Evidence map›Paper›PMID 7755693›Full record

ArticleBMJ (Clinical research ed.)1994

Mortality in relation to smoking: 40 years' observations on male British doctors.

R Doll, R Peto, K Wheatley, R Gray, I Sutherland

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 1994. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 460 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
460citing papers in PubMed, 17 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

460 citing papers in PubMed, 17 syntheses or guidelines pooled it.

  1. Effects of firsthand tobacco smoking on retinal vessel caliber: a systematic review and meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2024
    Pooled it
  2. Pooled it
  3. Smoking Prevalence among Physicians: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2021
    Pooled it
  4. Proposal for the Inclusion of Tobacco Use in Suicide Risk Scales: Results of a Meta-Analysis.International journal of environmental research and public health · 2021
    Pooled it
  5. The Shared Genetic Architectures Between Lung Cancer and Multiple Polygenic Phenotypes in Genome-Wide Association Studies.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021
    Pooled it
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  8. Guideline
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  13. Interventions for recruiting smokers into cessation programmes.The Cochrane database of systematic reviews · 2012
    Pooled it
  14. Guideline
  15. Pooled it
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  18. Trial
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  20. Changes in Biomarkers of Exposure on Switching From a Conventional Cigarette to the glo Tobacco Heating Product: A Randomized, Controlled Ambulatory Study.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2021
    Trial

400 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

R DollImperial Cancer Research Fund Cancer Studies Unit, Nuffield Department of Clinical Medicine, Radcliffe Infirmary, Oxford.
R Peto
K Wheatley
R Gray
I Sutherland

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the hazards associated with long term use of tobacco.

designProspective study of mortality in relation to smoking habits assessed in 1951 and again from time to time thereafter, with causes sought of deaths over 40 years (to 1991). Continuation of a study that was last reported after 20 years' follow up (1951-71). SUBJECTS: 34,439 British male doctors who replied to a postal questionnaire in 1951, of whom 10,000 had died during the first 20 years and another 10,000 have died during the second 20 years.

resultsExcess mortality associated with smoking was about twice as extreme during the second half of the study as it had been during the first half. The death rate ratios during 1971-91 (comparing continuing cigarette smokers with life-long non-smokers) were approximately threefold at ages 45-64 and twofold at ages 65-84. The excess mortality was chiefly from diseases that can be caused by smoking. Positive associations with smoking were confirmed for death from cancers of the mouth, oesophagus, pharynx, larynx, lung, pancreas, and bladder; from chronic obstructive pulmonary disease and other respiratory diseases; from vascular diseases; from peptic ulcer; and (perhaps because of confounding by personality and alcohol use) from cirrhosis, suicide, and poisoning. A negative association was confirmed with death from Parkinson's disease. Those who stopped smoking before middle age subsequently avoided almost all of the excess risk that they would otherwise have suffered, but even those who stopped smoking in middle age were subsequently at substantially less risk than those who continued to smoke.

conclusionResults from the first 20 years of this study, and of other studies at that time, substantially underestimated the hazards of long term use of tobacco. It now seems that about half of all regular cigarette smokers will eventually be killed by their habit.

Indexed as

AdultAgedAged, 80 and overAge FactorsCause of DeathFollow-Up StudiesHumansMaleMiddle AgedMortalityProspective StudiesSmokingSurvival AnalysisSurvival RateUnited Kingdom

Identifiers

PMID7755693
PMCPMC2541142

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.