Volume 1
The tobacco industry and the health risks of smoking : second report / Health Committee.
- Great Britain. Parliament. House of Commons. Health Committee
- Date:
- 2000
Licence: Open Government Licence
Credit: The tobacco industry and the health risks of smoking : second report / Health Committee. Source: Wellcome Collection.
22/92 page 20
![Awareness of the health risks of smoking Active Smoking 20. Evidence on the harmful effects of tobacco has been accumulating since the end of the eighteenth century, most notably in relation to cancer.** A prize winning treatise in Germany in 1795 took as its title “Carcinoma of the lip is most frequent when people indulge in tobacco pipes”.*° The first case-control study of lung cancer was conducted by F H Miiller in Cologne in 1939 who concluded that tobacco was an important cause of lung cancer.*® By 1947 the increase in lung cancer deaths had become so pronounced in the UK that the Medical Research Council held a conference to discuss the reasons for it. Austin Hill was asked to conduct a case-control study to test whether this trend was associated with the increased consumption of cigarettes. 21. The association of smoking with vascular disease occurred rather later. In 1908 L Buerger noted that a rare form of vascular disease (subsequently called Buerger’s disease) seldom occurred in non-smokers. In 1931, F L Hoffman noted a statistical correlation between the increasing number of reports of coronary thrombosis and the increasing consumption of cigarettes.*’ In 1940, F A Willius and J Berkson examined the records of 1,000 patients with the disease at the Mayo Clinic in Rochester Minnesota and 1,000 other patients matched for sex and age and found an association of smoking with coronary thrombosis.* 22. What Sir Richard Doll describes as a “watershed” in the study of the epidemiology of smoking occurred in 1950 with the publication of a series of case control studies.*” Two major papers were published, one by Richard Doll himself in conjunction with Austin Hill and the other in the USA by E L Wynder and E A Graham. These drew attention to the risk of lung cancer: the American study concluded that “excessive and prolonged use of tobacco, especially of cigarettes, seems to be an important factor in the induction of bronchogenic cancer’; the British study argued that “cigarette smoking is a factor, and an important factor, in the production of carcinoma of the lung”.*’ In 1951 a long term study of the effects of smoking in British doctors commenced. A questionnaire on smoking habits was distributed to all doctors on the medical register and survivors have been contacted regularly since 1957. The 40 year study published in 1994 and conducted by Sir Richard Doll and Sir Richard Peto showed that 80% of non-smokers survived to age 70 and 33% to age 85, whereas only 50% of heavy smokers survived to age 70 and 8% to 85. This led the authors to conclude: “Jt now seems that about half of all regular cigarette smokers will eventually be killed by their habit”.*! 23. Between 1952 and 1960 a series of huge North American cohort studies were undertaken. These culminated in 1959 in the American Cancer Society Twenty Five State study which followed a million subjects over five years and showed that “smokers of cigarettes had a [lung cancer] death tate of 9.2 times the rate for those who had never smoked”. 24. The Royal College of Physicians Report Smoking and Health was published in 1962 to alert health professionals to the dangers of smoking. This report concluded that cigarette smoking is a cause of lung cancer and bronchitis and probably contributes to the development of coronary heart disease and other illnesses. In the USA, similar conclusions were drawn in the First Surgeon General’s Report on smoking and health in 1964. Passive smoking 25. In 1983 the Independent Scientific Committee on Smoking and Health (ISCSH) referred to several reports relating to the health risks of environmental tobacco smoke (ETS). In particular they noted findings that children exposed to tobacco smoke from their parents had an increased risk of respiratory illness and that passive smoking exacerbated symptoms in adults already hee et 0) 8 35 Ey. p.21. 36 BV. p2k. 37 By., p.22. 38 By., p.22. eaevs p.23. 40 Ey., p.23. 41 Evy p.2: 42 Ev., p.2. bs Ev., p.2.](https://iiif.wellcomecollection.org/image/b32221083_0001_0022.jp2/full/800%2C/0/default.jpg)
