be fair, cowboys coughed for other reasons, including the dust that spewed forth on the prairie and trails. However, at the time, respiratory problems were typically due to actual health conditions such as tuberculosis. In fact, the term "lunger" was frequently used to describe someone with tuberculosis.

A final issue with constant tobacco use was one that cowboys probably never would have recognized: lowered fertility. Some studies have shown that regular male tobacco users tend to be less fertile than males who don't smoke or use chewing tobacco. Authors of a 2015 review in the World Journal of Men's Health observed that smoking has a more noticeable impact on both semen function and quality in fertile men than men who already have difficulty conceiving. Likewise, a 2025 article in Communications Biology found that although smoking-related infertility can be reversed, it still poses a major threat to a man's ability to produce viable sperm.