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34
Because "causes and effects" of medical problems are seldom
precise, it is clear that propaganda has little effect on the immature
mind, and repetition of available data merely promotes monotony.
Much more is likely to be achieved by example, namely the abstaining
from smoking of parents, doctors, teachers, etc.
It would appear that, with regard to health education and
the advocacy of abstention in relation to smoking, insufficient
emphasis is laid on the rarity of lung cancer in non-smokers. As
a matter of interest I quote a diagnostic aphorism postulated by
a certain specialist in New York. It is, "when a patient is brought
to me with a lung tumour and is not a smoker, I immediately
diagnose either an adenocarcinoma or a non-malignant disease. In
five years I have been wrong only twice. There is no other
diagnostic criterion which is normally so accurate as this one and
I believe a history of smoking is extremely important, diagnostically."
To emphasise this fact I would point out that Doll and
Bradford Hill in their paper of 1952, recorded only 7 non-smokers
among 1,357 men with lung cancer and in their investigation of
this disease in the medical profession they found only one nonsmoker
in a total of 84 dying from lung cancer. Again, in a
re-examination at a Manchester hospital of 184 bronchoscopies
taken during a 2^ year period to mid 1962 for the confirmation
or otherwise of lung cancer, the smoking history of each case
was registered. Eighty-one of these cases were proved to be nonmalignant
but of the 103 diagnosed as malignant all were smokers
—99 of cigarettes and 4 of pipes. This kind of information, collated
and properly presented, should be a good basis from which
to start an effective anti-smoking campaign if given official backing
and financial support.
There is no reasonable doubt that but for the smoking habit
the number of deaths from lung cancer would be almost insignificant
but it is paradoxical that whereas a yearly total of approximately
7.000 road deaths provoke a great deal of anxiety in the
minds of the public there is almost complete complacency about the
23,000 or so lung cancer deaths.
A major argument that cancer is really due to atmospheric
pollution is palpably not true for the highest male lung cancer rate
was returned by the island of Jersey where there is no air pollution
and where no lung cancer was recorded in a non-smoker.
Basically, all that is needed is a simple act of will-power.
Vascular Lesions of Nervous System.—This class, which
includes deaths arising from Cerebral Haemorrhage, Embolism and
Thrombosis was responsible for a total of 96 deaths (45 males, 51