Mortality in relation to smoking: 50 years' observations on male British doctors
Open accessAbstract
OBJECTIVE: To compare the hazards of cigarette smoking in men who formed their habits at different periods, and the extent of the reduction in risk when cigarette smoking is stopped at different ages. DESIGN: Prospective study that has continued from 1951 to 2001. SETTING: United Kingdom. PARTICIPANTS: 34 439 male British doctors. Information about their smoking habits was obtained in 1951, and periodically thereafter; cause specific mortality was monitored for 50 years. MAIN OUTCOME MEASURES: Overall mortality by smoking habit, considering separately men born in different periods. RESULTS: The excess mortality associated with smoking chiefly involved vascular, neoplastic, and respiratory diseases that can be caused by smoking. Men born in 1900-1930 who smoked only cigarettes and continued smoking died on average about 10 years younger than lifelong non-smokers. Cessation at age 60, 50, 40, or 30 years gained, respectively, about 3, 6, 9, or 10 years of life expectancy. The excess mortality associated with cigarette smoking was less for men born in the 19th century and was greatest for men born in the 1920s. The cigarette smoker versus non-smoker probabilities of dying in middle age (35-69) were 42% nu 24% (a twofold death rate ratio) for those born in 1900-1909, but were 43% nu 15% (a threefold death rate ratio) for those born in the 1920s. At older ages, the cigarette smoker versus non-smoker probabilities of surviving from age 70 to 90 were 10% nu 12% at the death rates of the 1950s (that is, among men born around the 1870s) but were 7% nu 33% (again a threefold death rate ratio) at the death rates of the 1990s (that is, among men born around the 1910s). CONCLUSION: A substantial progressive decrease in the mortality rates among non-smokers over the past half century (due to prevention and improved treatment of disease) has been wholly outweighed, among cigarette smokers, by a progressive increase in the smoker nu non-smoker death rate ratio due to earlier and more intensive use of cigarettes. Among the men born around 1920, prolonged cigarette smoking from early adult life tripled age specific mortality rates, but cessation at age 50 halved the hazard, and cessation at age 30 avoided almost all of it.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the study's meta-analyses of risk reduction among former smokers, cessation shifts smokers into a lower-risk category, with greater reduction in risk for longer durations since cessation.
“we found in our meta-analyses of risk reduction among former smokers that cessation shifts smokers into a lower-risk category, with greater reduction in risk for longer durations since cessation.40, 41, 42”
From Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 (2021) · cites this paper as [42]
The Mortality on stopping smoking section and the discussion on page 6 report lower mortality after cessation, with greater life-expectancy gains for men who stopped at younger ages. The source is a prospective study of male British doctors, not a meta-analysis, and it compares ages at cessation rather than directly establishing progressively greater risk reduction by duration since cessation. (LLM, conf=0.88)
Experimental — accuracy not yet measuredRelative risks of all-cause mortality from long-running cohort studies in the UK and the USA indicate that up to two-thirds of long-term smokers will eventually die of a disease attributable to smoking.
“Relative risks of all-cause mortality from long-running cohort studies in the UK41, 42 and the USA43 indicate that up to two-thirds of long-term smokers will eventually die of a disease attributable to smoking.”
The frequency or amount of a given behavior or activity is a potential objective indicator of control problems, as with frequency of alcohol consumption.
“The frequency or amount of a given behavior or activity is a potential objective indicator of control problems (eg, frequency of alcohol consumption45-47).”
From Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective (2024) · cites this paper as [47]
The Questionnaires section says the 1978 survey collected alcohol information, and Table 2 (p. 8) reports alcohol consumption in units per week. Neither passage treats consumption frequency or amount as an objective indicator of control problems; searches for that relationship found no supporting passage. (LLM, conf=0.76)
Experimental — accuracy not yet measuredQuitting smoking at age 50 reduces the risk of smoking-related death two-fold; cessation at age 30 avoids any risk; stopping at ages 60, 50, 40, or 30 years leads to gains of about three, six, nine, and ten years of survival, respectively.
“Specifically, it has been observed that quitting smoking at the age of 50 years reduces the risk of smoking-related death two-fold, and that cessation at the age of 30 years avoids any risk. In addition, stopping smoking at the age of 60, 50, 40, or 30 years has led to gains of about three years, six years, nine years, and ten years of survival, respectively [70].”
From Skeletal System Biology and Smoke Damage: From Basic Science to Medical Clinic (2021) · cites this paper as [70]
Former smokers reduce their risk to that of never-smokers over time.
“There is also evidence that former smokers reduce their risk to that of never-smokers over time [40].”
From The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors (2009) · cites this paper as [40]
After breaking the tobacco withdrawal cycle through smoking cessation, these systems recover, possibly in the same way that other systems damaged by smoking reverse after smoking cessation.
“After breaking the tobacco withdrawal cycle, through smoking cessation, these systems recover (Mamede et al., 2007), possibly in the same way that other systems damaged by smoking reverse after smoking cessation (Doll et al., 2004; Pirie et al., 2013).”
From An application of the stress-diathesis model: A review about the association between smoking tobacco, smoking cessation, and mental health (2023) · cites this paper as Doll et al., 2004
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
International Agency for Research on Cancer
National Cancer Institute (2020) · Definitions · doi:10.32388/pfg7jq · Cited by 9,493 · see citing works
The Causes of Cancer: Quantitative Estimates of Avoidable Risks of Cancer in the United States Today
Doll, R., & Peto, R. (1981) · JNCI: Journal of the National Cancer Institute · doi:10.1093/jnci/66.6.1192 · Cited by 3,927 · see citing works
Self-citationSmoking and Carcinoma of the Lung
Doll, R., & Hill, A. B. (1950) · BMJ · doi:10.1136/bmj.2.4682.739 · Cited by 1,999 · see citing works
Self-citationPeto, R., Darby, S., Deo, H., Silcocks, P., Whitley, E., & Doll, R. (2000) · British medical journal · doi:10.1136/bmj.321.7257.323 · Cited by 1,504 · see citing works
Self-citationMortality from tobacco in developed countries: indirect estimation from national vital statistics.
