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Skip to 0 minutes and 4 seconds So what did the evidence say and what was the response to it? The initial results of Doll and Bradford Hill’s study of doctors published in 1954 found a significant and steadily rising mortality from deaths due to cancer of the lung as the amount of tobacco smoked increases. On the 27th of June, 1957, the UK Medical Research Council published a special report warning of a direct cause and effect between smoking and lung cancer. According to the BBC, tobacco companies responded by saying this was merely a matter of opinion. Also in 1957, a report stating that cigarette smoking is a causative factor in lung cancer was published by a study group in the USA to very similar responses.

Skip to 1 minute and 4 seconds However, there were others who didn’t agree. Some doctors and scientists argued that there were other explanations for the association. The following video footage was recorded in 1957, at the time of the UK MRC report. Seeking a trade viewpoint, our reporter interviewed Sir Alexander Maxwell, Chairman of the Tobacco Manufacturers Standing Committee. What has your organisation done to aid research into the question of smoking and lung cancer? Well, in 1954, several of the leading manufacturers in this country gave a grant of 250,000 pounds to the Medical Research Council. So far, what are the conclusions reached by your organisation?

Skip to 1 minute and 47 seconds That there is need for much more research over a wide area and in my opinion, to single out smoking as a causal agent is on the evidence to date completely unjustified. Well, thank you very much, sir, for your help. Well, thank you very much for letting me put our views forward. You better have a cigarette before you go, eh? Thank you. Meanwhile in the USA, tobacco companies had issued an advertisement, “A Frank Statement to Cigarette Smokers,” in January 1954. This followed the publication of some laboratory studies. These studies showed that tar from cigarettes caused tumours in mice. The statement questioned research findings suggesting smoking was a cause of lung cancer and promised smokers that their cigarettes were safe.

Skip to 2 minutes and 37 seconds It also promised to supporting impartial research looking at whether smoking was harmful to human health. We’ve learned during the course that there are clear issues when interested parties and organisations fund research. This is borne out by documents that came to light during later court cases. The documents showed that a number of tobacco industry scientists had acknowledged during the 1950s that cigarette smoking wasn’t safe. Following the “Frank Statement,” the Tobacco Industry Research Committee was established. It was clearly not in the interest of the industry to support the findings of a causal link between smoking and lung cancer and research funding was spent looking at a range of other possible associations. These included heredity, infection, nutrition, hormones, nervous strain, and environmental factors.

Skip to 3 minutes and 38 seconds But this research funding provided important PR for tobacco companies and reported spending between 1954 and 1997 was over $300 million. So today, the link between smoking and lung cancer is accepted, although the tobacco industry didn’t finally say this until 1999. However, significant actions are still being fought. Some research published in July 2015 looked at the use of expert witnesses. These witnesses were in court to support tobacco industry claims that various head and neck cancers were not caused by smoking. The author, Professor Robert Jackler from Stanford University in the USA, found systematic bias in the testimony of the industry’s expert witnesses. These court cases took place between 2009 and 2014.

Skip to 4 minutes and 41 seconds This is over 60 years since Doll and Bradford Hill first researched into the health risks of smoking.

Smoking and lung cancer: responses to the evidence

In this presentation we examine the evidence set out by Doll and Bradford Hill and examine the industry response.

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This video is from the free online course:

Making Sense of Health Evidence: The Informed Consumer

Cardiff University