Loading
After following 34,439 male doctors for 50 years, lifelong smokers died on average about 10 years earlier than never-smokers, and stopping at 60, 50, 40 or 30 recovered about 3, 6, 9 or the full 10 years.
The British Doctors Study began in 1951 with questionnaires to male doctors and followed them for mortality until 2001, with periodic resurveys of smoking habits. This 50-year report used the full cohort of 34,439 men.
Men born around 1920 who continued to smoke had about twice the death rate in middle age of never-smokers and lost about 10 years of life expectancy. The excess was largest for lung cancer, chronic obstructive lung disease and vascular disease. Cessation at age 60, 50, 40 or 30 gained about 3, 6, 9 or 10 years of life expectancy respectively.
The study, together with the 1954 and 1956 reports, was the foundation of tobacco control worldwide.
Smoking is the single largest preventable cause of cancer death, and quitting at any age helps, with the greatest gain from quitting young. Cessation support belongs in every cancer service, including lung screening programmes.
The single most quotable number in tobacco control: quitting at 30 avoids almost all the risk, quitting at 50 avoids half of it, and it is never not worth stopping. It is also the argument for putting cessation support inside a lung screening appointment rather than beside it.
The methodological ancestor of modern cancer epidemiology. Cohort design, exposure recorded before outcome, and a dose-response relationship measured rather than asserted: this is the template every later study of a cancer risk factor follows.
Doll and Hill's 1950 study is where the evidence that smoking causes cancer begins. Everything from cigarette warnings and tax to smoke-free laws and lung screening eligibility descends from this study and the cohort that followed it.
Shares The mortality of doctors in relation to their smoking habits; a preliminary report, Doll and Hill 1950: the case-control study that tied smoking to lung cancer, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Prevention we already have is not deployed.
Shares Every lung screening visit includes stop-smoking medicine, opt-out, Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies, Prevention we already have is not deployed, Oesophageal cancer.
Shares Doll and Hill 1950: the case-control study that tied smoking to lung cancer, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Prevention we already have is not deployed, Non-small-cell lung cancer.
Shares Smoke-free generation laws with a built-in evaluation across countries, Prevention we already have is not deployed, Oesophageal cancer, Head and neck squamous cell carcinoma.
Shares BMJ, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Lung cancer (all types), Non-small-cell lung cancer.
Shares Incentives reward me-too drugs and marginal gains, Prevention we already have is not deployed, Oesophageal cancer, Head and neck squamous cell carcinoma.
Shares Prevention we already have is not deployed, Oesophageal cancer, Bladder & urothelial cancer, Head and neck squamous cell carcinoma.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Small-cell lung cancer, Lung cancer (all types), Non-small-cell lung cancer.