Some Thoughts on the British Doctors’ Study

Junican has a piece which is in part about the British Doctors’ Study, and reproduces this graph from it showing that smokers die younger than non-smokers:

BritishDoctorsStudy

He writes:

I have seen that many times. Bates uses that graph to illustrate that ‘lives lost through smoking’ is not as clear cut as that phrase suggests. What the graph illustrates is the average change in life expectancy, and not ’cause of death’. That is, smokers may die for all sorts of reasons and so might non-smokers. All sorts of factors come into the reasons for deaths. The graph does not show that smoking killed the doctors ten years before they should have died. It merely shows smoking might have been a factor in the deaths of smokers. THAT IS ALL.

Quite so. But it occurred to me today that, given that the British Doctors’ Study was conducted from 1954 to 2004, it was being conducted in a time when the war on smoking (and thus upon smokers) was gathering momentum in the UK. It didn’t all start on 1 July 2007, which was when I only really started noticing it. Smokers were almost certainly being persecuted long before that, and so it’s reasonable to suppose that they were also being fired from their jobs and evicted from their homes and refused medical treatment before that date. In fact, since the war on smokers was being conducted by doctors, it’s very likely that those doctors who continued to smoke became increasingly marginalised within the profession, refused promotions and pay rises, etc. And that it wasn’t smoking that was killing them off early, but instead the war on smokers.

For example, in the Nazi era a great many people were held in concentration camps, and in general Jews were treated worst of all. If so, then a study of concentration camp inmates (had there been any records) would have shown that Jews didn’t live as long as non-Jews. I’ve adapted the graph above to show this disparity:

BritishDoctorsStudy2

Of course, it wasn’t that being Jewish was the cause of their early deaths, but rather being persecuted for being Jewish between 1933 and 1943. So also it was perhaps not that being smokers was the cause of smokers’ early deaths, but rather being persecuted for being smokers between 1954  and 2004.

One interesting thing about the British Doctors’ Study was that the doctors were only asked once about their smoking habits, at the very start of the study, when about 87% (of those who responded) reported that they smoked. As they then died off one by one over the next 50 years, their death certificates were used to determine date and cause of death. For their future persecutors, the study would have been an invaluable source of information about which doctors were smokers (and therefore to be marginalised) and which weren’t. It would have been a bit like German doctors being asked in about 1930 whether they were Jewish or not, and then having this information used against them 5 or 10 years later.

So the British Doctors’ Study may have actually been an integral part of the war on smokers – or rather the more important war on smoking doctors -, and also a record of its success in eliminating them.

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54 Responses to Some Thoughts on the British Doctors’ Study

  1. harleyrider1978 says:

    Good incite there Frank and comparison

  2. harleyrider1978 says:

    So the British Doctors’ Study may have actually been an integral part of the war on smokers – or rather the more important war on smoking doctors -, and also a record of its success in eliminating them.

    They had to beat them into submission some how and not just on smoking but on forcibly accepting the NEW WORLD VIEW of lifestyles warfare on everyone.

    • harleyrider1978 says:

      I read about government and medical comittees in the 1950s where they started the new claims and the new view that lifestyle caused disease and not the conventional wisdom that age was the cause not lifestyles. Most of the Doctors laughed off the new claims as without merit yet the leaderships pushed aside their denials and pushed it thru as the new science and view point. Then began a war on everyone with smoking being the attack plan to use to persecute all of us by.

      • roobeedoo2 says:

        The thin end of the wedge, Harls.

        • Rose says:

          Smoking and the sea change in public health, 1945-2007

          “Today’s alliance between doctors and the government to influence individual lifestyles is a relatively recent phenomenon.
          First, it required the medical profession to abandon its culture of secrecy, based on patient confidentiality: this began with the use of television in the late 1950s.
          Second, it required the introduction into public policy of studies linking lifestyles and health risks: this began with a change in leadership at the Royal College of Physicians in the early 1960s.
          Third, it required a shift in the nature of public health from local information giving to central publicity campaigning: this began with the Cohen Report on health education in 1964, advocating a rethinking of the profession of health educators as persuaders, even salesmen.”
          http://www.historyandpolicy.org/policy-papers/papers/smoking-and-the-sea-change-in-public-health-1945-2007

    • Some French bloke says:

      the leaderships pushed aside their denials and pushed it [sc. “the new claims”] thru as the new science and view point.

