Smoking and lung cancer—70 long years on

Last week was the 70th anniversary of the UK government’s acceptance that smoking causes lung cancer.1 Cases of this previously rare disease had risen 10-fold since the end of the First World War, and epidemiological work by Richard Doll and Austin Bradford Hill had put the role of smoking as a cause beyond doubt.23 The health secretary Iain Macleod famously chain-smoked his way through the press conference. Macleod, considered to have coined the term nanny state to ridicule the “perishing nonsense” of speed limits on motorways, died of a heart attack at the age of 56 in 1970.4In 1954, around 80% of men and 40% of women smoked, yet the actual policy response to this newly understood risk, and other health harms due to smoking including tuberculosis, bronchitis, and blindness was, to say the least, rather muted.56 The chancellor of the exchequer commented: “We at the Treasury do not want…
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