Over on Forces, Søren Højbjerg writes:
In 1950, the first substantial post war antismoking statistics were published. They marked the starting point of a great stampede against smoking. Until now that stampede has lasted 60 years. Although it is showing signs of decay, it has not yet run out of steam.
The pretext for the antismoking stampede was, that by ‘eliminating’ smoking, lung cancer would be ‘eliminated’. While smoking has certainly lost some of its former popularity in the ‘western’ world, lung cancer remains on the rise. In the United States, cigarette sales topped in 1981, with 636 billion cigarettes. While cigarette consumption has almost dropped to half of this figure, the same cannot be said of lung cancer. Lung cancer does not seem to mind whether people smoke or not.
Once a year the American Cancer Association publishes estimates of cancer figures. The 2010 estimates were released recently. Lets have a look at them here: Cancer Facts and Figures 2010.
I went and looked and found a list of reports running from 2005 to 2010. In 2005 there were 172,570 new cases of cancer of lung and bronchus in both sexes. In 2006 there were 174,470 new cases. In 2007 there were 213,380. In 2008 215,020. In 2009 219,440. And in 2010 222,520. The numbers were rising steadily, year by year.
Of course, that’s only over 6 years. But what was US lung cancer incidence back in 1950? I couldn’t find figures for US lung cancer incidence (maybe somebody can point me to the right place), but according to one report,
In 1950 there were 18,318 deaths from lung cancer in the United States
Since there’s only a 10 – 15% survival rate for lung cancer, that suggests that 1950 lung cancer incidence was about 20,000 in both sexes. And what that means is that over 60 years the incidence of lung cancer in the USA has risen tenfold.
However, US population has doubled over the same period from 152 million in 1950 to 308 million in 2010. So the per capita incidence of lung cancer has risen fivefold over the period. And still is rising.
So what was US smoking prevalence over the same period? According to P N Lee Statistics (web edition), US male cigarette smoking prevalence was actually steadily falling throughout this entire period.
A quick look at UK smoker prevalence (on the same site) produced figures that went back even further. These weren’t all shown on the accompanying chart, and so I’ve extended the chart back to show figures for 1928 and 1938 (pink area):
This shows a similar falling prevalence of male smoking, but over a period almost 20 years longer, and from a higher level (88% in 1928, 89% in 1938). This suggests that the 98% male prevalence of smoking in the Doll and Hill 1950 London Hospitals study (commenced in 1948) may not have been at all unusual, particularly in a large city in the immediate aftermath of WW2. It also suggests that the 87% male prevalence of smokers in the Doll and Hill British Doctors study (commenced in 1951) was not unusual either.
I don’t have any figures for UK lung cancer incidence over the period, but I believe it follows much the same pattern as the USA. CRUK provides a graph of lung cancer incidence, which they say shows male lung cancer falling from 1975 to 2005. But their actual graph appears to say exactly the opposite.
If anything, these extra figures seem to make Højbjerg’s case even stronger. In both the USA and the UK male smoking prevalence was steadily falling while lung cancer incidence was steadily rising. There doesn’t seem to be any correlation whatsoever between smoking and lung cancer. There isn’t even a ’30 year delay’.
Last word to Højbjerg:
The antismoking stampede will come to a halt one day. That day is getting ever closer. Currently, one of two factors is slanted to end it.
One factor is contraband tobacco. Cigarette smuggling has reached enormous proportions in certain areas. Contraband rates of 50 % on cigarettes and 70 % on rolling tobacco are not unusual. This will make the ‘war on drugs’ look like a sunday school picnic. It has the potential to bring to the masses’ attention that nothing useful has come out of the antismoking stampede.
The other factor is the uninterrepted rise in the number of lung cancer cases. It cannot continue unnoticed forever, that smoking cessation is not making a dent in the rise of lung cancer. At some point lung cancer will catch up with the antismoking stampede.