      Funny that your thinking should square so nicely with that of a Marxist, although not one of the conventional, let alone the “Groucho” description – in fact the man seems to have been a bit of a wet blanket, albeit in the ‘wet-led’ or ‘heavily imbibed’ sense. Take a gander at this passage from Guy Debord’s “Comments on the Society of the Spectacle” (1988)

      – No longer is science asked to understand the world, or to improve any part of it. It is asked instead to immediately justify everything that happens….spectacular domination has cut down the vast tree of scientific knowledge in order to make itself a truncheon.

      Some other quotes from same essay (most of them resonate with what’s been said here, and elsewhere, about TC, the corruption of science, Big Pharma, etc.):

      – With the destruction of history, contemporary events themselves retreat into a remote and fabulous realm of unverifiable stories, uncheckable statistics, unlikely explanations and untenable reasoning.

      – Everyone accepts that there are inevitably little areas of secrecy reserved for specialists; as regards things in general, many believe they are in on the secret.

      – What is false creates taste, and reinforces itself by knowingly eliminating any possible reference to the authentic. And what is genuine is reconstructed as quickly as possible, to resemble the false.

      – The Mafia is not an outsider in this world; it is perfectly at home. Indeed, in the integrated spectacle it stands as the model of all advanced commercial enterprises.

      – It is hardly surprising that children should enthusiastically start their education at an early age with the Absolute Knowledge of computer science; while they are unable to read, for reading demands making judgments at every line…. Conversation is almost dead, and soon so too will be those who knew how to speak.

      https://en.wikiquote.org/wiki/Guy_Debord

      I’m hoping some active minds will eventually find a way to give the lie to this last quote’s somber prediction. Using the internet’s still largely untapped potential (which was probably hardly thinkable back in 1988) for informed discussion, they should be able to achieve just that, otherwise we’d better prepare to collectively go down in history as just a bunch of mental midgets.

      • roobeedoo2 says:

        That last statement is typically Marxist; assuming the responsibility for education is up to the State not individual parents. Personally, I’ve learnt a hell of lot from my children but fair’s fair, I did teach them to read ;)

        The problem is, I guess, education is not widely perceived as a two-way thing; it flows from teacher to pupil. And I guess that’s why the term ‘expert’ (teacher in the classroom) has been put on a pedestal. Unfortunately in some cases the term ‘expert’ has become a bust ;)

      • Frank Davis says:

        …spectacular domination has cut down the vast tree of scientific knowledge in order to make itself a truncheon.

        Wonderful! But I wouldn’t think of this as being particularly Marxist. I’d think of it as being very French.

        There seem to be quite a lot of French intellectuals who followed in the footsteps of Jean-Paul Sartre and Albert Camus. The names of Lacan and Foucault and Baudrillard come to mind, for no particular reason. Many of them wrote books of almost perfect incomprehensibility, but they also came up with memorable little gems like the one above. I tend to imagine them all with Gauloises hanging from their lips as they expounded their doctrines to their compatriots in smoky bistros.

        Guy Debord

      • Frank Davis says:

        It is hardly surprising that children should enthusiastically start their education at an early age with the Absolute Knowledge of computer science; while they are unable to read, for reading demands making judgments at every line…. Conversation is almost dead, and soon so too will be those who knew how to speak.

        I’m not sure what is meant by an “Absolute Knowledge of computer science”, but speaking as a long time computer programmer, I get the impression of most children that, while they are very skilled at playing computer games and using social media and surfing the web, they mostly know next to nothing about computer science, or even computer programming.

        I suspect that what he meant is that more and more people seem to spend their time silently poring over their ipads, texting each other. Or that is what he would have meant if he had lived to see it.

        I’d also add that writing computer programs requires making judgments at every line.

        • Some French bloke says:

          the Absolute Knowledge of computer science

          You’re right, this does not work too well as a self-contained quote, and a little more context from the original paragraph is needed:

          “… the computer’s binary language is an irresistible inducement to the continual and unreserved acceptance of what has been programmed according to the wishes of someone else and passes for the timeless source of a superior, impartial and total logic.”

          http://www.notbored.org/commentaires-old.html

          He’s in fact alluding to the limitations of the fundamentally binary logic at the heart of computer science, with respect to education or human experience at large. Which calls to mind Magnetic’s comments on how the healthist’s physicalist approach to human well-being would be insufficient, even if it were based on exact science.

  3. Tony says:

    You may be right about the Doctor’s “study” data being to persecute doctors who smoked but I doubt it was a major issue. I think there are many issues with this survey (or “study” if you wish) and I’ll try to lay out 3 of them here:

    1. In the UK, the middle classes considered cigarette smoking to be something that the working classes (and a few rebels) indulged in. It was not respectable.
    So if you wanted to compare longevity of working class versus middle class, a survey of smoking habits would be ideal. Pipe smokers would be middle class of course and I suspect that non-smokers would be too for various reasons. Smoking acting as a proxy for class in terms of upbringing and outlook. Middle class patients would not have tolerated a cigarette smoking GP and nor would the other doctors in a middle class practice.

