控烟培训监课件精要.ppt

* * In 1951, Richard Doll and Bradford Hill initiated the now renowned prospective cohort study of British physicians. The population included 40,000 physicians, mostly men. In a 1954 report on the initial findings, Doll and Hill found that the physicians who were mild smokers were seven times more likely to die of lung cancer than non-smokers and for ‘immoderate’ smokers, the risk was 24 times greater.1 These results were published with the title ‘The Mortality of Doctors in Relation to their Smoking Habits’ in the British Medical Journal. By the late 1950s and early 1960s, the mounting evidence on the health effects of smoking received formal review and evaluation by government committees. In the United Kingdom, the 1962 report of the Royal College of Physicians concluded that smoking was a cause of lung cancer and bronchitis and a contributing factor to coronary heart disease.2 In the US, the 1964 report of the Advisory Committee to the Surgeon General concluded that smoking was a cause of lung cancer in men and of chronic bronchitis.3 The Royal College of Physicians report received massive publicity. Its main recommendations were: restrictions of tobacco advertising, increased taxation on cigarettes, more restrictions on the sale of cigarettes to children and smoking in public places, and more information on the tar and nicotine content of cigarettes. For the first time in a decade, cigarettes sales fell.4 In 1981, Professor Takeshi Hirayama published a prospective cohort study of 91,540 non-smoking Japanese women whose husbands were smokers. The non-smoking wives were followed for mortality, including lung cancer mortality, for 14 years. Risk of lung cancer was examined in relation to the level of smoking by the spouse with the finding of a statistically significant exposure-response relationship. This was the first study to assess the possible importance of passive smoking as one of the causal factors for lung cancer.5 References: 1. Doll R, Hill AB. The mo