Peto, R., Boreham, J., Lopez, A. D., Thun, M., & Heath, C. (1992) · The Lancet · doi:10.1016/0140-6736(92)91600-d · Cited by 1,394 · see citing works
Self-citationMortality in relation to smoking: 40 years' observations on male British doctors
Doll, R., Peto, R., Wheatley, K., Gray, R., & Sutherland, I. (1994) · BMJ · doi:10.1136/bmj.309.6959.901 · Cited by 1,321 · see citing works
Self-citationMortality in relation to smoking: 20 years' observations on male British doctors.
Doll, R., & Peto, R. (1976) · BMJ · doi:10.1136/bmj.2.6051.1525 · Cited by 1,320 · see citing works
Self-citationAlcohol consumption and mortality among middle-aged and elderly U.S. adults
Thun, M. J., Peto, R., Lopez, A. D., Monaco, J. H., Henley, S. J., Heath, C. W., & Doll, R. (1997) · New England Journal of Medicine · doi:10.1056/nejm199712113372401 · Cited by 1,313 · see citing works
Self-citationReducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General.
Heidel, R. E. (1989) · Population and Development Review · doi:10.2307/1973420 · Cited by 1,182 · see citing works
Randomised trial of prophylactic daily aspirin in British male doctors
Peto, R., Gray, R. G., Collins, R., Wheatley, K., Hennekens, C. H., Jamrozik, K. D., Warlow, C., Hafner, B., Thompson, E., Norton, S., et al. (1988) · BMJ · doi:10.1136/bmj.296.6618.313 · Cited by 1,164 · see citing works
Self-citationTobacco smoke and involuntary smoking.
(2004) · PubMed Central · Cited by 1,052 · see citing works
The Mortality of Doctors in Relation to Their Smoking Habits
Doll, R., & Hill, A. B. (1954) · BMJ · doi:10.1136/bmj.1.4877.1451 · Cited by 924 · see citing works
Self-citationLung Cancer and Other Causes of Death in Relation to Smoking
Doll, R., & Hill, A. B. (1956) · BMJ · doi:10.1136/bmj.2.5001.1071 · Cited by 801 · see citing works
Self-citationTobacco and Cancer: Recent Epidemiological Evidence
Vineis, P., Alavanja, M. C. R., Buffler, P. A., Fontham, E. T. H., Franceschi, S., Gao, Y., Gupta, P., Hackshaw, A. K., Matos, E., Samet, J., et al. (2004) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djh014 · Cited by 740 · see citing works
Self-citationDoll, R., & Peto, R. (1978) · Journal of Epidemiology & Community Health · doi:10.1136/jech.32.4.303 · Cited by 706 · see citing works
Self-citationMortality in Relation to Smoking: Ten Years' Observations of British Doctors
Doll, R., & Hill, A. B. (1964) · BMJ · doi:10.1136/bmj.1.5396.1460 · Cited by 683 · see citing works
Self-citationLiu, B.-Q., Peto, R., Chen, Z. M., Boreham, J., Wu, Y., Li, J. Y., Campbell, T. C., & Chen, J.-S. (1998) · BMJ · doi:10.1136/bmj.317.7170.1411 · Cited by 570 · see citing works
Self-citationStudy of the Aetiology of Carcinoma of the Lung
Doll, R., & Hill, A. B. (1952) · BMJ · doi:10.1136/bmj.2.4797.1271 · Cited by 563 · see citing works
Self-citationMortality in Relation to Smoking: Ten Years' Observations of British Doctors
Doll, R., & Hill, A. (1964) · BMJ · doi:10.1136/bmj.1.5395.1399 · Cited by 545 · see citing works
Self-citationGajalakshmi, V., Peto, R., Kanaka, T. S., & Jha, P. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14109-8 · Cited by 476 · see citing works
Self-citation(1995) · Choice Reviews Online · doi:10.5860/choice.32-5996 · Cited by 432 · see citing works
Tobacco or health: a global status report.
Mindell, J. S. (1998) · UCL Discovery (University College London) · Cited by 354 · see citing works
The future worldwide health effects of current smoking patterns
Peto, R., & López, A. D. (2004) · Oxford University Press eBooks · doi:10.1093/oso/9780198526872.003.0016 · Cited by 328 · see citing works
Self-citationLevin, M. L. (1950) · JAMA · doi:10.1001/jama.1950.02910390008002 · Cited by 316 · see citing works
The Mortality of Doctors in Relation to Their Smoking Habits: A Preliminary Report
Stockman, J. (2006) · Yearbook of Pediatrics · doi:10.1016/s0084-3954(07)70287-7 · Cited by 230 · see citing works
TOBACCO: A MAJOR INTERNATIONAL HEALTH HAZARD
Zaridze, D. G., & Peto, R. (1986) · Cited by 200 · see citing works
Self-citationPeto, R., Chen, Z., & Boreham, J. (1999) · Nature Medicine · doi:10.1038/4691 · Cited by 184 · see citing works
Self-citationInternational Smoking Statistics
Forey, B. A., Hamling, J., Lee, P. N., & Wald, N. (2002) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780198508564.001.0001 · Cited by 155 · see citing works
Harris, J. E. (2004) · BMJ · doi:10.1136/bmj.37936.585382.44 · Cited by 147 · see citing works
Tobacco smoking as an etiologic factor in disease; cancer.