    2. A thought experiment: Suppose everybody gave up smoking at the age of 60. What would the average age at death of a lifelong smoker be? How about a lifelong non-smoker?
    After thinking about that, you might wonder about ex-smokers. Why they didn’t do much better? Perhaps giving up smoking is bad? It would only need a slight effect to match the sort of result that Doll achieved.

    3. Another thought experiment: Suppose that (at the start of the study) smokers were, on average, several years older than never-smokers. Suppose also that everyone died at life expectancy age (for simplicity). Then consider the rise in life expectancy from around 60 years in 1951 to nearly 80 in 2004. What effect would that have on age at death for lifelong smokers etc.

    Another quick thought: A never smoker was defined as someone who had never smoked as much as 100 cigs or equivalent in their lifetime. Strikes me as a very odd group.
    Anyway, there is vastly more to say on this, I’ve barely scratched the surface. And it just shows how utterly ridiculous Doll’s claim, of 7.5 years (1994 report) lost as a direct result of smoking cigs, is (he reported 10 years in 2004). If Doll and Hill had deliberately set out to concoct (fake) evidence to persuade people that smoking was bad then they could hardly have designed a better “study”.

    • Rose says:

      If I remember correctly, talking of middle class smoking habits in the 50’s and 60’s, in the lounge of the Royal Hotel Scarborough where I was occasionally allowed to venture and before continental travel became popular, as a rule the gentlemen smoked cigars and the ladies smoked cigarettes.

      Am I right in thinking that Doll give cigar smokers a free pass?

      • mikef317 says:

        See page 112 of the 1964 Surgeon General’s report. Cigar / pipe smokers live about as long as non-smokers. They are no more likely to die of lung cancer than non-smokers.

        Another interesting fact is that people who stop smoking cigars and pipes die EARLIER than people who keep smoking – the opposite of cigarette data.

        I don’t have links, but I think the cigar / pipe anomaly was first discovered by looking deeper into Doll’s numbers. At any rate, it was found multiple times.

        Despite what Tobacco Control may say, the statistical link between smoking and lung cancer only pertains to cigarettes. Buy yourself some cigars and a pipe – there’s not much chance that you’ll die of lung cancer.

        P. S.: Luther Terry (the Surgeon General responsible for the 1964 report) smoked cigarettes. He switched to a pipe because there was no statistical relationship between that kind of smoking and lung cancer.

        • Jonathan Bagley says:

          It is possible to to buy an enhanced annuity (pension) if you are a cigarette smoker, but not if you are a pipe or cigar smoker. Back in the sixties, the official advice was fro smokers to switch from gigs to pies or cigars. My father switched to cigars at 35 and quit altogether at 50. He’s still alive at 88.

  4. waltc says:

    Erm. I too doubt that the doctors were persecuted or demoralized into an early death. I date the start –and a fairly slow start it was–of the actual war to 1988 and the first Surgeon general’s report on ets. In the U S at least that merely ushered in a demand for separate areas in restaurants. The war picked up in the wake of the EPA report, 1993, but it wasn’t until late in the 90s that we got full train and plane bans and the incremental start of workplace, bar/restaurant and outdoor bans tho even then only on a regional basis. No one was yet fired, evicted, or denied medical care till the early 2000s.

    So to tackle the doc stats one way, the subjects were born between 1900-1930. IOW when the war started they were already 58 to 88 years old and by the time it got really and truly nasty, they were 70+ to 90+. Then too they were doctors, implying to me they were financially comfortable and , by 58, for the most part married family men, not inclined to be overly affected by bar bans and, as doctors, never denied medical care. Many in fact were old enough to retire comfortably if hospital campus bans affected their work.

    If we’re going to invert the Doll stats, though, how about the theory that smoking is a form of self-medication? We know that, at least for some asthmatics, smoking provides relief and easier breathing though asthma can itself be a cause of early death. We know smoking can delay, ameliorate or possibly prevent fatal things like Parkinson’s etc. I’ve even read a few studies (not saying I give them credence) that prospective lung cancer causes smoking not the other way around. What I’m postulating is that it might be that a certain % of smokers–just enough to tilt the stats–are self-medicating for pre-existing or incipient fatal diseases and it’s the diseases, not the smoking, that causes their earlier deaths. (Presuming, of course, that the Doll stats are right.) I’m not saying I believe the theory I just proposed but just saying it has a logic.

