View report page

74
Clearly, every effort must be made and every technique of
persuasion used to convince an individual of the futility of adopting
the smoking habit. But when we find that the Health Education
Council's annual outlay on anti-smoking campaigns amounts only
to £100,000 compared with the £52 millions spent by British
tobacco manufacturers in promoting their products, we can be
certain that success will be very limited. Undoubtedly prevention
possibilities would be considerably enhanced if greater governmental
support, unconnected with fiscal policy or political control,
were to be forthcoming. Meanwhile, for those who are irrevocably
"hooked" on smoking the advice must be:—
Smoke fewer cigarettes.
Smoke less of each cigarette.
Smoke brands with minimum nicotine and tar contents.
Inhale less.
Take fewer puffs from each cigarette.
Remove cigarette from the mouth between puffs.
Even this regimen will not eliminate the hazards associated with
smoking, a fact which poses a number of moral questions. Has a
smoker any moral right to preferential hospital treatment, medicines
or antibiotics for chest conditions over his non-smoking neighbour
who helps, financially, to provide these facilities?
Another prime cause of respiratory disability, namely, atmospheric
pollution, is being tackled by most local authorities with
resolution and, in the struggle for cleaner air, measures taken
against this environmental fouling are gradually gaining the
public's active support. Furthermore, there is evidence to show
that industry, by and large, is becoming more "welfare" minded
and, with official co-operation and guidance, is beginning to
grapple successfully with its dust and grit problems.
Over the last two decades, abandonment of surgery and collapse
therapy for B.C.G. vaccination and chemotherapy, together with
an extension of mass X-ray have led to a high degree of success
in the control of tuberculosis. Mortality rather than morbidity
rates are more reliable guides to the prevalence of tuberculosis in
the community and although, generally, both these figures are
declining some disturbing facts have been revealed by a recent
study carried out by the British Thoracic and Tuberculosis
Association into reported tuberculosis deaths. These investigations,
small perhaps in themselves, nevertheless showed that 20% of
deaths were posthumous diagnoses and 53% were cases dying
more than 3 months after discovery, the former indicating a failure
to diagnose and the latter a probable "falling short" of management
and treatment. Our previous successes in this sphere should