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      The historical decline of tobacco smoking among Australian physicians: 1964–1997

      review-article
      1 , 2 , , 2 , 1
      Tobacco Induced Diseases
      BioMed Central

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          Abstract

          Background

          Physicians occupy an important position as tobacco control exemplars and their own smoking habits are known to influence how effective they may be in such a role.

          Methods

          A comprehensive review of all published manuscripts describing tobacco usage rates and tobacco control activities in the Australian medical profession between 1964 and 1997.

          Results

          Some of the earliest surveys revealed that around one-quarter of Australian physicians were smoking in the mid twentieth century, a rate which rapidly declined in the 1970s and 1980s, with reductions beyond that achieved by the general population.

          Conclusion

          Overall, our review suggests that not only do contemporary Australian physicians smoke at very low rates when compared internationally, but that an active professional community can also make a real difference to the lifestyle choices of its own members.

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          Most cited references83

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          Mortality from cancer in relation to smoking: 50 years observations on British doctors

          A total of 34 439 male British doctors, who reported their smoking habits in November 1951, were followed, with periodic up date of changes in their habits, until death, emigration, censoring. or November 2001. Information was obtained about their mortality from 28 of the 30 types of cancer in men reviewed by the International Agency for Research on Cancer (no death was recorded from the other two). In all, 11 of the 13 types in men that the Agency classed as liable to be caused by smoking were significantly related to smoking and the findings for the other two, which caused only few deaths, suggested they might be. Of the 13 types in men for which the Agency found only sparse or inconsistent data and for which we had data, only two appeared to be possibly related (one positively, one negatively), and the 638 deaths for the summed group were clearly unrelated to smoking. Of the two types for which the Agency thought that the relationship with smoking might be due to bias or confounding, the findings for one (prostate cancer) tended to support the belief that smoking was unrelated, and those for the other (colorectal cancer) showed a weak relationship with smoking, which (in a small subset) could not be attributed to confounding with the consumption of alcohol.
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            Non-smoking wives of heavy smokers have a higher risk of lung cancer: a study from Japan.

            T Hirayama (1981)
            In a study in 29 health centre districts in Japan 91 540 non-smoking wives aged 40 and above were followed up for 14 years (1966-79), and standardised mortality rates for lung cancer were assessed according to the smoking habits of their husbands. Wives of heavy smokers were found to have a higher risk of developing lung cancer and a dose-response relation was observed. The relation between the husband's smoking and the wife's risk of developing lung cancer showed a similar pattern when analysed by age and occupation of the husband. The risk was particularly great in agricultural families when the husbands were aged 40-59 at enrolment. The husbands' smoking habit did not affect their wives' risk of dying from other disease such as stomach cancer, cervical cancer, and ischaemic heart disease. The risk of developing emphysema and asthma seemed to be higher in non-smoking wives of heavy smokers but the effect was not statistically significant. The husband's drinking habit seemed to have no effect on any causes of death in their wives, including lung cancer. These results indicate the possible importance of passive or indirect smoking as one of the causal factors of lung cancer. They also appear to explain the long-standing riddle of why many women develop lung cancer although they themselves are non-smokers. These results also cast doubt on the practice of assessing the relative risk of developing lung cancer in smokers by comparing them with non-smokers.
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              The mortality of doctors in relation to their smoking habits; a preliminary report.

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                Author and article information

                Journal
                Tob Induc Dis
                Tobacco Induced Diseases
                BioMed Central
                1617-9625
                2008
                29 December 2008
                : 4
                : 1
                : 13
                Affiliations
                [1 ]WorkCover New South Wales Research Centre of Excellence, School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, Australia
                [2 ]Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, Australia
                Article
                1617-9625-4-13
                10.1186/1617-9625-4-13
                2646683
                19114012
                18e6cefd-c057-491a-b341-29db9f7f0499
                Copyright © 2008 Smith and Leggat; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 September 2008
                : 29 December 2008
                Categories
                Review

                Respiratory medicine
                Respiratory medicine

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