MORTALITY IN RELATION TO SMOKING - 20 YEARS OBSERVATIONS ON MALE BRITISH DOCTORS
MORTALITY IN RELATION TO SMOKING - 20 YEARS OBSERVATIONS ON MALE BRITISH DOCTORS
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DOI：
10.1136/bmj.2.6051.1525
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发表时间：
1976-01-01
影响因子：
--
通讯作者：
PETO, R
中科院分区：
文献类型：
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作者：
DOLL, R;PETO, R
1951年，英国医学协会向所有英国医生转发了一份关于他们吸烟习惯的调查问卷，34440名男性做出了回复。除了少数例外，所有在1951年回复的男性都被跟踪了20年。所有10072例死亡和随后吸烟习惯改变的已证实原因都被记录下来。对于70岁以下的男性，吸烟者的死亡率与终身不吸烟者的死亡率之比约为2：1，而对于70岁以上的男性，这一比例约为1-5：1。这些比率表明，如果过量的死亡率实际上是由吸烟造成的，那么所有吸烟者中有一半到三分之一会死于吸烟。为了调查情况是否如此，研究人员调查了许多不同死因与年龄和烟草消费的关系，以及戒烟的影响。吸烟在中年男性中主要由心脏病(在老年男性中相对风险较小)、肺癌、慢性阻塞性肺疾病和各种血管疾病导致。这项研究的显著特点是随访的完整性，死亡证明的准确性，以及研究人群作为一个整体在观察期间大幅减少了香烟消费的事实。结果，随着研究的进展，肺癌变得相对不那么常见，但其他癌症却不是这样，从而以一种不同寻常的方式说明了吸烟和肺癌之间的因果关系。
In 1951 the British Medical Association forwarded to all British doctors a questionnaire about their smoking habits, and 34440 men replied. With few exceptions, all men who replied in 1951 have been followed for 20 years. The certified causes of all 10 072 deaths and subsequent changes in smoking habits were recorded. The ratio of the death rate among cigarette smokers to that among lifelong non-smokers of comparable age was, for men under 70 years, about 2:1, while for men over 70 years it was about 1-5:1. These ratios suggest that between a half and a third of all cigarette smokers will die because of their smoking, if the excess death rates are actually caused by smoking. To investigate whether this is the case, the relation of many different causes of death to age and tobacco consumption were examined, as were the effects of giving up smoking. Smoking caused death chiefly by heart disease among middle-aged men (and, with a less extreme relative risk, among old men,) lung cancer, chronic obstructive lung disease, and various vascular diseases. The distinctive features of this study were the completeness of follow-up, the accuracy of death certification, and the fact that the study population as a whole reduced its cigarette consumption substantially during the period of observation. As a result lung cancer grew relatively less common as the study progressed, but other cancers did not, thus illustrating in an unusual way the causal nature of the association between smoking and lung cancer.