Scientific Committee on Tobacco and Health
Wellington House 135-155 Waterloo Road London SE1 8UG
Telephone 0171 972 2000
Sir Kenneth Calman
Chief Medical Officer
Richmond House
79 Whitehall
London
SW1A 2NS
5 February 1998
Dear Sir Kenneth
It is my privilege to present to you the report of the Scientific Committee on Tobacco and Health.
It has been an honour to chair this committee during a time of increased public and government awareness of the extent of the tobacco epidemic, the alarming global mortality caused by tobacco and the growing awareness of the dangers to non smokers from passive smoking.
This is the first major UK report since the fourth report of the previous Independent Scientific Committee on Smoking and Health chaired by Sir Peter Froggatt. Taking our lead from that report, we decided to carry out an in depth examination of the emerging science of the health effects of environmental tobacco smoke. We were greatly assisted in this examination by three important overviews of existing studies in relation to lung cancer, ischaemic heart disease and childhood respiratory diseases. Most of this work has now been published as individual papers.
Because the excess risks that we are discussing are not of great magnitude, in the region of 20-30% in the case of lung cancer, we took particular care in assessing evidence submitted to us from the Tobacco Manufacturers’ Association which drew the conclusion that there was no increased risk of lung cancer in exposed non smokers. We were grateful for the expertise of members of the Committee on Carcinogenicity of Chemicals in Food, Consumer Products and the Environment who carried out a separate overview of the relevant studies and also considered the chemical composition of environmental tobacco smoke and the evidence for the deposition of genotoxic carcinogens in the respiratory tract. The entirety of the statement which was produced by the CoC on ETS and lung cancer is attached as an annex to this report. Our careful study led us to reject the evidence of the Tobacco Manufacturers’ Association and conclude, as did the Independent Scientific Committee on Smoking and Health, that long term exposure to environmental tobacco smoke is a cause of lung cancer.
As ischaemic heart disease is much more common than lung cancer, the similar increased risk in exposed non smokers, which new papers are suggesting, is of considerable public health implication. It may be that thousands of such deaths in the UK are caused by passive smoking. The evidence of the damage to the health of infants and children is also of considerable public health significance.
Although our focus was on passive smoking, we attempted to avoid an unbalanced report by looking back at the accumulated knowledge of the major health risks of active smoking. The committee has drawn conclusions relating to the health effects of both active and passive smoking and has made recommendations based on those conclusions. However, we felt that it was vital to focus on key messages, for individuals and for government, which appear at the beginning of the report. These key messages address the topics of active smoking, passive smoking, nicotine addiction, price and marketing of tobacco products and smoking cessation.
With your consent, we sought expert opinions on advertising of tobacco products, particularly in relation to vulnerable young people. We share your concern that the prevalence of cigarette smoking is rising in schoolchildren and welcome the consensus achieved by European Health Ministers on banning tobacco advertising.
If we are to reduce the predicted mortality from tobacco related diseases, amongst our current smokers, then we feel that there should be particular focus on smoking cessation interventions by health professionals and increased utilisation of the effective nicotine medications by smokers who are motivated to stop.
It is salutary to note that one third of the cancer deaths in Britain and one sixth of deaths from other causes could be prevented by avoidance of smoking. If we are serious about improving public health then tobacco control warrants priority attention from government. Resources devoted to this area should reap substantial benefits for the current generation of smokers and for generations to come.
I would like to thank the members of my committee for their invaluable support, expertise and patience. I would also like to extend my gratitude to the medical and scientific secretariat for their hard work and enthusiasm.
Yours sincerely
Chairman
Copies to:
Sir David Carter CMO Scotland
Dr Ruth Hall CMO Wales
Dr Henrietta Campbell CMO Northern Ireland
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