BMJ Press Releases, Saturday 12 October 1996
Volume 313 No 7062

EMBARGOED 00.01 HRS 11 OCTOBER 1996

SMOKE NOW - PAY LATER

[Life expectancy in men who have never smoked and those who have smoked continuously: 15 year follow up of a large cohort of middle aged British men]

Men who never smoke have a 78 per cent chance of living to the age of 73, but lifelong male smokers have only a 42 per cent chance, according to a study in this week's BMJ.

In a 15 year follow up of 7,735 middle aged men in the British regional heart study, it was found that men who started smoking by the age of 20, and never stopped, stood much less chance of living into their seventies.

Dr Andrew Phillips of the Royal Free Hospital, London, and colleagues, carried out the study on men from 24 British towns . The men were aged between 40 and 59 in 1978-80 when they entered the British regional heart study. By the cut off date of 31 December 1993, 1,278 of the 7,735 men had died - 127 of them non smokers and 560 of them lifelong smokers.

National mortality statistics were used in conjunction with the study to assess survival probabilities. Estimates of life expectancy according to smoking habits have not previously been available for a representative sample of British men. Dr Phillips and colleagues say stopping smoking should lead to sizeable reductions in the risk of early death. He commented: "These estimates present the effects of smoking on mortality in a way that is easily communicated to patients and the general public in health promotion initiatives."

Contact:

Dr Andrew Phillips

Dept Primary Care & Population Sciences
Royal Free Hospital Schol of Medicine
London NW3 2PF

Tel: 0171 794 0500 x4238
Fax: 0171 794 1224

PASSIVE SMOKING RISKS

[Passive smoking and health: should we believe Philip Morris's "experts"?]

A detailed attack on the research behind the recent adverts which questioned the harmful effects of passive smoking appears in this week's BMJ. The paper by Professor George Davey Smith and Dr Andrew Phillips points out that the report on which the Phillip Morris ads were based was an industry-funded enterprise. The adverts which appeared in newspapers throughout Europe compared the risk of lung cancer form passive smoking with a variety of other apparent risks from everyday activities. "The central message of the advert is that passive smoking is not really a meaningful health risk to people who have chosen not to smoke" says the BMJ paper. It goes on to challenge the scientific basis of the claims made, criticising methodology, omissions and biases. The BMJ authors state: "The tobacco industry is clearly going to considerable trouble to discredit evidence that environmental tobacco smoke is detrimental to health." It suggests this is both to protect the industry from the economic threat of legal cases from those damaged by passive smoking and to protect against a drop in cigarette sales if stringent smoking restrictions were introduced at workplaces.

Research suggests there is a 20 per cent increased risk of lung cancer from passive smoking. Other health problems which may be associated with passive smoking include coronary heart disease in adults and respiratory disease in children. Professor Davey Smith comments that investigating the links between tobacco smoke and disease is beset with methodological problems. At the same time the public is sceptical about reports of new health risks. "The tobacco industry capitalises on this situation to protect its commercial interests through the promotion and magnification of confusion."

Contact:

Prof George Davey Smith

Dept of Social Medicine
University of Bristol
BS8 2PR

Tel: 0117 928 7329
Fax:0117 928 7325
e-mail: zetkin@bristol.ac.uk

MASS TRAINING IN RESUSCITATION : DOES IT WORK?

[Effectiveness of the BBC's 999 training roadshows on cardiopulmonary resuscitation: video performance of cohort of unforewarned participants at home six months afterwards]

Large numbers of volunteers attended the training courses in cardiopulmonary resuscitation (CPR) organised by the BBC 999 programme roadshow. A study in this week's BMJ reports on the effectiveness of the training six months later - with disappointing results. When 280 trainees were unexpectedly asked to demonstrate their CPR skills on a dummy, only 19 (7 per cent) were able to provide safe resuscitation. Large numbers failed to call for help, summon an ambulance or effectively assess the status of the "patient". The good news is that retraining greatly improves performance.

All the people in the study had agreed to take part in unspecified further research when they took part in the resuscitation training. Six months later , researchers turned up on their doorstep with a video camera and a dummy and asked them to demonstrate what they had learned. Ineffective performances were recorded for 243 people (87 per cent) and of these, 110 (45 per cent) were also classed as potentially injurious. Females were more likely than males to perform procedures in a non harmful way, and younger people (under 45 ) were better than older ones. The study points out that any potentially injurious effect must be balanced against the certainty of harm caused by doing nothing. It has been shown that cardiopulmonary resuscitation from bystanders improves survival rates in cardiac arrest victims away from hospital. The paper states: "Although the 999 roadshows undoubtedly recruit many people, attention should now be given to retraining strategies."

Contact:

Dr P.D. Donnelly

Centre for Applied Public Health Medicine
University of Wales
College of Medicine
Cardiff F1 8UL

Tel: 01792 458 066 x 7343
Fax: 01792 459 936
or
Tel: 01222 233651 x2928
Fax: 01222 237930

CALL TO REMOVE SUNBEDS

A call to remove sunbeds from local authority leisure centres comes in this week's BMJ in a letter from a consultant dermatologist.

Dr J.F.B.Norris of Dumfries and Galloway Royal Infirmary, writes that in the light of increasing evidence that ultraviolet A is a promoter of skin cancer and melanoma in particular, the risk benefit ratio of using ultraviolet A sunbeds should be re-examined. The medical profession should be more critical of sunbed salons operating purely for financial gain. All local authorities should seriously consider closing their sunbed facilities, writes Dr Norris. Some councils have already done so.

Contact:

Dr J.F.B.Norris
Consultant Dermatologist

Dumfries and Galloway Royal Infirmary
Dumfries DG1 4AP

Tel: 01387 246246 x3574
Fax: 01387 241639

EMBARGO: 00.01 HRS FRIDAY 11 OCTOBER 1996

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