Did you know that RCSI Library holds over one hundred and fifty years of the British Medical Journal (BMJ) in its archives? One hundred and sixty four to be precise; with holdings from 1853 to the present day.
Early BMJ Volumes at RCSI Library
As you would expect a number of groundbreaking articles have been published in the journal. In this post, RCSI Heritage Collections takes a look at a series of seminal articles published in the BMJ which helped demonstrate the link between tobacco consumption and lung cancer.
In the first half of the twentieth century, there was a massive increase in the consumption of tobacco thanks largely to modern manufacturing methods which enabled their mass production [1]. At the same time there was a sharp rise in Lung Cancer – some suspected this was a result of increased tobacco consumption while others believed it was due to improved diagnosis or air pollution [2].
A major milestone in the linking of smoking and lung cancer was the publication in the BMJ of a series of articles by Richard Doll and Austin Bradford Hill. The first of these was ‘Smoking and carcinoma of the lung: preliminary report’ which was published in 1950 . This was a case control study with 600 lung cancer cases and 600 controls;from this study Doll and Hill concluded that smoking was ‘a cause, and an important cause, of lung cancer’[3].
Doll, R. & Hill, A.B. (1950)
A much larger study was carried out by Doll and Hill soon after. In 1951 questionnaires were sent to over 34,000 male British physicians which collected details of their smoking habits and their health. This led to the publication of ‘The mortality of doctors in relation to their smoking habits: a preliminary report’ which was published in the BMJ in 1954 [4]. The report found that smokers had higher mortality rates than non smokers and there was a clear relationship between smoking and contracting lung cancer. The report also showed there were significant health benefits to giving up smoking; in fact Doll himself gave up his habit 2/3 of the way through the study [5].
Doll, R. & Hill, A.B. (1954)
A number of follow-up reports were published, the final one of which was published in the BMJ in 2004, 50 years after the original report was published. This report showed that, for men born around 1920, prolonged smoking from early adulthood resulted in death 10 years earlier than for non-smokers. However the report also found that giving up smoking at age 50 halved this risk and that giving up at age 30 almost eliminated it [6].
(Doll, R., Peto, R., Boreham, J. and Sutherland, I., 2004)
It is likely that Doll and Hill’s research, along with that of other trailblazers in the field of smoking and associated health risks, saved millions of lives. Today the health dangers of smoking are well known and just 26% of British adults smoke, down from 80% in 1954 [7].
Stay tuned for more groundbreaking medical research from our archives!
1. National Center for Chronic Disease Prevention and Health Promotion , The Health Consequences of Smoking - 50 Years of Progress: A Report of the Surgeon General. 2014: Atlanta
2. Hutchinson, E. Milestone 8 (1950) Smoking and cancer. 2006. Available from: http://www.nature.com/milestones/milecancer/full/milecancer08.html
3. Doll, R. and Hill, A.B., 1950. Smoking and carcinoma of the lung. British Medical Journal, 2(4682), p.739.
4. Doll, R. and Hill, A.B., 1954. The mortality of doctors in relation to their smoking habits. British Medical Journal, 1(4877), p.1451.
5. BBC. Sir Richard Doll: A life's research. 2004; Available from: http://news.bbc.co.uk/2/hi/health/3826939.stm
6. Doll, R., Peto, R., Boreham, J. and Sutherland, I., 2004. Mortality in relation to smoking: 50 years
observations on male British doctors. BMJ, 328(7455), p.1519.
7. BBC. Sir Richard Doll: A life's research. 2004; Available from: http://news.bbc.co.uk/2/hi/health/3826939.stm