    • Frank Davis says:

      I date the start –and a fairly slow start it was–of the actual war to 1988

      The war on smoking (and therefore on smokers) started way, way earlier than that. In both the UK and the USA it can be dated to the string of studies which were published in 1950, the Doll and Hill London Hospitals study being the largest. The main US study was by Wynder and Graham earlier that year. There were about 4 studies in total, all saying the same thing, and it spooked a lot of people into stopping smoking immediately. And then there was the US Surgeon General’s report in 1964, which gave the antismoking bandwagon a powerful kick down the road. And then in 1975 or so there was George Godber’s plan to make secondhand smoking be perceived as dangerous. And of course, as I’ve often remarked, I met my first fruitcase antismoking doctor in 1965. By 1988 smoking was already being banned in most compartments in trains and buses in the UK, and advertising was about to be banned. Since then, of course, it’s become an all-consuming out-of-control juggernaut.

      And I’m sure that smoking doctors would have been the first to feel the storm winds. Quoting Tony above:

      Middle class patients would not have tolerated a cigarette smoking GP and nor would the other doctors in a middle class practice.

      • waltc says:

        Sure, swirling bits about the dangers of smoking began in the 1950s and the ’64 report started causing smokers to voluntarily quit (and doctors may have been among the first to do so.) I’m also aware of the hazy plots to invent shs and use it to spur bans as early as 1975. But in practical terms, it took the intervening years to turn the shs myth into “fact” and use the fact to enact laws and propel propaganda that actually affected smokers’ lives. I date the first bans and smokers-are-killing-you propaganda to c. 1988. That was the end of the Mr Niceguy approach. So I stick to my schedule as to when the campaign entered the ohase if persecution and isolation.

  5. nisakiman says:

    And let us not forget that since his death, Doll has been found to have been a ‘consultant for rent’, defending what many consider to be indefensible in the chemical industry.

    It was he who, acting as an ‘expert witness’, assured the Australian government that the ailments that soldiers returning from Vietnam were suffering had nothing to do with Agent Orange, the defoliant made by Monsanto that was used liberally during the conflict. It was only after he died that it was discovered that at the time he was defending Agent Orange in Australia, he was being paid $1500 per day ‘consultancy’ fees by….yup….Monsanto.

    Which rather raises a question mark over the reliability of any of his studies in which he had a personal or pecuniary interest.

    • Rose says:

      He certainly milked his smoking study for the rest of his life. Even preventing government compensation for the Nuclear Test Veterans by suggesting their illness were due to their smoking habits. Government and big industry must have thanked their lucky stars.

      Miners win historic compensation claim
      1998
      “Six miners who suffered chronic ill health from inhaling coal dust during their work have won compensation claims against the UK Government.”
      “Mr Justice Turner awarded the six test case miners up to £10,000 each for pain, suffering and disability from emphysema and chronic bronchitis. All but one of the claims were reduced because smoking contributed to the diseases.”
      http://news.bbc.co.uk/1/hi/uk/49973.stm

      How does that work when presumably the non smoker fully compensated got the same diseases.

      “Yet Hueper knew how defence attorneys and their medical witnesses would seize upon a plaintiff’s smoking to provide a “convenient escape for the guilty industrial part to pay compensation to the victim or to his widow and orphans.”
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1381166/?page=8

      “As to ‘medical supervision . . . I shall have a Rockefeller Scholar in my department who might be used on it at little cost. A much better alternative would be Richard Doll who has been employed by the Council in the survey of peptic ulcer (sic) in industry and which is coming to an end I believe.”
      http://www.denialdelay.org.uk/prologue.htm

      Rockefeller – Standard Oil amongst many other things, how fortunate for them that Doll found it wasn’t one of their products..

      https://en.wikipedia.org/wiki/Standard_Oil

  6. margo says:

    One of the problems with this study, for me, has always been that it only picked on smoking. I remember the point being made in the late 50s that there might be underlying factors that ’caused’ both smoking and death. We have no idea about these doctors, who they were, except whether they smoked or not – as if all other things must be equal. So it’s not a study to find out cause of death, it’s a study to prove that smokers die younger. (By the way, I don’t remember smoking as being a particularly working class thing in the 50s – all sorts of people smoked, though your income probably dictated the brand – Woodbines were the cheap fags, for instance.)

    • nisakiman says:

      I would concur with that, Margo. My family was solidly middle class, and although neither of my parents smoked, many (most) in their social circle did. I remember my father always had a rather splendid cigarette box with a selection of brands to offer guests when they visited. It would have been quite impolite not to.