Schrèk, R., & La, B. (1950) · PubMed · Cited by 118 · see citing works
Tobacco smoking habits and cancer of the mouth and respiratory system.
Mills, C. A., & Porter, M. M. (1950) · PubMed · Cited by 113 · see citing works
Lungenkrebs und Tabakverbrauch
Schairer, E., & Schöniger, E. (1944) · Journal of Cancer Research and Clinical Oncology · doi:10.1007/bf01628727 · Cited by 102 · see citing works
Cohort study of all-cause mortality among tobacco users in Mumbai, India.
Gupta, P. C., & Mehta, H. (2000) · Europe PMC (PubMed Central) · Cited by 100 · see citing works
A Study of the Aetiology of Carcinoma of the Lung
Simon, K., Doll, R., & Hill, A. B. (1953) · The Milbank Memorial Fund Quarterly · doi:10.2307/3348495 · Cited by 50 · see citing works
Self-citationDoll, R. (1999) · Journal of Urban Health · doi:10.1007/bf02345669 · Cited by 47 · see citing works
Self-citationTobacco smoking and cancer of the lung
Grace, E. J. (1943) · The American Journal of Surgery · doi:10.1016/s0002-9610(43)90445-3 · Cited by 26 · see citing works
Origin conditions for lung cancer.
Wf, W. (1948) · PubMed · Cited by 11 · see citing works
Flagged first, then by citations
1 of the 39 references couldn’t be matched to a known paper.
Research works printed but not linked: 5
- Müller FH. Tabakmissbrauch und lungencarcinoma. Zeitschrift Krebsforsch 1939;49:57- 85.
- Wassink WF. Onstaansvoorwasrden voor Longkanker. Ned Tijdschr Geneeskd 1948;92:3732-47.
- Wynder EL, Graham EA. Tobacco smoking as a possible etiologic factor in bronchogenic carcinoma. JAMA 1950;143:329-36.
- Thun MJ, Peto R, Lopez AD, Monaco JH, Henley J, Heath CW, et al. Alcohol consump- tion and mortality among middle-aged and elderly US adults. N Engl J Med 1997; 337:1705-14.
- Lam TH, Ho SY, Hedley AJ, Mak KH, Peto R. Mortality and smoking in Hong Kong: a case-controlled study of all adult deaths in 1998. BMJ 2001;323:1-6.
Cited by
Sorted by citations
Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17018-9 · Cited by 12,026 · see citing works
2016 European Guidelines on cardiovascular disease prevention in clinical practice
Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M.-T., Corrà, U., Cosyns, B., Deaton, C., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw106 · Cited by 6,457 · see citing works
2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Benetos, A., Biffi, A., Boavida, J.-M., Capodanno, D., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab484 · Cited by 6,485 · see citing works
Prospective Studies Collaboration (2009) · The Lancet · doi:10.1016/s0140-6736(09)60318-4 · Cited by 4,807 · see citing works
“…did not smoke as many cigarettes when young as the British doctors did (or, indeed, as young smokers do nowadays), and partly because many who were current smokers at baseline in the PSC would have quit during follow-up (which is taken account of in the doctors’ study, 36 but not in the PSC).”
KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease
Stevens, P. E., Ahmed, S. B., Carrero, J. J., Foster, B., Francis, A., Hall, R. K., Herrington, W. G., Hill, G., Inker, L. A., Kazancıoğlu, R., et al. (2024) · Kidney International · doi:10.1016/j.kint.2023.10.018 · Cited by 8,530 · see citing works
Mendelian randomization: Using genes as instruments for making causal inferences in epidemiology
Lawlor, D. A., Harbord, R. M., Sterne, J. A. C., Timpson, N., & Davey Smith, G. (2008) · Statistics in Medicine · doi:10.1002/sim.3034 · Cited by 4,618 · see citing works
“Notable examples include work pioneered by Sir Richard Doll that identified the link between cigarette smoking and lung cancer, heart disease and other adverse health outcomes [10, 11], and work establishing the causal associations of both high blood pressure and dyslipidaemia with cardiovascular disease [12, 13].”
Danaei, G., Ding, E. L., Mozaffarian, D., Taylor, B., Rehm, J., Murray, C. J. L., & Ezzati, M. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000058 · Cited by 2,860 · see citing works
“There is also evidence that former smokers reduce their risk to that of never-smokers over time [40].”
BackgroundForouzanfar, M. H., Alexander, L., Anderson, H. R., Bachman, V. F., Biryukov, S., Brauer, M., Burnett, R., Casey, D., Coates, M. M., Cohen, A., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00128-2 · Cited by 2,701 · see citing works
Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death
The Emerging Risk Factors Collaboration (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1008862 · Cited by 2,726 · see citing works
Lung Cancer: Epidemiology, Etiology, and Prevention
Cruz, C. S. D., Tanoue, L. T., & Matthay, R. A. (2011) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2011.09.001 · Cited by 2,501 · see citing works
Reitsma, M. B., Kendrick, P. J., Ababneh, E., Abbafati, C., Abbasi-Kangevari, M., Abdoli, A., Abedi, A., Abhilash, E. S., Abila, D. B., Aboyans, V., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01169-7 · Cited by 1,759 · see citing works
“40–42 Relative risks of all-cause mortality from long-running cohort studies in the UK 41,42 and the USA 43 indicate that up to two-thirds of long-term smokers will eventually die of a disease attributable to smoking.”
