No other plant in this atlas has undergone so complete a transformation of meaning, and the transformation is worth stating plainly because it is the reason the sacred use is now hard to see.
Tobacco reached Europe within a few decades of contact and was received first as a medicine, credited with curing a long list of complaints, and then as a luxury. Cultivation for export reshaped the economies of the Chesapeake and the Caribbean and was a principal driver of the transatlantic slave trade, since tobacco is labour intensive and the plantations were worked by enslaved people. Industrial cigarette manufacture from the late nineteenth century, using the milder Nicotiana tabacum and a cured leaf that could be inhaled deeply, produced a delivery system optimised for continuous use, and with it a global epidemic of lung disease that kills several million people a year.
Two things follow that are easy to get wrong. The first is that the sacred use is not a milder ancestor of the commercial one; it is a different plant, a different route and a different frequency, and the traditions that use it ritually are frequently strict about not using it casually. The second is that indigenous communities in North America now carry an unusually heavy burden of commercial tobacco harm, which has led many to draw an explicit distinction between traditional tobacco and the manufactured product, and to build public health work around that distinction.