      Also, when I was at school, nearly all the teachers smoked. When I paid a (all too frequent, unfortunately) visit to the headmaster’s office at my grammar school for the inevitable ‘six of the best’, he chain-smoked throughout the whole sorry episode, every time. Player’s Navy Cut was his brand.

    • Frank Davis says:

      I don’t remember smoking as being a particularly working class thing either..King George VI smoked. Winston Churchill smoked. Clement Attlee smoked. Tony Benn smoked. My solidly middle class father smoked. More or less all intellectuals and artists and musicians smoked. I remember watching the Brain’s Trust on my grandfather’s home-made TV set, with people like Bertrand Russell talking for hours, shrouded in pipe smoke. The pipe was the very emblem of cool, clear thinking. It was one reason why that master fictional detective – Sherlock Holmes – was never without his pipe.

      What happened was that the middle classes got the wind up after the Surgeon General’s 1964 report, and started quitting smoking one by one. I’ve lost count of the number of people I knew who stopped smoking. I never did because, unlike them, I knew one of the antismoking doctors, and thought he was a bit round the bend. And that’s what I still think.

      • roobeedoo2 says:

        ‘My solidly middle class father smoked. More or less all intellectuals and artists and musicians smoked.

        You couldn’t just go and get the book cover, Clicky?

  7. malagabay says:

    It is very important to remember [in the words of the study] that “the hazards associated with cigarette smoking differ substantially from one birth cohort to another”.

    It is also important to observe that the study shows that the situation for “smokers” rapidly deteriorates during the 20th century [see fig 2 below].

    Subdivision of the younger participants by decade of birth (1900-1909, 1910-1919, or 1920-1929; only one was born in 1930) shows that, even among those born in the 20th century, the hazards associated with cigarette smoking differ substantially from one birth cohort to another (fig 2).

    http://static.www.bmj.com/content/bmj/328/7455/1519/F2.large.jpg?width=800&height=600

    Mortality in relation to smoking: 50 years’ observations on male British doctors
    Richard Doll, Richard Peto, Jillian Boreham and Isabelle Sutherland
    BMJ 2004;328:1519
    http://www.bmj.com/content/328/7455/1519

    At this point in the “study” it is evident that smoking became progressively more dangerous during the 20th century.

    Therefore: Why did tobacco become progressively more dangerous during the 20th century?

    The elephants in the room are World War One [which introduced chemical weapons that are carcinogenic and mutagenic – amongst many other deadly things] and World War Two [which introduced nuclear fallout which is carcinogenic and mutagenic – amongst many other deadly things]

    Tobacco consumption and War are clearly related.

    The key question is whether the long term effects of the World Wars are more deadly that smoking.

    Richard Doll clearly answered that question [although that was not his intention].

    Study the data – not the propaganda.

    See: https://malagabay.wordpress.com/2015/03/10/tobaccos-bum-rap/

    • Rose says:

      Why did tobacco become progressively more dangerous during the 20th century?

      I quite agree with you about mustard gas but to muddy the waters even further, there was a big change to curing practices after WW2, the tobacco companies started using fuel oil to cure the leaves.

      The consequences of which were discovered decades later when anti-tobacco picked up on it.

      Tobacco-specific nitrosamines

      “Before this year, virtually all the flue-cured tobacco produced in North Carolina was cured in direct-fired curing barns. A burner that burns natural or propane gas is attached to each barn. This burner heats the air in the barn, curing the tobacco.

      Tobacco was not always cured this way in North Carolina. Boyette said that before World War II wood was the preferred fuel for curing barns. A wood fire burned just outside the barn. The heat and combustion gases flowed through a flue, usually made of brick, that snaked across the floor of the barn, then rose up through the barn. Because the gases moved through the flue, the tobacco was never exposed to them. The barns were heated, and the tobacco cured, but the heat was indirect. Presumably, the tobacco from those barns contained low levels of nitrosamines.”
      http://www.cals.ncsu.edu/agcomm/magazine/winter01/back.htm

      Retrofitting Tobacco Curing Barns
      “Recent research has shown that a class of carcinogenic (cancer-causing) compounds known as tobacco specific nitrosamines (TSNAs) may be formed in flue-cured tobacco leaves during the curing process.

      These compounds are not found in green (uncured) tobacco.

      Present research suggests that TSNAs are formed through a chemical reaction between nicotine and other compounds contained in the uncured leaf and various oxides of nitrogen (NOx) found in all combustion gases, regardless of the fuel used. Eliminating NOx compounds in the curing air by using a heat exchanger system has been shown capable of reducing TSNAs to undetectable levels in cured tobacco.”