21st-Century Hazards of Smoking and Benefits of Cessation in the United States
Jha, P., Ramasundarahettige, C., Landsman, V., Rostron, B., Thun, M., Anderson, R. N., McAfee, T., & Peto, R. (2013) · New England Journal of Medicine · doi:10.1056/nejmsa1211128 · Cited by 1,767 · see citing works
Self-citationBenowitz, N. L. (2010) · New England Journal of Medicine · doi:10.1056/nejmra0809890 · Cited by 1,508 · see citing works
Herrington, W. G., Lacey, B., Sherliker, P., Armitage, J., & Lewington, S. (2016) · Circulation Research · doi:10.1161/circresaha.115.307611 · Cited by 1,483 · see citing works
2016 European Guidelines on cardiovascular disease prevention in clinical practice
Authors/Task Force Members, Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M. T., Corrà, U., Cosyns, B., et al. (2016) · European Journal of Preventive Cardiology · doi:10.1177/2047487316653709 · Cited by 1,409 · see citing works
Development of a rational scale to assess the harm of drugs of potential misuse
Nutt, D., King, L. A., Saulsbury, W., & Blakemore, C. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60464-4 · Cited by 1,302 · see citing works
DNA methylation age of blood predicts all-cause mortality in later life
Marioni, R. E., Shah, S., McRae, A. F., Chen, B. H., Colicino, E., Harris, S. E., Gibson, J., Henders, A. K., Redmond, P., Cox, S. R., et al. (2015) · Genome Biology · doi:10.1186/s13059-015-0584-6 · Cited by 1,261 · see citing works
“…disease, diabetes, and hypertension [27], genetic factors such as presence of the APOE e4 allele [29], lifestyle variables such as smoking [30] and education [31], behavioral traits such as cognitive ability [31,32], the personality trait of conscientiousness [33], and candidate…”
50-Year Trends in Smoking-Related Mortality in the United States
Thun, M. J., Carter, B. D., Feskanich, D., Freedman, N. D., Prentice, R., Lopez, A. D., Hartge, P., & Gapstur, S. M. (2013) · New England Journal of Medicine · doi:10.1056/nejmsa1211127 · Cited by 1,177 · see citing works
Handbook of Religion and Health
Koenig, H. G., VanderWeele, T. J., & Peteet, J. R. (2023) · doi:10.1093/oso/9780190088859.001.0001 · Cited by 1,150 · see citing works
We can do better―improving the health of the American people
Schroeder, S. A. (2007) · New England Journal of Medicine · doi:10.1056/nejmsa073350 · Cited by 1,065 · see citing works
Alberg, A. J., & Samet, J. M. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-4710-0.00046-8 · Cited by 1,060 · see citing works
Gene-environment interplay and psychopathology: multiple varieties but real effects
Rutter, M., Moffitt, T. E., & Caspi, A. (2006) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2005.01557.x · Cited by 1,058 · see citing works
The burden of non-communicable diseases in South Africa
Mayosi, B. M., Flisher, A. J., Lalloo, U., Sitas, F., Tollman, S. M., & Bradshaw, D. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61087-4 · Cited by 1,015 · see citing works
Teo, K. K., Ôunpuu, S., Hawken, S., Pandey, M., Valentín, V., Hunt, D. U., Díaz, R., Rashed, W. A., Freeman, R. V., Jiang, L., et al. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69249-0 · Cited by 999 · see citing works
Risk factors for lung cancer worldwide
Malhotra, J. D., Malvezzi, M., Negri, E., Vecchia, C. L., & Boffetta, P. (2016) · European Respiratory Journal · doi:10.1183/13993003.00359-2016 · Cited by 984 · see citing works
Varenicline: An α4β2 Nicotinic Receptor Partial Agonist for Smoking Cessation
Coe, J. W., Brooks, P. R., Vetelino, M. G., Wirtz, M. C., Arnold, E. P., Huang, J., Sands, S. B., Davis, T. I., Lebel, L. A., Fox, C. B., et al. (2005) · Journal of Medicinal Chemistry · doi:10.1021/jm050069n · Cited by 930 · see citing works
“Abstract: Herein we describe a novel series of compounds from which varenicline (1, 6,7,8,9-tetrahydro-6,10-methano- 6H-pyrazino[2,3-h][ 3 ]benzazepine) has been identified for smoking cessation.”
BackgroundA LIFE COURSE APPROACH TO CHRONIC DISEASE EPIDEMIOLOGY
Lynch, J. W., & Smith, G. D. (2005) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.26.021304.144505 · Cited by 923 · see citing works
“The age at smoking cessation is the key to reducing risk, which declines fairly rapidly after cessation (51, 105, 154, 193).”
