Tobacco and Tuberculosis in the Past, Present, and Future: a Bioarchaeology of People, Products, and Pathogens

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Through the lens of tobacco use, Part 1 of this fellowship demonstrates the value of Bioarchaeology for current health debates. Later, part 2 expands on this approach and explores human tuberculosis co-evolution. Tobacco, mostly commodified to generate wealth for governments and elites in the post-medieval period (16th-19th centuries), is known today to significantly alter the patterns and prevalence of socially significant diseases. Yet, tobacco use is not considered in social histories of health. This misses a chance to examine less direct dictators of health in the past, e.g. sociopolitics and commodification of tobacco, and for Bioarchaeology to contribute to one of today's most pressing public health issues.Bone constantly adapts in life, chemically and physically, reflecting consumed products, environment, and disease. Thus, research on the remains of past people reveal how changes, including new behaviours and social priorities, impact us. Part 1 of this fellowship uses skeletal remains in a comparative approach to examine how disease patterns changed after the arrival of tobacco in three different post-medieval societies. It examines important diseases of the period (tuberculosis, vitamin D deficiency, dental disease, and cancer) all known to be exacerbated by tobacco use today. By contextualising disease patterns with historical sources on tobacco use and commodification, we can assess how commodification impacted health. Additionally, in using pre-modern individuals (pre 1900s) we can begin to disentangle the role of tobacco from other modern life variables (pollution, domestic smoke, and antibiotics) in disease causation and expression.Based at the School of Archaeology and Ancient History (University of Leicester (UoL)), this project uses 900 skeletons from three regions of differing tobacco history: England, major tobacco producers and mainly pipe smoking; the Netherlands, importers of English tobacco and mainly pipe smokers; and Spain, importers and users of snuff, cigars and cigarettes. Working with the UoL's Department of Genetics and Genome Biology and the Institute of Genomics at the University of Tartu, biomolecular methods, including genetic and proteomic (proteins), will complement macroscopic methods for disease analysis (palaeopathology) to conceptualise disease patterns. A novel biomolecular approach using metabolomics will be developed with the UoL's Precision Medical Diagnostic Institute to improve detection of tobacco use and exposure in past individuals. Metabolomics is a biochemical method that studies all small molecules in a biological sample. Analysis of these molecules permits researchers to identify distinctive indicators (biomarkers) of drug use or disease in biological material, including bone and teeth. Its development and application here would be the first on archaeological bone, and sets up the foundations for research in part 2 where we aim to provide insight into changing TB dynamics. Due to tremendous public interest in archaeology, an exhibition, podcasts, and an online teaching resource will improve understandings of the role of tobacco in developing chronic diseases less well known to be exacerbated by smoking. Such initiatives are valuable in preventing the uptake of smoking, a priority for many health agencies, and improving people's life quality. An interdisciplinary working group focusing centred on archaeological remains will be formed and information disseminated through open access publication and conference presentation. Overall, in exploring how tobacco commodification altered disease in past groups, and how TB patterns change overtime, this fellowship will demonstrate Bioarchaeology's power to provide unique insights into the complex dynamics between people, cultural behaviours and health in the past, and feed into contemporary health debates of significance today.