      “To receive price support for tobacco grown in 2001 and thereafter, producers must retrofit, or change, all barns used to cure the crop to operate with indirect-fired curing systems.”

      “Research during the 2000 curing season has shown that converting from direct- to indirect-fired curing can reduce levels of TSNAs in cured leaf to below detectable levels (less than 0.1 part per million).”
      http://web.archive.org/web/20070406121827/http://www.cpes.peachnet.edu/tobacco/retrofitinfo.htm

      What About Existing Diesel Burners??

      “Orginal fuel oil heat exchanger models were not solid welded and have the potential for leaking combustion gases in the curing chamber. Current models are solid welded.”
      http: //web.archive.org/web/20090303052524/http://www.cpes.peachnet.edu/tobacco/fueloil.htm

      Diesel exhausts do cause cancer, says WHO – 2012

      “Exhaust fumes from diesel engines do cause cancer, a panel of experts working for the World Health Organization says.
      It concluded that the exhausts were definitely a cause of lung cancer and may also cause tumours in the bladder.”
      http: //www.bbc.co.uk/news/health-18415532

      A lesson to us all, never store your home grown produce in the garage.

      But once again nitrosamines are not unique to tobacco.

      • harleyrider1978 says:

        Well my router died but my phone internet works and I’m like wtf to tech support. Who says well you have two big mountains between u and the towers and we don’t guarantee service in your area

        • harleyrider1978 says:

          But I did crawl out of the house and cut the whole yard today. A first in 3 months for me. Was a tad dizzy after but that went away pretty quick after all the bumps and turns. But my chest muscles didn’t hurt after turning the more steering wheel……….that’s what I was worried about pulling that apart again then being down 3-4 days for it to quit hurting.

          Now we got stomach flu and upper respiratory crud running rampant all down here 3 weeks after schools started………as usual I done got a touch of it all.

  8. Tony says:

    Just to clarify, I wasn’t saying that smoking was working class. As far as I remember, it was popular amongst all classes. However cigarettes were perceived as working class. The middle classes tending to opt for pipes (and cigars). It always seemed to me to have more than a whiff of snobbery to it.
    At least that’s my recollection but I’ve read similar views elsewhere many times.

  9. garyk30 says:

    ” What the graph illustrates is the average change in life expectancy, and not ’cause of death’”

    Doll’s study results showed that smokers, ex-smokers, never-smokers, and cigar/pipe smokers all had about an 85% chance of dying from the diseases ’caused’ by smoking.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC437139/pdf/bmj32801519.pdf

    Mortality in relation to smoking: 50 years’ observations on male
    British doctors

    Page 3
    Age standardised mortality rate per 1000 men/year

    The chart shows that never smokers had a death rate of 19.38 of which 16.2 were from the diseases ’caused’ by smoking.
    16.2/19.38 = 84%

    Ex-smokers = 85%

    current smokers = 85%

    Pipe/cigar smokers = 85%

    • Peter Rachow says:

      It’s a better idea to observe then chart on Table 4 on page 6: It says that over all decades of the study smokers had a higher risk of dying than non-smokers. Do you really think it’s a good idea trying to get data out of the study that’s not in there?

  10. slugbop007 says:

    Just found this tidbit on ETS levels in bars and restaurants that have good ventilation systems, dating from 2001:
    http://www.ncbi.nlm.nih.gov/pubmed/11754526

    • Joe L. says:

      Nice find, slugbop.

      “The results indicate that ETS component concentrations in the nonsmoking section of the facility in question were not statistically different (P < 0.05) from those measured in similar facilities where smoking is prohibited."

      So banning smoking outright accomplished what, again?

  11. garyk30 says:

    Heavy smokers and never-smokers have almost precisely the same chances of NOT dying from those diseases caused by smoking.
    Doll’s doctor mortality report.
    http://www.bmj.com/highwire/filestream/400720/field_highwire_article_pdf/0/bmj.38142.554479.AE

    The table on page 3 shows this:
    Lung cancer deaths per year.
    heavy smokers(25+/day) = 4.17/1,000 = 995.83 did not die.

    never-smokers = 0.17/1,000 = 999.83 did not die.

    999.83 divided by 995.83 = 1.004.

    Never-smokers are only 1.004 times more likely than heavy smokers, to not die from lung cancer!!!

    When you have to go to 3 decimal places to find a difference, that difference is, for all practicality, non-existent.

    Other results:
    mouth/throat cancers = 1.001 times more likely to not die.

    all other cancers = 1.002 times.

    COPD = 1.002 times.

    other respiratory = 1.002 times.

    heart attack = 1.005 times.

    stroke = 1.002 times.

    other vascular = 1.003 times.