BackgroundHuxley, R. R., & Woodward, M. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60781-2 · Cited by 906 · see citing works
Global Effects of Smoking, of Quitting, and of Taxing Tobacco
Jha, P., & Peto, R. (2014) · New England Journal of Medicine · doi:10.1056/nejmra1308383 · Cited by 843 · see citing works
Self-citationSelf‐selection and bias in a large prospective pregnancy cohort in Norway
Nilsen, R. M., Vollset, S. E., Gjessing, H. K., Skjærven, R., Klungsøyr, K., Schreuder, P., Alsaker, E. R., Haug, K., Daltveit, A. K., & Magnus, P. M. (2009) · Paediatric and Perinatal Epidemiology · doi:10.1111/j.1365-3016.2009.01062.x · Cited by 836 · see citing works
Newman, C. B., Preiss, D., Tobert, J. A., Jacobson, T. A., Page, R. L., II, Goldstein, L. B., Chin, C. C., Tannock, L. R., Miller, M. J., Raghuveer, G., et al. (2019) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atv.0000000000000073 · Cited by 760 · see citing works
“The relationship between tobacco and lung cancer is a good example in which causality could be established because of the HR >10 comparing lung cancer mortality in lifelong smokers versus never-smokers (after accounting for known confounders).(22) In this situation, there is no need for an RCT, which would have been b…”
American Cancer Society lung cancer screening guidelines
Wender, R. C., Fontham, E. T. H., Barrera, E., Colditz, G. A., Church, T. R., Ettinger, D. S., Etzioni, R., Flowers, C. R., Gazelle, G. S., Kelsey, D. K., et al. (2013) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21172 · Cited by 716 · see citing works
Chang, C.-K., Hayes, R. D., Perera, G., Broadbent, M. T. M., Fernandes, A. C., Lee, W. E., Hotopf, M., & Stewart, R. (2011) · PLoS ONE · doi:10.1371/journal.pone.0019590 · Cited by 714 · see citing works
“. For British doctors born in 1900–1930 and followed up for fifty years, continued smoking was associated with around 10 years life lost, compared to lifelong non-smokers”
BackgroundGlobal cancer patterns: causes and prevention
Vineis, P., & Wild, C. P. (2013) · The Lancet · doi:10.1016/s0140-6736(13)62224-2 · Cited by 716 · see citing works
Moore, S. C., Patel, A. V., Matthews, C. E., Berrington de Gonzalez, A., Park, Y., Katki, H. A., Linet, M. S., Weiderpass, E., Visvanathan, K., Helzlsouer, K. J., et al. (2012) · PLoS Medicine · doi:10.1371/journal.pmed.1001335 · Cited by 693 · see citing works
“For comparison, longterm cigarette smoking reduces life expectancy by approximately 10 y [35].”
BackgroundCohort Profile: The 45 and Up Study
Collaborators, 4. A. U. S. (2007) · International Journal of Epidemiology · doi:10.1093/ije/dym184 · Cited by 707 · see citing works
Parsons, A., Daley, A., Begh, R., & Aveyard, P. (2010) · BMJ · doi:10.1136/bmj.b5569 · Cited by 696 · see citing works
“As well as potentially reducing the risk of cancer related morbidity and mortality, quitting smoking at diagnosis could reduce overall mortality, as smoking cessation reduces mortality from other diseases such as heart disease, stroke, and chronic obstructive airways disease.”
BackgroundTobacco smoking: health impact, prevalence, correlates and interventions
West, R. (2017) · Psychology & Health · doi:10.1080/08870446.2017.1325890 · Cited by 694 · see citing works
Pirie, K., Peto, R., Reeves, G. K., Green, J., & Beral, V. (2013) · The Lancet · doi:10.1016/s0140-6736(12)61720-6 · Cited by 799 · see citing works
Self-citationHackshaw, A. K., Morris, J. K., Boniface, S., Tang, J.-L., & Milenković, D. (2018) · BMJ · doi:10.1136/bmj.j5855 · Cited by 658 · see citing works
Vangeli, E., Stapleton, J., Smit, E. S., Borland, R., & West, R. (2011) · Addiction · doi:10.1111/j.1360-0443.2011.03565.x · Cited by 607 · see citing works
Impacts of cigarette smoking on immune responsiveness: Up and down or upside down?
Qiu, F., Liang, C.-L., Liu, H., Zeng, Y., Hou, S., Huang, S. M., Lai, X., & Dai, Z. (2016) · Oncotarget · doi:10.18632/oncotarget.13613 · Cited by 628 · see citing works
Alberg, A. J., Ford, J. G., & Samet, J. M. (2007) · CHEST Journal · doi:10.1378/chest.07-1347 · Cited by 625 · see citing works
JBS3 Board (2014) · Heart · doi:10.1136/heartjnl-2014-305693 · Cited by 608 · see citing works
Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology
Wood, D. E., Kazerooni, E. A., Baum, S. L., Eapen, G. A., Ettinger, D. S., Hou, L., Jackman, D. M., Klippenstein, D. L., Kumar, R., Lackner, R. P., et al. (2018) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2018.0020 · Cited by 610 · see citing works
A Nationally Representative Case–Control Study of Smoking and Death in India
Jha, P., Jacob, B. J., Gajalakshmi, V., Gupta, P. C., Dhingra, N., Kumar, R., Sinha, D. N., Dikshit, R. P., Parida, D. K., Kamadod, R., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmsa0707719 · Cited by 554 · see citing works
Self-citation2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
Visseren, F. L. J., Mach, F., Smulders, Y. M., Carballo, D., Koskinas, K. C., Bäck, M., Bénétos, A., Biffi, A., Boavida, J.-M., Capodanno, D., et al. (2021) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwab154 · Cited by 565 · see citing works
Dai, X., Gakidou, E., & Lopez, A. D. (2022) · Tobacco Control · doi:10.1136/tobaccocontrol-2021-056535 · Cited by 535 · see citing works
Avoidable global cancer deaths and total deaths from smoking
Jha, P. (2009) · Nature Reviews Cancer · doi:10.1038/nrc2703 · Cited by 522 · see citing works
“Among British doctors who were born between 1900 and 1930 and followed between 1951 and 2001, the death rates were three times higher in doctors who smoked than in those who did no”
BackgroundRollema, H., Chambers, L. K., Coe, J. W., Glowa, J., Hurst, R. S., Lebel, L. A., Lu, Y., Mansbach, R. S., Mather, R. J., Rovetti, C. C., et al. (2007) · Neuropharmacology · doi:10.1016/j.neuropharm.2006.10.016 · Cited by 533 · see citing works
“Department of Health and Human Services, 2004; Doll et al., 2004 ).”
