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Cited by 5,932Smoking Behavior and CessationGlobal Cancer Incidence and ScreeningChronic Obstructive Pulmonary Disease (COPD) Research

The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.

Mortality in relation to smoking: 40 years' observations on male British doctors

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Doll, R, Peto, R, Wheatley, K, Gray, R, Sutherland, I·1994·BMJ
DOI 10.1136/bmj.309.6959.901PMC PMC1732608
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Abstract

Objective: To assess the hazards associated with long term use of tobacco. Design: Prospective study of mortality in relation to smoking habits assessed in 1951 and again from20time to time thereafter, with causes sought of deaths20over 40 years (to 1991). Continuation of a study that was last reported after 20 years' follow up (1951-71). Subjects: 34 439 British male doctors who replied20to a postal questionnaire in 1951, of whom 10 000 had died during the first 20 years and another 10 000 have died during the second 20 years. Results - Excess mortality associated with20smoking was about twice as extreme during the second half of the study as it had been during the first half. The death rate ratios during 1971-91 (comparing continuing cigarette smokers with lifelong20non-smokers) were approximately threefold at ages 45-64 and twofold at ages 65-84. The excess mortality was chiefly from diseases that can be caused by smoking. Positive associations with smoking were confirmed for death from cancers of the mouth, oesophagus, pharynx, larynx, lung, pancreas, and bladder; from chronic obstructive pulmonary disease and other respiratory diseases; from vascular diseases; from peptic ulcer; and (perhaps because of confounding by personality and alcohol use) from cirrhosis, suicide, and poisoning. A negative association was confirmed with death20from Parkinson's disease. Those who stopped20smoking before middle age subsequently avoided almost all of the excess risk that they would otherwise have suffered, but even those who stopped smoking in middle age were subsequently at substantially less risk than those who continued to smoke. Conclusion: Results from the first 20 years of this study, and of other studies at that time, substantially20underestimated the hazards of long term use of tobacco. It now seems that about half of all regular cigarette smokers will eventually be killed by their habit.

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Research works printed but not linked: 31

  1. Doll R Hill AB . Smoking and carcinoma of the lung. Preliminary report. BMJ 1950;ii:739-48. · DOI · Paper page
  2. Wynder, 1950, Tobacco smoking as a possible etiologic factor in bronchogenic carcinoma., JAMA, 143, 329, 10.1001/jama.1950.02910390001001 · DOI
  3. Doll R Hill AB . The mortality of doctors in relation to their smoking habits. A preliminary report. BMJ 1954;i:1451-5. · DOI
  4. Doll R Hill AB . Lung cancer and other causes of death in relation to smoking. A second report on the mortality of British doctors. BMJ 1956;ii:1071-6. · DOI
  5. Doll R Hill AB . Mortality in relation to smoking: ten years' observations of British doctors. BMJ 1964;i:1399-414, 1460-7. · DOI
  6. Doll R Peto R . Mortality in relation to smoking: 20 years' observations on male British doctors. BMJ 1976;ii:1525-36. · DOI
  7. Doll, 1980, Mortality in relation to smoking: 22 years' observation on female British doctors., BMJ, 280, 967, 10.1136/bmj.280.6219.967 · DOI
  8. Peto, 1988, Randomised trial of prophylactic daily aspirin in British male doctors., BMJ, 296, 313, 10.1136/bmj.296.6618.313 · DOI
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  11. Graves, 1991, Alcohol and tobacco consumption as risk factors for Alzheimer's disease: a collaborative reanalysis of case-control studies, Int J Epidemiol, 20, S48, 10.1093/ije/20.Supplement_2.S48 · DOI
  12. Fletcher, 1969, A survey of doctors' attitudes to smoking., Br J Prev Soc Med, 23, 145
  13. Fletcher, 1977, The natural history of chronic airflow obstruction., Br Heart J, 1, 1645
  14. 1957, Medical Research Council. Tobacco smoking and cancer of the lung, BMJ, i, 1523
  15. Doll R Forman D La Vecchia C Woutersen R . Alcoholic beverages and cancers of the digestive tract and larynx. In: Verschuren PM , ed. Health issues related to alcohol consumption. Washington, DC: ILSI Press, 1993.
  16. Key T . Diet and smoking related disease: lung cancer and coronary heart disease. Journal of Tobacco-related Disease (in press).
  17. National Research Council. Health risks of randon and other internally deposited alpha-emitters. BEIR IV. Washington, DC: National Academy Press, 1988.
  18. Bosch, 1992, Risk factors for cervical cancer in Colombia and Spain., Int J Cancer, 52, 750, 10.1002/ijc.2910520514 · DOI
  19. Jarvis J . A profile of tobacco smoking. Addiction (in press).
  20. Schoenborn CA Horm J . Negative moods as correlates of smoking and heavier drinking: implications for health promotion. Advance data No 236. Rockville, MD: US Department of Health and Human Services Public Health Service, 1993. · DOI
  21. Eysenck, 1960, Smoking and personality, BMJ, i, 456
  22. Thompson, 1992, Cigarette smoking and food and nutrient intakes in relation to coronary heart disease., Nutrition Res Rev, 5, 131, 10.1079/NRR19920011 · DOI
  23. Margetts, 1993, Interactions between people's diet and their smoking habits: the dietary and nutritional survey of British adults., BMJ, 307, 1381, 10.1136/bmj.307.6916.1381 · DOI
  24. Marmot, 1991, Alcohol and cardiovascular disease: the status of the U shaped curve., BMJ, 303, 565, 10.1136/bmj.303.6802.565 · DOI
  25. Doll, 1994, Mortality in relation to comsumption of alcohol: 13 years' observations on male British doctors., BMJ, 309, 911, 10.1136/bmj.309.6959.911 · DOI
  26. 10.1016/0140-6736(92)91600-D · DOI · Paper page
  27. Baron JA Sandler RS . Cigarette smoking and cancer of the large bowel. In: Wald N Baron J , eds. Smoking and hormone related disorders. Oxford: Oxford University Press, 1990:167-80. · DOI
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  29. 10.1007/BF00053184 · DOI
  30. Peto R Lopez A Boreham J Heath C Thun M . Mortality from tobacco in developed countries, 1950-2000. Oxford: Oxford University Press, 1994.
  31. World Bank . World development report 1993. Investing in health. New York: Oxford University Press, 1993. · DOI · Paper page

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Metadata

Authors
Doll, R., Peto, R., Wheatley, K., Gray, R., & Sutherland, I.
Affiliations
University of Oxford (GB)
Corresponding author
Doll, R
ORCID
Venue
BMJ
Publisher
BMJ
Published
1994-10-08
Volume
309
Issue
6959
Pages
901-911
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.309.6959.901
PMC
PMC1732608
OpenAlex
W2100346673
Cited by
5,932
References
3
Citations by year
2026: 9 · 2025: 33 · 2024: 73 · 2023: 128 · 2022: 90 · 2021: 144 · 2020: 174 · 2019: 164 · 2018: 181 · 2017: 181 · 2016: 197 · 2015: 253 · 2014: 245 · 2013: 317 · 2012: 299
FWCI
191.96
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Keywords
smoking, mortality, tobacco use, long-term smoking, excess mortality, cancer mortality, chronic obstructive pulmonary disease, cardiovascular disease, peptic ulcer, liver cirrhosis, Parkinson's disease, smoking cessation, British doctors
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Cause of Death, Follow-Up Studies, United Kingdom, Humans, Male, Middle Aged, Mortality, Prospective Studies, Smoking, Survival Rate, Survival Analysis

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