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. 1988 Jan-Feb;103(1):8–18.

Tobacco and health: a review of the history and suggestions for public health policy.

E L Wynder 1
PMCID: PMC1477945  PMID: 3124202

Abstract

The suspicion that the use of tobacco adversely affects health existed for some time before a case-control study appeared in 1950 of 684 cases of lung cancer strongly associated with cigarette smoking. This paper, a brief history, describes the background of the 1950 landmark study as well as other pertinent epidemiologic and experimental studies of the 1950s and 1960s. This body of research provided evidence for the causative association between tobacco use and lung cancer and other chronic diseases such as several other types of cancer and coronary heart disease. Despite this body of evidence, support from scientists, health professionals, and government officials on the issue of smoking and health came slowly. The scientific application of this discovery to prevent tobacco-linked diseases continues to be far more difficult than the discoveries themselves. Thus, although the low-yield cigarette has provided some assistance to smokers, smoking prevention is far more important, and greater efforts are needed to achieve cessation, particularly among women and minority groups. Beyond this approach, efforts to prevent children and young people from beginning to smoke should stress State-mandated school health education beginning in the earliest grades. The Know Your Body School Education Program, which includes an annual screening with the results entered into a personalized Health Passport starting in first grade, has demonstrated reductions in onset of smoking as well as improved health behavior in nutrition. To further reduce tobacco use, cancer prevention units staffed by health educators, behavioral scientists, and epidemiologists should practice prevention on a communitywide basis. The prevention of diseases as the ultimate aim of medicine and science can be demonstrated by the smoking and health issue that establishes that the prevention of many cancers is attainable.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BROSS I. J., CORNFIELD J., O'DONNELL W. E., WYNDER E. L. Lung cancer in women; a study of environmental factors. N Engl J Med. 1956 Dec 13;255(24):1111–1121. doi: 10.1056/NEJM195612132552401. [DOI] [PubMed] [Google Scholar]
  2. Covey L. S., Wynder E. L. Smoking habits and occupational status. J Occup Med. 1981 Aug;23(8):537–542. [PubMed] [Google Scholar]
  3. DOLL R., HILL A. B. A study of the aetiology of carcinoma of the lung. Br Med J. 1952 Dec 13;2(4797):1271–1286. doi: 10.1136/bmj.2.4797.1271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. DOLL R., HILL A. B. Lung cancer and other causes of death in relation to smoking; a second report on the mortality of British doctors. Br Med J. 1956 Nov 10;2(5001):1071–1081. doi: 10.1136/bmj.2.5001.1071. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. DOLL R., HILL A. B. Smoking and carcinoma of the lung; preliminary report. Br Med J. 1950 Sep 30;2(4682):739–748. doi: 10.1136/bmj.2.4682.739. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. DOLL R., HILL A. B. The mortality of doctors in relation to their smoking habits; a preliminary report. Br Med J. 1954 Jun 26;1(4877):1451–1455. doi: 10.1136/bmj.1.4877.1451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. GRAHAM E. A., CRONINGER A. B., WYNDER E. L. Experimental production of carcinoma with cigarette tar. IV. Successful experiments with rabbits. Cancer Res. 1957 Dec;17(11):1058–1066. [PubMed] [Google Scholar]
  8. HAMMOND E. C., HORN D. Smoking and death rates; report on forty-four months of follow-up of 187,783 men. I. Total mortality. J Am Med Assoc. 1958 Mar 8;166(10):1159–1172. doi: 10.1001/jama.1958.02990100047009. [DOI] [PubMed] [Google Scholar]
  9. Hoffmann D., Hecht S. S. Nicotine-derived N-nitrosamines and tobacco-related cancer: current status and future directions. Cancer Res. 1985 Mar;45(3):935–944. [PubMed] [Google Scholar]
