Has the mortality of male doctors improved with the reductions in their cigarette smoking?

Abstract

From 1951 to 1971 male doctors reduced their cigarette smoking more than did men in social classes I and II combined. In 1970–2, 665 male doctors died aged under 65. Had they shown the same improvements in cause-specific death rates over the 20 years as men in classes I and II, 699 deaths would have been expected. This “saving” of 34 deaths in the doctors comprised savings from coronary heart disease (83), stroke (16), and lung cancer (8) balanced by 60 “losses” from three stress-related causes—namely, accidents, poisonings, etc (30); suicide (26); and cirrhosis of the liver (4)—plus 13 from other causes. As a relative reduction in mortality from heart disease in doctors (as compared with that in social classes I and II) also occurred during 1931–51—that is, before they began to give up smoking—some of the saving in heart-disease deaths in 1951–71 was probably not related to changes in smoking habits. The relative worsening in mortality from stress-related diseases may have been due partly to a possible adverse effect of giving up smoking if smoking had acted to reduce stress. From these findings, the benefits of giving up smoking may not be so great as has commonly been assumed. © 1979, British Medical Journal Publishing Group. All rights reserved.