The Structure of the Report
Since the inaugural meeting in March 1994, the Committee has received a number of presentations on issues relevant to tobacco and health, has considered contemporary publications, and has reviewed DH commissioned studies. In general, the Committee met four times a year.
The Report opens with key messages, to which members wish to give particular prominence. The key messages are followed by the Committee's conclusions and recommendations, for each individual part of the report, which are drawn together for ease of reference.
The main body of the Report begins with a global view of the scale of the smoking problem (Part One). In this section the evolving tobacco epidemic in less developed countries is contrasted with that of the developed world. The situation in the United Kingdom is described. The section considers nicotine addiction and finishes with a brief overview of smoking-related diseases and their attributable risks.
The main topic under consideration by SCOTH has been the health effects of exposure of non-smokers to environmental tobacco smoke (ETS), in particular the evaluation of possible increased risks of lung cancer, ischaemic heart disease, and respiratory and other diseases in childhood. The Committee considered new overviews in these three areas, commissioned by DH, and also received papers on ETS and lung cancer from the Tobacco Manufacturers' Association. The Committee was assisted in their deliberations on ETS and lung cancer by a statement from the Committee on Carcinogenicity of Chemicals in Food, Consumer Products and the Environment (CoC). Part Two of the report addresses these topics.
Part Three of the report examines general aspects of the influence of price and promotion on tobacco consumption. Given the concern about the increasing prevalence of smoking in young people, the Committee considered DH commissioned work on factors relevant to adolescent smoking and heard presentations on the effect of advertising on young people. This aspect is dealt with in Part Four.
The important area of smoking cessation and the role of nicotine replacement therapy is considered in Part Five.
Miscellaneous topics are described in Part Six of the report, which includes the effect of smoking on performance and mood, smoking in pregnancy and congenital defects, oral cancer and periodontal disease, and diseases with a lower risk in smokers.
At each meeting the Committee was updated on the activities of the Technical Advisory Group (TAG), mentioned in Part Seven of the report, which also deals with the routine and research programme of the Laboratory of the Government Chemist (LGC). The specific work of the TAG to review emissions from cigarette smoke is included in Part Seven.
Part Eight explains the revised Voluntary Agreement for the approval of new additives to tobacco products.
Part Nine takes a brief look at areas of interest which require more research or in which new developments are to be expected.
Separate annexes (Annexes A-G) at the end of the report include information on the previous Independent Scientific Committee on Smoking and Health (ISCSH), and the Terms of Reference and Membership of SCOTH and TAG.
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