  12. garyk30 says:

    Doll’s Doctor Study and smokers vs ex-smokers and total cancer deaths.

    Death rates per 1,000 per year

    Current smokers = 7.78 died(992.22 did not die)

    Ex-smokers = 4.66 died(995.34 did not die)

    By quitting, smokers will improve their chances of not dying from cancer by only 3/10ths of 1%.
    That is not statistically significant.

  13. junican says:

    Hi Frank,

    Doll did start asking questions about whether smokers had stopped smoking or cut down. In the 1991 report, he produced graphs showing how stopping affected life expectancy. I have produced figure 1 with great difficulty. Hope it works:

    It compares continuing smokers, non-smokers and former smokers who stopped smoking before age 35. What is very interesting is that former smokers who stopped before age 35 outlived non-smokers! They are represented by the dotted line on the graph.

    Curious, doncha think.

    • Frank Davis says:

      I believe he did go back and ask a few more questions, as it was one of the major criticisms of the study. However, since quite a few people had died by the time he did, he wouldn’t have had complete data.

  14. junican says:

    It worked! Ah, the benefit of both of being on wordpress!

  15. roobeedoo2 says:

    OT but this is an interesting split – the BBC have dropped the Met Office for it’s weather bulletins, over its phone app, apparently:

    http://www.independent.co.uk/news/uk/home-news/met-office-lost-bbc-contract-due-to-arguments-over-dumbing-down-and-their-bad-weather-app-10469783.html

  16. Peter Rachow says:

    Incredible bullshit. Your comparism between Nazis who killed millions of jews and smokers who die earlier ist disgusting. Seems that consuming nicotine causes severe brain defects. On the other hand this is another stupid conspiracy theorie which may come to people’s mind if there are no more scientific arguments.

    Needless to say that it is not importand to talk about death causes. It has been convincingly shown that the probabilty to die earlier if you are a smoker is much higher than if you are a non-smoker. Don’t care about what will kill you. Just care about when it will strike.

    • Frank Davis says:

      Your comparism between Nazis who killed millions of jews and smokers who die earlier ist disgusting.

      Why so? The Nazis set out to rid the world of Jews, and the antismokers in Tobacco Control have set out to rid the world of smokers. And both did so for the same reason: as a public health measure, a eugenic programme. Both began by imposing restrictions and exclusion zones, and moved on to firing people from their jobs, and evicting them from their homes, while conducting a public campaign of vilification and hatred against their target social group. The Nazis went further, and took their campaign to its logical. murderous conclusion. But at least the Nazis only had about 10 or 20 million people in their sights: Tobacco Control has about 1,500 million people in its crosshairs.

      • Peter Rachow says:

        Even if try to set up dozens of parallel figures it won’t work. It’s still crap you’re talking.

        Nazi ideology was based on the the principle that it was regarded appropriate to kill people. Mainly because of ETHINC (read carefully ETHNIC!) reasons.

        Nowadays nobody wants to kill smokers. For neither reason. And why should one? Smokers kill themselves. No need to take dedicated action.

        The other way round it makes sense: Anti-smoking campaigns have been launched because people should be preserved from committing suicide and to enable them drawing a sensible decision. Against smoking.

        As I said before: Smoking obviously causes distorted minds.

        BTW: Your attempt to draw certain conclusions out of Doll/Peto’s work and make your readers believe that smoking is not the big killer is ridiculous. OK, I understand: Smokers like you know that your hobby is one of the deadliest one can have. But then stop being a wimp! No need to relativization. Take it as a man! When some day the doctor will tell you about your fate just accept the fact that your suicide attemp is just going to succeed.

        • Some French bloke says:

          Smoking obviously causes distorted minds.

          Three points for your consideration:
          – Many thinkers and artist you probably admire derived at least some of their acumen and creativity from their smoking.

          – The benefits of smoking as regards neuro-degenerative disease prevention have been part of popular wisdom for very long, and most importantly, the Mass Media (and the world of “Cacademia”) have had nothing to do with that perception. Should these very probable benefits be relinquished for the sake of some bogus explanation for the rise in lung cancer prevalence throughout the 20th century?

          – I’ve been a non-smoker for most (25 years) of my adult life, then started doing some research on the merits of all those anti-smoking claims, and came to the same conclusions as many of those ‘degenerates’ who’d kept on smoking, some of whom are regular contributors to Frank’s blog. One of those conclusions being that the divisive and destructive anti-smoking movement is arguably the most horrendous scandal in the history of human thought, the Galileo episode not excluded.

