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28
From the preceding table it can be seen that the age group
45 to 65 years is still the period of greatest mortality and is more
than twice that of the next age group, viz: 65 to 75 years, a category
in which the reverse would have been a more normal pattern.
In 1948, there were 28 deaths of Greenwich residents from
cancer of the lung, approximately one half of the total registered
for pulmonary tuberculosis, viz. 62. During the current year,
figures of 50 and 14 respectively have been recorded showing that
the position with regard to these two diseases has been more than
reversed. In comparison with the Borough rate of 0.56 for lung
cancer, that for London as a whole is 0.64 and for England and
Wales 0.46.
Nationally as well as locally, lecent years have shown an. exceptionally
rapid decline in the death rate of pulmonary tuberculosis
whereas that for cancer of the lung has increased, one might almost
say, correspondingly and the epidemic proportions of this disease
become more apparent each year.
In this connection, facts presented by the Medical Research
Council emphasize the hazard to life occasioned by the smoking
habit. Indeed, the Government felt the evidence so strong that in
a statement of June, 1957, the Minister of Health charged the local
health authorities with the duty of informing the public of the
risks involved in cigarette smoking. Unfortunately, smoking is a
personal habit not known to involve risk to non-smokers and
therefore the usual approach on epidemiological grounds for its
elimination can hardly be justified. It is clear, however, that Health
Authorities have a real part to play in the dissemination of information
in such a way as, on the one hand, to be easily understood
by the layman and on the other, not to increase apprehension
or alarm or to produce hypochondriases. Personal abstention by
health workers in public could be a power for good in that it would
be taken by others to be a practical demonstration of their belief.
It seems logical that education in these matters should commence
first with the young in preventing the adoption of the
"smoking" habit and then to persuade the moderates and unaddicted
to refrain. Unhappily it is a fact that juveniles find the
task of obtaining cigarettes far too easy and the risk of their age
being questioned by the police is negligible. Hence, by the age of
16 years, approximately 50% of boys and 20% of girls are already
smoking and well on the way to addiction. The hard core of heavy
smokers, however, presents a much more formidable obstacle and
it is difficult to know what practical steps can be taken to break
this pernicious habit other than a reasoned statement of the true
facts, to counteract the enormous amount of propaganda met with
in modern advertisements.