PMID: 9654637Jul 9, 1998Paper

Uncovering the effects of smoking: historical perspective

Statistical Methods in Medical Research
R Doll

Abstract

Tobacco was introduced into Europe from America at the end of the fifteen century. At first used primarily for medicinal purposes it came to be burnt in pipes for pleasure on a large scale nearly 100 years later, at first in England and subsequently in Europe and throughout the world. Pipe smoking gave way to the use of tobacco as snuff and, in turn, to cigars and cigarettes at different times in different countries until cigarette smoking became the dominant form in most of the developed world between the two world wars. Societies were formed to discourage smoking at the beginning of the century in several countries, but they had little success except in Germany where they were officially supported by the government after the Nazis seized power. In retrospect it can now be seen that medical evidence of the harm done by smoking has been accumulating for 200 years, at first in relation to cancers of the lip and mouth, and then in relation to vascular disease and cancer of the lung. The evidence was generally ignored until five case-control studies relating smoking to the development of lung cancer were published in 1950. These stimulated much research, including the conduct of cohort studies, which, by the late 1950s, were begin...Continue Reading

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