  10. Howson C. P., Hiyama T., Wynder E. L. The decline in gastric cancer: epidemiology of an unplanned triumph. Epidemiol Rev. 1986;8:1–27. doi: 10.1093/oxfordjournals.epirev.a036288. [DOI] [PubMed] [Google Scholar]
  11. Kabat G. C., Dieck G. S., Wynder E. L. Bladder cancer in nonsmokers. Cancer. 1986 Jan 15;57(2):362–367. doi: 10.1002/1097-0142(19860115)57:2<362::aid-cncr2820570229>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]
  12. Kabat G. C., Wynder E. L. Determinants of quitting smoking. Am J Public Health. 1987 Oct;77(10):1301–1305. doi: 10.2105/ajph.77.10.1301. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kaufman D. W., Helmrich S. P., Rosenberg L., Miettinen O. S., Shapiro S. Nicotine and carbon monoxide content of cigarette smoke and the risk of myocardial infarction in young men. N Engl J Med. 1983 Feb 24;308(8):409–413. doi: 10.1056/NEJM198302243080801. [DOI] [PubMed] [Google Scholar]
  14. Koop C. E. The quest for a smoke-free young America by the year 2000. J Sch Health. 1986 Jan;56(1):8–9. doi: 10.1111/j.1746-1561.1986.tb05672.x. [DOI] [PubMed] [Google Scholar]
  15. LITTLE C. C. Some phases of the problem of smoking and lung cancer. N Engl J Med. 1961 Jun 15;264:1241–1245. doi: 10.1056/NEJM196106152642406. [DOI] [PubMed] [Google Scholar]
  16. Silverberg E., Lubera J. Cancer statistics, 1987. CA Cancer J Clin. 1987 Jan-Feb;37(1):2–19. doi: 10.3322/canjclin.37.1.2. [DOI] [PubMed] [Google Scholar]
  17. WYNDER E. L. An appraisal of the smoking-lung-cancer issue. N Engl J Med. 1961 Jun 15;264:1235–1240. doi: 10.1056/NEJM196106152642405. [DOI] [PubMed] [Google Scholar]
  18. WYNDER E. L., BROSS I. J. A study of etiological factors in cancer of the esophagus. Cancer. 1961 Mar-Apr;14:389–413. doi: 10.1002/1097-0142(196103/04)14:2<389::aid-cncr2820140220>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  19. WYNDER E. L., BROSS I. J., DAY E. A study of environmental factors in cancer of the larynx. Cancer. 1956 Jan-Feb;9(1):86–110. doi: 10.1002/1097-0142(195601/02)9:1<86::aid-cncr2820090108>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  20. WYNDER E. L., BROSS I. J., DAY E. Epidemiological approach to the etiology of cancer of the larynx. J Am Med Assoc. 1956 Apr 21;160(16):1384–1391. doi: 10.1001/jama.1956.02960510010003. [DOI] [PubMed] [Google Scholar]
  21. WYNDER E. L., CORNFIELD J. Cancer of the lung in physicians. N Engl J Med. 1952 Mar 12;248(11):441–444. doi: 10.1056/NEJM195303122481101. [DOI] [PubMed] [Google Scholar]
  22. WYNDER E. L., GRAHAM E. A., CRONINGER A. B. Experimental production of carcinoma with cigarette tar. Cancer Res. 1953 Dec;13(12):855–864. [PubMed] [Google Scholar]
  23. WYNDER E. L., ONDERDONK J., MANTEL N. AN EPIDEMIOLOGICAL INVESTIGATION OF CANCER OF THE BLADDER. Cancer. 1963 Nov;16:1388–1407. doi: 10.1002/1097-0142(196311)16:11<1388::aid-cncr2820161104>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  24. WYNDER E. L. Tobacco as a cause of lung cancer, with special reference to the infrequency of lung cancer among non-smokers. Pa Med J. 1954 Nov;57(11):1073–1083. [PubMed] [Google Scholar]
  25. WYNDER E. L., WRIGHT G. A study of tobacco carcinogenesis. I. The primary fractions. Cancer. 1957 Mar-Apr;10(2):255–271. doi: 10.1002/1097-0142(195703/04)10:2<255::aid-cncr2820100208>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
  26. Wynder E. L., Graham E. A. Landmark article May 27, 1950: Tobacco Smoking as a possible etiologic factor in bronchiogenic carcinoma. A study of six hundred and eighty-four proved cases. By Ernest L. Wynder and Evarts A. Graham. JAMA. 1985 May 24;253(20):2986–2994. doi: 10.1001/jama.253.20.2986. [DOI] [PubMed] [Google Scholar]
  27. Wynder E. L., Mabuchi K., Maruchi N., Fortner J. G. Epidemiology of cancer of the pancreas. J Natl Cancer Inst. 1973 Mar;50(3):645–667. doi: 10.1093/jnci/50.3.645. [DOI] [PubMed] [Google Scholar]
  28. Wynder E. L., Mabuchi K., Whitmore W. F., Jr Epidemiology of adenocarcinoma of the kidney. J Natl Cancer Inst. 1974 Dec;53(6):1619–1634. [PubMed] [Google Scholar]
  29. Wynder E. L., Stellman S. D. Comparative epidemiology of tobacco-related cancers. Cancer Res. 1977 Dec;37(12):4608–4622. [PubMed] [Google Scholar]

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