Public health initiatives on smoking in Britain are comparable in scale to the clean water and sanitation interventions of the 19th century, a leading expert has said.
Sir Richard Peto, emeritus professor of medical statistics and epidemiology at the University of Oxford, worked with scientist Richard Doll, who discovered the link between smoking and cancer 70 years ago on Wednesday.
Peto said the current landscape regarding smoking in Britain had changed significantly since he started his career in the 1960s, when the dangers of smoking were not taken seriously.
Since then, smoking has caused the deaths of around 9 million people in Britain and is responsible for almost a fifth of new cancer cases every year.
“During the 1950s and 1960s, cigarette consumption in Britain rose at one point,” Peto said. “You see a group of four people smoking and think that on average one of the four will die before the age of seventy.”
He added that at the time it seemed as if the warnings from Peto and other researchers about the dangers of smoking had not gotten through to the public. “The general population didn’t believe it, not even lawyers and architects. Many journalists did not take tobacco seriously in the 1970s,” Peto said. “Even at the headquarters of the British Medical Research Council, there were ashtrays all over the committee rooms.”
He added: “Even in the 1990s, polls showed that half of the British population agreed that smoking couldn’t be so dangerous or the government wouldn’t allow it to be advertised.
“The 1997 elections were a turning point. Labor sought an EU-wide advertising ban, after which both major parties are serious about reducing tobacco deaths.”
According to Peto, public health interventions against smoking in Britain are of such scale that they are comparable to some of the public health interventions implemented during the Victorian era.
“Going back to the 19th century, sanitation and sewerage was one of the major public health interventions. That was an extraordinary change,” Peto said. Public health measures on smoking were “similar to the great revolutions in public health, such as in sewerage and clean water.”
Peto also made clear that public health initiatives regarding smoking must be a global effort.
“Ninety-nine percent of the world is not British. In Britain we have 6 million smokers, China about 300 million,” Peto said. “The UK has seen around 10 million tobacco-related deaths since 1950, but it is not just a British story. Globally, there were about 100 million deaths from tobacco use in the 20th century and there will be about a billion deaths this century if the world continues to smoke as it does now, with about half of young men and 10% of young women taking up smoking, and most don’t stop. .”
But prevention efforts may be hampered by the fact that tobacco-related deaths have normalized as the overall harmful effects of smoking are now well known, compared to a new disease like Covid-19.
“When we look at the coronavirus pandemic, it was new, so it became news. We had 200,000 coronavirus deaths in this country as a result of the pandemic,” Peto said. “At the same time, we have 300,000 deaths from tobacco use and no one has mentioned it because it is not news… we are desensitized to it compared to the coronavirus.”
Commenting on the significance of the anniversary since the discovery of the link between tobacco and cancer, Dr Ian Walker, Executive Director of Policy at Cancer Research UK, said: “Seventy years since scientists discovered the link between smoking and cancer, this remains the biggest cause of cancer in Britain, and the biggest cause of health inequalities. Research shows that nothing would have a greater impact on reducing the number of preventable deaths than quitting smoking.
“History shows that the number of smokers is declining as a result of government intervention. That is why it is crucial that the next government recommits to legislation to raise the age for the sale of tobacco products in the First King’s Speech. This is a unique opportunity to save lives, relieve pressure on the NHS and leave a lasting legacy.”