The Body: A Guide for Occupants by Bill Bryson

Author:Bill Bryson
Language: eng
Format: epub, mobi, azw3
Tags: Non-Fiction, Science, Health, Guide, Manual
Publisher: Knopf Doubleday Publishing Group
Published: 2019-10-15T00:00:00+00:00

III

ONE OTHER ALL-TOO-COMMON affliction of the lungs deserves a mention, not so much because of what it does to us as because of how extraordinarily long it took us to accept that it was doing it. I refer to smoking and lung cancer.

It would seem almost impossible to ignore a link between the two. A person who smokes cigarettes regularly (about a pack a day) is fifty times more likely than a nonsmoker to get cancer. In the thirty years between 1920 and 1950, which is when cigarette smoking took off in a big way in the world, the number of lung cancer cases soared. In America, they tripled. Similar increases were noted elsewhere. Yet it took forever to gain consensus that smoking caused lung cancer.

It seems crazy to us today, but it wasn’t so crazy to people back then. The problem was that huge proportions of people smoked—80 percent of all men by the late 1940s—yet only some of them developed lung cancer. And some people who didn’t smoke also developed lung cancer. So it was not especially straightforward to see a direct link between smoking and cancer. When lots of people are doing something and only some of them are dying from it, it makes it hard to impute blame to a single cause. Some people blamed air pollution for the rise of lung cancer. Others suspected the increased use of asphalt as a paving surface.

One leading skeptic was Evarts Ambrose Graham (1883–1957), a chest surgeon and professor at Washington University in St. Louis. Graham famously (but facetiously) maintained that we might as plausibly blame lung cancer on the development of nylon stockings because they had become popular at the same time as smoking. But when a student of his, the German-born Ernst Wynder, sought permission to conduct a study on smoking and cancer in the late 1940s, Graham gave his consent, mostly in the expectation that it would disprove the theory of a link between smoking and cancer once and for all. In fact, Wynder demonstrated conclusively that there was a link—so much so that Graham was persuaded by the evidence to change his mind. In 1950, the two men published a joint paper in The Journal of the American Medical Association outlining a clear statistical link between smoking and lung cancer. Soon afterward, the British Medical Journal ran a study with more or less identical findings by Richard Doll and A. Bradford Hill of the London School of Hygiene and Tropical Medicine.*1

Although two of the world’s most prestigious medical journals had now demonstrated a clear association between smoking and lung cancer, the findings had almost no effect. People just loved smoking too much to quit. Richard Doll in London and Evarts Graham in St. Louis, both lifelong smokers, quit tobacco, but too late in the case of Graham. He died of lung cancer seven years after his own report. Elsewhere smoking just kept rising. The volume of smoking in the United States increased by 20 percent in the 1950s.

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