BackgroundMinimal Clinically Important Differences in COPD Lung Function
Donohue, J. (2005) · COPD · doi:10.1081/copd-200053377 · Cited by 517 · see citing works
Accounting for Bias Due to Selective Attrition
Weuve, J., Tchetgen, E. J. T., Glymour, M. M., Beck, T. L., Aggarwal, N. T., Wilson, R. S., Evans, D. A., & de Leon, C. F. M. (2011) · Epidemiology · doi:10.1097/ede.0b013e318230e861 · Cited by 518 · see citing works
Exercise interventions for smoking cessation
USSHER, M. H., Taylor, A. H., & Faulkner, G. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002295.pub5 · Cited by 509 · see citing works
Woodcock, J., Franco, O. H., Orsini, N., & Roberts, I. (2010) · International Journal of Epidemiology · doi:10.1093/ije/dyq104 · Cited by 509 · see citing works
van Iersel, C. A., de Koning, H. J., Draisma, G., Mali, W. P. T. M., Scholten, E. T., Nackaerts, K., Prokop, M., Habbema, J. D. F., Oudkerk, M., & van Klaveren, R. J. (2006) · International Journal of Cancer · doi:10.1002/ijc.22134 · Cited by 489 · see citing works
“tality rates stratified for the number of cigarettes smoked, seemed to be comparable.(21,34) Although the cohorts are not completely comparable to exclude a possible risk difference between the US and Europe, a significant difference seems unlikely.”
BackgroundGillison, M. L., Zhang, Q., Jordan, R. C., Xiao, W., Westra, W. H., Trotti, A., Spencer, S. A., Harris, J., Chung, C. H., & Ang, K. K. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.38.4099 · Cited by 486 · see citing works
2016 European Guidelines on cardiovascular disease prevention in clinical practice
Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M. T., Corrà, U., Cosyns, B., Deaton, C., et al. (2016) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2016.05.037 · Cited by 488 · see citing works
Stages of the cigarette epidemic on entering its second century
Thun, M., Peto, R., Boreham, J., & Lopez, A. D. (2012) · Tobacco Control · doi:10.1136/tobaccocontrol-2011-050294 · Cited by 583 · see citing works
Self-citationIntegrative oncology: Addressing the global challenges of cancer prevention and treatment
Mao, J. J. J., Pillai, G. K. G., de Andrade, C. J. C., Ligibel, J. A., Basu, P. S., Cohen, L. G., Khan, I. A., Mustian, K. M., Puthiyedath, R., Dhiman, K. S., et al. (2021) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21706 · Cited by 471 · see citing works
“137-139 Studies that have examined poor diet, insufficient physical activity, and being overweight or obese have been largely observational.”
Ganna, A., & Ingelsson, E. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60175-1 · Cited by 411 · see citing works
Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer
Ishihara, R., Arima, M., Iizuka, T., Oyama, T., Katada, C., Kato, M., Goda, K., Goto, O., Tanaka, K., Yano, T., et al. (2020) · Digestive Endoscopy · doi:10.1111/den.13654 · Cited by 442 · see citing works
Patterns of Comorbidities in Newly Diagnosed COPD and Asthma in Primary Care
Soriano, J. B., Visick, G. T., Muellerova, H., Payvandi, N., & Hansell, A. L. (2005) · Chest · doi:10.1378/chest.128.4.2099 · Cited by 615 · see citing works
Leonardi‐Bee, J., Jere, M. L., & Britton, J. R. (2011) · Thorax · doi:10.1136/thx.2010.153379 · Cited by 439 · see citing works
Reitsma, M. B., Flor, L. S., Mullany, E. C., Gupta, V., Hay, S. I., & Gakidou, E. E. (2021) · The Lancet Public Health · doi:10.1016/s2468-2667(21)00102-x · Cited by 453 · see citing works
Polosa, R., Caponnetto, P., Morjaria, J. B., Papale, G. A., Campagna, D., & Russo, C. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-786 · Cited by 431 · see citing works
“This is because cigarette smoke harms several organ systems of the human body, thus causing a broad range of diseases, many of which are fatal [2,3].”
Definition, epidemiology and natural history of COPD
Viegi, G., Pistelli, F., Sherrill, D. L., Maio, S., Baldacci, S., & Carrozzi, L. (2007) · European Respiratory Journal · doi:10.1183/09031936.00082507 · Cited by 426 · see citing works
Mealing, N. M., Banks, E., Jorm, L. R., Steel, D. G., Clements, M., & Rogers, K. D. (2010) · BMC Medical Research Methodology · doi:10.1186/1471-2288-10-26 · Cited by 414 · see citing works
“By their nature, cohort studies tend not to be directly representative of the general population, however over time, their results have usually been shown to be both reproducible and generalisable to the larger population [6,7].”
