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the position with regard to these two diseases has been more than
reversed. In comparison with the Borough rate of 0.71 for lung
cancer, that for London as a whole is 0.70 and for England and
Wales 0.48.
Nationally as well as locally, recent 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.
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. Surveys undertaken in
schools in various parts of the country have elicited the information
that smoking is more common in the South of England than
the North and that, age for age, secondary modern school boys
are more likely to be smoking than grammar school boys and
further, that by the age of 16 years, approximately 50% of boys
and 20% of girls are already smoking and well on the way to
addiction.
In the field of education, an intermittent programme carried
out in Southern England among school children, inter alia, focused
attention on the lack of suitable films, posters and other visual
aids and on the need for extensive planning and preparation.
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.