Forty fatal years: a review of the 40 years since the publication of the 1962 report of the Royal College of Physicians

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By the Royal College of Physicians and ASH

This review was published in 2002.

The humble cigarette is responsible for a dozen times more deaths in the UK in the past 40 years than British casualties from World War II - over five million. This is not a cold statistic, but a human tragedy. Five million people - people who deserved better; their lives ended prematurely by complicated patterns of disease, aided and abetted by the addictive power of nicotine, social attitudes and pressures, tobacco company marketing, and finally, years of government inaction or half-hearted initiatives that failed to protect them from the consequences of smoking.

Yet it is a very different world to that of 40 years ago. No-one alive at that time can forget the fug of train carriages and buses, the unapologetic lighting up next to babies and children, the unspoken assumption accompanied by the offering of a cigarette packet. It was into this world the RCP report Smoking and health was launched, to bring to public attention the dangers of smoking and persuade the government to do something about it. It was largely based on the ground-breaking research of doctors Sir Richard Doll and Austin Bradford Hill.

There have been some successful legislative measures and government policy initiatives, but the major changes in smoking prevalence have come about as people themselves have taken onboard public health messages and advice from their own doctors, made sensible choices about their health by giving up or not starting to smoke, and as a consequence will live longer and in a more pleasant environment..


  • Foreword
  • Summary
  • Forty years ago
  • Then and now
  • The way forward
  • Letter from the RCP president, Professor Sir George Alberti, outlining recommendations that need to be implemented to establish an effective tobacco policy

The review can be downloaded as a pdf

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