Kontis, V., Mathers, C. D., Rehm, J., Stevens, G. A., Shield, K. D., Bonita, R., Riley, L. M., Poznyak, V., Beaglehole, R., & Ezzati, M. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60616-4 · Cited by 418 · see citing works
Health promotion: An effective tool for global health
Kumar, S., & Preetha, G. S. (2012) · Indian Journal of Community Medicine · doi:10.4103/0970-0218.94009 · Cited by 398 · see citing works
“The Framingham Heart Study has led to the identification of major CVD risk factors such and blood pressure, blood triglycerides and cholesterol level, age, gender and psychosocial issues (Framingham Heart Study).(18)”
Gibson, P. G., McDonald, V. M., & Marks, G. B. (2010) · The Lancet · doi:10.1016/s0140-6736(10)61087-2 · Cited by 395 · see citing works
Smoking and Smoking Cessation in Relation to Mortality in Women
Kenfield, S. A. (2008) · JAMA · doi:10.1001/jama.299.17.2037 · Cited by 396 · see citing works
“and coupled with improvements in treatment, an estimated two-thirds of those persistent smokers were likely to die from smoking.(21) We did not see differences in early cigarette exposure among women born between 1920 and 1929 compared with women born between 1930 and 1939, translating into similar hazards for total m…”
Correll, C. U., Robinson, D. G., Schooler, N. R., Brunette, M. F., Mueser, K. T., Rosenheck, R. A., Marcy, P., Addington, J., Estroff, S. E., Robinson, J., et al. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.1314 · Cited by 384 · see citing works
Mortality from cancer in relation to smoking: 50 years observations on British doctors
Doll, R., Peto, R., Boreham, J., & Sutherland, I. (2005) · British Journal of Cancer · doi:10.1038/sj.bjc.6602359 · Cited by 392 · see citing works
“A more detailed account of the population and the methods of follow-up and analysis are described elsewhere (Doll et al, 2004).”
Self-citationPolygenic basis and biomedical consequences of telomere length variation
Codd, V., Wang, Q., Allara, E., Musicha, C., Kaptoge, S. K., Stoma, S., Jiang, T., Hamby, S. E., Braund, P. S., Bountziouka, V. P., et al. (2021) · Nature Genetics · doi:10.1038/s41588-021-00944-6 · Cited by 376 · see citing works
Are sirtuins viable targets for improving healthspan and lifespan?
Baur, J. A., Ungvari, Z. I., Minor, R. K., Couteur, D. G. L., & de Cabo, R. (2012) · Nature Reviews Drug Discovery · doi:10.1038/nrd3738 · Cited by 389 · see citing works
Chen, Z., Peto, R., Zhou, M., Iona, A., Smith, M., Yang, L., Guo, Y., Chen, Y., Bian, Z., Lancaster, G., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00340-2 · Cited by 430 · see citing works
Self-citationSchaller, J., Keller, D. B., Poget, L., Pratte, P., Kaelin, E., McHugh, D., Cudazzo, G., Smart, D. J., Tricker, A. R., Gautier, L., et al. (2016) · Regulatory Toxicology and Pharmacology · doi:10.1016/j.yrtph.2016.10.001 · Cited by 374 · see citing works
“Although the causal relationship between smoking and several diseases is well established (Doll et al., 2004), there is still very little understanding of the underlying mechanisms by which smoking causes disease.”
BackgroundDare, S., Mackay, D., & Pell, J. P. (2015) · PLoS ONE · doi:10.1371/journal.pone.0123579 · Cited by 366 · see citing works
“Smoking increases the risk of cancer, respiratory and cardiovascular diseases, and is the leading preventable cause of death in developed countries [1].”
BackgroundScreening for and early detection of chronic obstructive pulmonary disease
Soriano, J. B., Zielinski, J., & Price, D. B. (2009) · The Lancet · doi:10.1016/s0140-6736(09)61290-3 · Cited by 363 · see citing works
Impact of graphic and text warnings on cigarette packs: findings from four countries over five years
Borland, R., Wilson, N., Fong, G. T., Hammond, D. G., Cummings, K. M., Yong, H.-H., Hosking, W., Hastings, G., Thrasher, J. F., & McNeill, A. D. (2009) · Tobacco Control · doi:10.1136/tc.2008.028043 · Cited by 350 · see citing works
“Tobacco is a very unusual consumer product, given that it is highly addictive and kills around half of its long-term users.”
BackgroundToking, Vaping, and Eating for Health or Fun
Schauer, G. L., King, B. A., Bunnell, R. E., Promoff, G. R., & McAfee, T. A. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.05.027 · Cited by 344 · see citing works
Smoking and All-Cause Mortality in Older People
Gellert, C., Schöttker, B., & Brenner, H. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.1397 · Cited by 340 · see citing works
Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis.
Groenman, A. P., Janssen, T. W. P., & Oosterlaan, J. (2017) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2017.05.004 · Cited by 335 · see citing works
Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis
O’Keeffe, L. M., Taylor, G. M. J., Huxley, R., Mitchell, P., Woodward, M., & Peters, S. A. E. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-021611 · Cited by 335 · see citing works
“The sevenfold higher RRs of lung cancer associated with smoking found in the present meta-analysis are considerably smaller than the 20-fold increased risks reported in the Million Women’s Study 13 and the British Doctors Study.(14) Both of these studies had the advantage of capturing smoking-related risks in populati…”
ResultProspective Study of One Million Deaths in India: Rationale, Design, and Validation Results
Jha, P., Gajalakshmi, V., Gupta, P. C., Kumar, R., Mony, P., Dhingra, N., Peto, R., & Collaborators, R.-C. P. S. (2005) · PLoS Medicine · doi:10.1371/journal.pmed.0030018 · Cited by 323 · see citing works
Self-citationImpact of Tobacco Control Policies and Mass Media Campaigns on Monthly Adult Smoking Prevalence
Wakefield, M. A., Durkin, S. J., Spittal, M. J., Siahpush, M., Scollo, M., Simpson, J. A., Chapman, S. F., WHITE, V. M., & Hill, D. (2008) · American Journal of Public Health · doi:10.2105/ajph.2007.128991 · Cited by 328 · see citing works
Pinkhasov, R. M., Wong, J., Kashanian, J. A., Lee, M., Samadi, D. B., Pinkhasov, M. M., & Shabsigh, R. (2010) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2009.02290.x · Cited by 327 · see citing works
Byberg, L., Melhus, H., Gedeborg, R., Sundström, J., Ahlbom, A., Zethelius, B., Berglund, L., Wolk, A., & Michaëlsson, K. (2009) · BMJ · doi:10.1136/bmj.b688 · Cited by 322 · see citing works
“and smoking is probably the most well established modifiable behavioural risk factor for premature death.”