        • Peter Rachow says:

          You thinkit’s a good idea trying to prevent getting Parkinson’s disease in the eighties when dying from lung cancer, emphysema, stroke or heart attack in the sixties. Dream on!

        • Frank J says:

          Fine, you believe this gunge, we don’t. We find it inadequate and pauce. As Sir Ronald Fisher said at the time the best that can be said is that more work is needed. Fisher,btw, was the the foremost statistician of his time.

          I should also add that the Royal Society of Statisticians (regarded as one of the world’s best) was bemused as to why they were never invited into Doll’s so called survey. I wonder why. Any ideas?

        • Peter Rachow says:

          Your problem is: As a smoker you know that it will kill you. Now there are two things that don’t go together: Your nicotine addiction and the awareness that it probably will kill you. So, what can lead you out of the dilemma? The way “out” is telling yourself just that science is wrong and that smoking is not responsible for lung cancer and other diseases that hit smokers much more often than non-smokers.

          And due to this you try to pick out the cherries out of the data: “Something MUST be wrong there and I will find it!”

          Nothing new, by the way. I’ve a seen lot of those “believers”. When the doctor told them about their fatal disease the building of self induced lies collapsed within a few days. It’s an experience that might be waiting for you. Think of it!

        • Frank J says:

          So, no answer, then. Epidemiology is NOT science. It is statistics and the results can vary depending upon the base information fed in and the end point chosen. Note the word ‘chosen’. This is where Doll at al failed completely and replicating a holed methodology achieves nothing but the same result, hence Fisher’s comments. Appeals to authority do nothing on sites such as this. If you cannot answer the questions then you are just rambling.

        • Peter Rachow says:

          Oh, now I see: You haven’t undergone any scientific education. Just to enlighten you: Mathematics is science. Statistics is science. Epidemiology is science, too. To end up this useless discussion: Before yo start talking about science, study, pass a graduate and then we can talk on. But I refuse talking to people about science who don’t know what I’m talking about. Thank you for your understanding. Have a nice day!

    • Some French bloke says:

      It has been convincingly shown that the probabilty to die earlier if you are a -smoker is much higher than if you are a non-smoker. Don’t care about what will kill you. Just care about when it will strike.

      If you’re ready to accept that smoking only affects the age at diagnosis, that makes you a proponent of the ‘promoter’ effect (same level of same diseases at an earlier age) as opposed to the ‘precipitator’ (higher rates at the same modal age) and ‘initiator’ effects (higher and earlier rates) – see P.R.J. Burch’s “Biology of Cancer”, p. 320. But consider these basic facts: with the same low smoking rate as the UK (about 20%), the US population has three years less life expectancy than western European countries like the UK, Italy, France and Germany, even though, if there’s a delayed effect (lag-time), US smoking rates at their highest (60% for male smoking throughout the 1950s and 60s) never reached the British level (80+%) in the same time-frame. Also note that these days, the French, e.g., are 50% more likely to smoke than the British.
      As to heart risk (the famous Framingham Study has risk factors for heart disease by the hundreds!), I know first-hand that some smokers have an increased heart-rate after smoking just one cigarette, while their friend/partner’s is unaffected even after 20 cigs. And if an increased heart rate in itself is a ‘risk’, then why exercice? This last factor is classified both as a risk and as a protective factor, depending on circumstances!
      Smoking cessation – which cannot have been a putative factor prior to the 1970s – has nothing to do with present-day life expectancies, and the logic behind these claims is too fuzzy to mention.
      If you’re still convinced by the ‘sterling’ scientific research produced by Doll/Hill/Peto and their US counterparts, please think twice before joining the ranks of those people who think they know enough to start despising or bullying others. As malagabay recommends above: “Study the data – not the propaganda”.

  17. Pingback: Hello World | Frank Davis

  18. Some French bloke says:

    @Peter Rachow
    To end up this useless discussion”

    Well if the “discussion” is ended, the exchange can still bear with an epilogue:
    You disregarded every fact we gave you, such as life expectancy figures in various countries with respect to the decades-of-life-lost-to-smoking mantra you so eagerly gobbled up and don’t seem well disposed to regurgitate for the time being. And you’ve brought us no fact that we hadn’t already weighted against other, obviously less publicized, evidence that can also be found in the very “studies” that are routinely used to bolster the anti-smoking claims, each of which studies containing inconvenient results that can easily dispose of its official conclusion. So it seems the blame for the “uselessness” of this discussion can’t be pinned on us. You’ve simply been wielding the truncheon that’s been carved out of the felled tree of scientific knowledge (see the Debord quote above) by using as your only debating points the two favorite soundbites of the deranged TC cult, “the debate is over”, being only second to “smoking kills”.

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