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  » Smoking and health effect  »  Foreword

In 1962, the Royal College of Physicians published its first report on the effects of smoking on health, drawing attention to the strong relationship between cigarette smoking and lung cancer. The report concluded that this association was probably causal, that smoking may also cause other diseases including chronic bronchitis and coronary heart disease, and that smokers may be addicted to nicotine.

In the years since that report was published, the true scale of the harm caused by smoking has become apparent. Smoking is now recognised as the single largest avoidable cause of premature death and disability in Britain and in most other economically developed countries, and probably the greatest avoidable threat to public health worldwide.

Public recognition of the health risks of smoking was probably one of the major factors underlying the progressive fall in smoking prevalence that occurred in Britain between the early 1960s and mid-1990s. However, recent data suggest that it is now beginning to stabilise in Britain at approximately one in four adults, whilst smoking in younger people is becoming more common. To achieve further marked reductions in smoking prevalence, it is therefore necessary to look in more detail at the factors that cause individuals to smoke, and to consider new methods of primary and secondary prevention.

This report addresses the fundamental role of nicotine addiction in smoking. It is now recognised that nicotine addiction is one of the major reasons why people continue to smoke cigarettes, and that cigarettes are in reality extremely effective and closely controlled nicotine delivery devices. Recognition of this central role of nicotine addiction is important because it has major implications for the way that smoking is managed by doctors and other health professionals, and for the way in which harmful nicotine delivery products such as cigarettes should be regulated and controlled in society. At a time when smoking still causes one in every five deaths in Britain, measures designed to achieve further reductions in smoking are clearly important and, if successful, will realise substantial public health benefits. It is time for nicotine addiction to become a major health priority in Britain. This report explains why.

February 2000 KGMM ALBERTI
President, Royal College of Physicians