Smoking and lung cancer notice turns fifty but 20% Britons still smoke: Report

By Dr. Ananya Mandal, MDMar 7 2012

According to health experts, it has been five decades after doctors issued their first warning about the dangers of cigarettes. Still more than 20 percent of Britons still smoke - and unless they quit, half of them will die from the habit. Smoking has killed more than six million people in Britain since 1962, when the Royal College of Physicians (RCP) published a landmark report about the health risks of tobacco.

The RCP's 1962 report on “smoking and health” was the first time senior doctors in Britain had drawn a causal link between smoking and lung cancer, as well as a host of other illnesses. Its conclusion said “cigarette smoking is a cause of lung cancer and bronchitis, and probably contributes to the development of coronary heart disease and various other less common diseases” and “the number of deaths caused by diseases associated with smoking is large.” Two years later in the United States, the Surgeon General's office issued its 1964 report also warning for the first time that “cigarette smoking is causally related to lung cancer” and that “the risk of developing lung cancer increases with duration of smoking and the number of cigarettes smoked per day.”

The new report from the RCP said smoking rates have fallen substantially in Britain the past 50 years, and at least 360,000 deaths from smoking have been prevented as people have accepted health advice and quit. Yet smoking is still the biggest avoidable killer in the UK, said the head of the RCP's tobacco advisory group John Britton, and some 10 million people are still addicted. “Smokers smoke because of an addiction to nicotine that is usually established before adulthood. There is so much more that can and should be done to prevent the death, disease and human misery that smoking causes,” he said in a statement. Unless they quit, half of all smokers will die from their habit, which the RCP said equates to a loss of one hundred million years of life in Britain.

The World Health Organization (WHO) describes smoking as “one of the biggest public health threats the world has ever faced.” It causes lung cancer, which is often fatal, and other chronic respiratory diseases and is also a major risk factor for cardiovascular diseases, the world's number one killers. The United Nations health body predicts that smoking could be killing 8 million people every year by 2030 if governments don't take more action to help people quit.

In Britain, there have been several policy changes aimed at reducing the burden of tobacco-related death and disease, including a ban on smoking in public places, a ban on tobacco advertising and sponsorship, cigarette price rises, a growth of smoking cessation services and restrictions on the sale of cigarettes to children.

At the meeting, the RCP will discuss further action for cutting the number of smokers. It believes the cost of tobacco and cigarettes should be put up, arguing that although heavily taxed, cigarettes are still 50% more affordable now than they were in 1965. Real prices are also undercut by discounting, small pack sizes and illegal supplies, it says. The RCP wants unnecessary brand images for tobacco removed from films and TV programmes watched by children and young people, and supports a move towards plain packaging for tobacco.

There has been a social change in smoking too, says Dr Penny Tinkler of the University of Manchester. “If you go back to the 60s for men, it was cross-class, and for women, it was cross-class but with particular emphasis among those who were comfortably off. It's really shifted over the decades in terms of who is smoking so now instead of being associated with affluence, it's more associated with disadvantage. In part it's because people who can afford to give up, or people who have a better quality of life, can give up. It's always been harder to give up if things have been difficult so it's not surprising those people in difficult circumstances are less inclined to give up.” Smokers, once comfortably in the majority, now find themselves on the outside.

Sir Richard Thompson, RCP president, said, “This important conference marks another milestone in the RCP's efforts to reduce unnecessary deaths and disease from smoking. I hope that in another 50 years smoking, like slavery, will have passed into history.”