Primary Prevention of Tobacco-Related Cancer

Abstract

For more than a century, tobacco usage has been shown to induce cancer in man. As early as 1795, Soemmering described a cancer of the lip induced by pipe smoking. However, it was not until the twentieth century that the enormous rise in lung cancer elicited serious interest as a tobacco-related problem. As we reflect upon this history, we need to appreciate that a monograph on lung cancer written by Adler in 1912 included the question: “Is it worthwhile to write on such a rare disease?” Even in 1939, when Mueller in Germany had reported on the increased risk of lung cancer in smokers, the admission of a lung cancer patient to Barnes Hospital in St. Louis, Missouri, prompted the staff to call interns and residents together to see such a rare case (Mueller 1939). In 1950, when the first major papers on the role of tobacco in the etiology of lung cancer were published, lung cancer had become a common observation in men though still relatively uncommon in women (Doll and Hill 1950; Levin et al. 1950; Wynder and Graham 1950). Today, in most developed countries, lung cancer is the most common cause of cancer deaths in males and is readily on its way to becoming the leading cause of cancer deaths in women by the end of this decade (International Agency for Research on Cancer 1986). The retrospective studies of 1950 were followed by a series of prospective studies, all showing an increase in lung cancer proportional to the number of cigarettes smoked and the duration of the habit.

Supported by U.S. National Cancer Institute grants no. PO1-CA-32167, CA-17613, CA-38219, and CA-41621