The great studies of smoking and disease in the twentieth century
This chapter examines the contributions of several large prospective studies conducted over the second half of the 20th century to our understanding of the health hazards of tobacco use. Beginning in the early 1950s, large cohort studies played a major role in helping to identify the multitude of adverse health effects caused by tobacco use, particularly manufactured cigarettes. They demonstrated that the harmful effects applied to women as well as men, that cigarettes with low machine-measure tar and nicotine were no less hazardous with respect to lung cancer than filter-tip ‘regular’ tar cigarettes, and that the burden of disease caused by smoking increased over time as smokers initiated regular cigarette smoking at progressively earlier ages. Large cohort studies will continue to be important for monitoring the course of the epidemic as it evolves in different cultures and for sustaining the political resolve to end it.
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