BackgroundBanks, E., Joshy, G., Korda, R., Stavreski, B., Kay, S., Egger, S. J., Day, C., Clarke, N. E., Lewington, S., & López, A. D. (2019) · BMC Medicine · doi:10.1186/s12916-019-1351-4 · Cited by 322 · see citing works
Time perspective, personality and smoking, body mass, and physical activity: An empirical study
Adams, J. M., & Nettle, D. (2008) · British Journal of Health Psychology · doi:10.1348/135910708x299664 · Cited by 316 · see citing works
Clustering of risk behaviors with cigarette consumption: A population-based survey
Chiolero, A., Wietlisbach, V., Ruffieux, C., Paccaud, F., & Cornuz, J. (2006) · Preventive Medicine · doi:10.1016/j.ypmed.2006.01.011 · Cited by 310 · see citing works
“health risk increases sharply with daily cigarette consumption (Doll et al., 2004).”
BackgroundLin, H.-H., Murray, M. B., Cohen, T., Colijn, C., & Ezzati, M. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61345-8 · Cited by 303 · see citing works
Mouse models for human lung cancerPreprint
Meuwissen, R. L. J., & Berns, A. J. M. (2005) · Genes & Development · doi:10.1101/gad.1284505 · Cited by 301 · see citing works
“Although smoking cessation before the age of 30 does substantially reduce the risk of lung cancer, this is significantly less for those who stop smoking at 50 or 60 yr (Peto et al. 2000; Doll et al. 2004).”
Campbell, S. C., Moffatt, R. J., & STAMFORD, B. A. (2008) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2008.04.046 · Cited by 298 · see citing works
Talmud, P. J., Hingorani, A. D., Cooper, J. A., Marmot, M. G., Brunner, E. J., Meena Kumari, B., Mika Kivimaki, B., & Humphries, S. E. (2010) · BMJ · doi:10.1136/bmj.b4838 · Cited by 294 · see citing works
“As a technology, however, genotype based tests have several inherent advantages over non-genetic tests. Genotype based assays are cheap, have high fidelity, and can be multiplexed, in contrast to multiple phenotypic risk factors and biomarkers, many of which require different methods for their measurement, and which a…”
BackgroundDecramer, M., Rennard, S., Troosters, T., Mapel, D., Giardino, N., Mannino, D., Wouters, E., Sethi, S., & Cooper, C. (2008) · COPD · doi:10.1080/15412550802237531 · Cited by 328 · see citing works
“People who stop smoking, even in middle age, have a survival benefit (180).”
BackgroundÜnal, B., Critchley, J., & Capewell, S. (2005) · BMJ · doi:10.1136/bmj.38561.633345.8f · Cited by 292 · see citing works
Kotz, D., Brown, J., & West, R. (2014) · Addiction · doi:10.1111/add.12429 · Cited by 283 · see citing works
“Every year that someone continues to smoke after early middle age loses them 3 months of life expectancy [2].”
BackgroundCigarette smoking: An undertreated risk factor for cardiovascular disease
Erhardt, L. (2009) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2009.01.007 · Cited by 287 · see citing works
Roberts, E. T., Haan, M. N., Dowd, J. B., & Aiello, A. E. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq177 · Cited by 281 · see citing works
“Smoking status, hypertension, low density lipoprotein cholesterol, and high density lipoprotein cholesterol were assessed as covariates because they are associated with death (22, 23) and CMV infection.”
Background
- Authors
- Doll, R., Peto, R., Boreham, J., & Sutherland, I.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Doll, Richard
- ORCID
- Peto, Richard
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2004-06-22
- Volume
- 328
- Issue
- 7455
- Pages
- 1519
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC437139
- OpenAlex
- W4292672078
- Cited by
- 2,920
- References
- 39
- Citations by year
- 2026: 81 · 2025: 79 · 2024: 125 · 2023: 135 · 2022: 127 · 2021: 134 · 2020: 159 · 2019: 135 · 2018: 158 · 2017: 134 · 2016: 153 · 2015: 165 · 2014: 146 · 2013: 182 · 2012: 162
- FWCI
- 59.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Cancer Research UK
- British Heart Foundation
- University of Oxford
- Medical Research Council
- Topics
- Health Sciences › Medicine › Physiology › 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
- cigarette smoking, mortality, smoking cessation, life expectancy, birth cohort differences, vascular disease, neoplasms, respiratory diseases, smoking intensity, cardiovascular disease, lung cancer, chronic obstructive pulmonary disease, alcohol consumption, tobacco control, smoking cessation counseling, smoking cessation interventions
- MeSH terms
- Adult, Aged, Aged, 80 and over, Cause of Death, Epidemiologic Methods, United Kingdom, Humans, Lung Neoplasms, Male, Middle Aged, Mortality, Neoplasms, Physicians, Prospective Studies, Smoking, Smoking Cessation, Age Distribution
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
