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35
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. Indeed, for some time,
statistics have indicated that serious illnesses and in particular lung
cancer were affecting smokers rather than non-smokers but controversy
regarding the implication of the smoking habit was widespread.
In order that physicians should be in possession of up-to-date
and relevant information to enable them to advise their patients,
the Royal College of Physicians accordingly decided in April, 1959,
to set up a committee " to report on the question of smoking and
atmospheric pollution in relation to carcinoma of the lung and other
diseases." Although the committee was asked to report on the effects
of smoking and atmospheric pollution, the preventive measures are
so dis-similar that it was decided to report separately on these
two hazards.
The committee's Report "Smoking and Health," which was
approved for publication on the 26th October, 1961, recounts the
history of tobacco smoking in Britain, emphasises recent trends,
reviews the evidence for and against the hypothesis that smoking
causes various kinds of diseases, discusses the psychological aspects
of smoking and makes recommendations as to the action which
may be required in the light of present evidence.
Notwithstanding that the Report sustains its conclusions with
what almost amounts to a surfeit of facts and figures, it is a publication
capable of being read and understood by the layman and no
attempt is made here to cover the Report in full. However, several
of the most important aspects justify inclusion and these follow in
an abbreviated form.
In dealing with diseases in relation to smoking the Report
makes particular reference to cancer of the lung and in recapitulating
and assessing the mass of evidence incriminating the cigarette
it endorses all the grave warnings which have been given by
medical authorities during the past few years. It acknowledges the
fact that during the past 45 years lung cancer in many countries has
changed from being an infrequent disease to a major cause of
death and that this increase has been most serious in men and
women in late middle age. Undoubtedly some of this increase is
due to more accurate diagnosis but the evidence indicates unquestionably
that not only is a large part of the increase real but
also that it bears a direct relationship to the rise in cigarette consumption.
It has been estimated that heavy cigarette smokers may