Cancer Country

When tobacco was first introduced into Europe and Asia, potentates saw harm in it and some enacted the death penalty for those of their subjects who persisted in smoking. But only a proportion of the culprits were in fact put to death for the widespread crime, and the potentates soon substituted taxes for excommunications and executions. After three hundred years the death penalty is still linked to smoking, though not now by due process of law, and taxes on tobacco are still levied by governments: neither the risk of a shortened life, nor expense, nor alternative pleasures have eliminated smoking, nor is it less profitable for the revenue. Why the habit should have spread so fast and so far, and proved so tenacious, is a matter for conjecture. Other problems which it offers have not been left to conjecture, but made the subject of very active research. These are the problems raised by the association of cigarette smoking with disease, or, more specifically, by the association of cigarette smoking with cancer of the lung. Two impressive reports, from the Royal College of Physicians in England and the Surgeon General’s Advisory Committee in the United States, documented and reviewed the present state of knowledge about this threatening aspect of public health. Both reports concluded that cigarette smoking is an important cause of lung cancer, far outweighing all other factors.

Although the consensus of informed opinion is powerfully to this effect, there are dissenters whose criticisms have demanded close scrutiny—people like Dr. Berkson of the Mayo Clinic who have been voicing their misgivings for a good many years, and others more recent, like Professor Eysenck, the author of this book.

Professor Eysenck is a psychologist well known for his many valuable contributions to the study of personality in its varied aspects, and for his lively polemical writing, as spirited and forthright in defense as in attack, and firmly based on the principle of tit for tat. His powers of lucid exposition have been evident in a large number of publications, describing the psychological experiments and arguments on which his views rest. In this book, characteristically readable, he lays an axe to the generally accepted conclusion about the role of cigarette smoking, and he links the association between smoking and cancer to certain features of his study of personality. His survey and his assertions are broadly on the following lines.

Epidemiological methods of investigation can suggest causal relation but cannot confirm or ensure it: Only experiment can do that. The association between smoking and lung cancer is not specific; other diseases also are related to cigarette smoking. The populations on whom the observations have been made were not selected in such a way that they can each be accepted as a representative sample, nor did a sufficiently large proportion of the people to be studied agree to take part in the inquiries. Measurement of the amount of smoking was unduly crude. The samples of population studied were self-selected. These and other …

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Letters

Smoking & Cancer April 28, 1966