Deaths from smoking: the avoidable holocaust

At the beginning of the 20th century hardly anyone smoked cigarettes. By 1948 82% of men in Britain were smoking some form of tobacco. By 2009 only 22% were. Extrapolate forwards this rate of decline and by 2031 Britain should have no male smokers. (Women are on a slightly different trajectory.)

Would that it were so simple. A meeting to mark the 50th anniversary of the Royal College of Physicians’ report Smoking and Health (BMJ 2012;344:e1676, doi:10.1136/bmj.e1676) offered three main messages on how change on this scale was achieved. Firstly, there was no single magic bullet: controls on marketing and sales, health warnings on packs, and prohibition of smoking in public places all played a part. Secondly, legislation worked much better than persuasion. And lastly, tobacco companies fought the controls every step of the way.

Yet these companies are purveyors of death on an industrial scale. In the 50 years since Smoking and Health’s publication smoking has killed six million people in the United Kingdom. It remains the country’s number one cause of premature death, responsible for killing about 100 000 people a …