Tobacco and Public Health - TCSC Indonesia

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TOBACCO IN GREAT BRITAIN
Per capita cigarette consumption
4500
4000
3500
3000
2500
2000
1500
1000
500
Tobacco consumption in men: UK 1871–1987
Cigarettes All tobacco
products
1870 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980
Fig.10.1 The different ways tobacco was used from the late nineteenth to late twentieth
century among UK males, with the rise of the cigarette around the turn of the century and
the decline of other forms of tobacco use. (The scale on the left is per capita cigarette
consumption, and on the right, kilogrammes of tobacco.) (Source: M. Jarvis from Wald and
Nicolaides-Bouman 1991.)
Like many other love affairs, Britain’s dalliance with tobacco began to sour. The
groundbreaking work of Richard Doll and Sir Austin Bradford Hill in 1950 proving the
link between smoking and lung cancer attracted professional attention but went largely
unreported in the British press. The government of the day not only failed to act to
reduce smoking, but even went out of its way to downplay the weight of evidence.
Finally, frustrated by its failure to address the problem through traditional channels,
the Royal College of Physicians of London made its first intervention in a public health
debate since 1725 when it had opposed cheap gin (RCP/ASH 2002). The publication of
Smoking and Health (1962) was a landmark event in public health in the United
Kingdom. Nine years later the RCP founded Action on Smoking and Health (ASH)
and tobacco control advocacy moved into the public arena.
Tobacco control had a big job on its hands. By the end of the twentieth century,
smoking annually caused more than 120 000 deaths in the United Kingdom of people
aged 35 and older; one in five deaths at all ages. Cigarette smoking caused 46 000
deaths from cancer, 40 000 from circulatory disease and 34 000 from respiratory disease.
Nine in ten lung cancer deaths in men and three in four in women were caused by
smoking. Smoking caused 30 per cent of all deaths from cancer. More than two in five
deaths under 65 from ischaemic heart disease and two in five from stroke were caused
by smoking. Some 14 people—nine men and five women—died every hour because of
their smoking (Callum 1998).
6
5
4
3
2
1
kg tobacco products per person