Electrical Anaesthesia

Abstract

weight of the baby and increased neonatal mortality. Experimental studies have confirmed that condensates of tobacco smoke induce cancer in laboratory animals. Now, rightly or wrongly, the Tobacco Research Council has accepted two main aims-firstly, to find the formula for a " safe " or " safer " cigarette ; and, secondly, to find ways of distinguishing individuals who are more susceptible than average to the harmful effects of smoking. These aims are constructive both from the point of view of the industry, which wishes above all to continue selling tobacco, and from the point of view of a large section of the public, who wish to continue smoking. But how realistic are the aims ? On the basis of present knowledge a completely safe cigarette seems to be out of the question. On the other hand,.a safer cigarette (made of tobacco which yields the minimum of " tar ") and advice to smokers on how to reduce the risk to their health (choose cigarettes with an efficient filter, throw away a long butt)5 have been feasible for several years already, and progress in these directions should be accelerated. It is likely that individuals do differ in susceptibility to the various effects of tobacco, though not in an absolute sense.' Research into this is justified, but there are no real leads yet in the case of susceptibility to respiratory disease. The suggestion that smokers who develop a cough early in their smoking careers are also more likely to develop lung cancer' is certainly open to question.' Who then should do what ? Until it has had time to diversify its interests, and while it is so vulnerable to change in tobacco sales, it is unrealistic to expect the tobacco industry to make decisions that will cut its own throat. In the long run its only hope is that through the efforts of the Tobacco Research Council and of research generally knowledge will be acquired that makes the continued sale of tobacco justifiable. In the meantime only the Government and the general public are in a position to act. The progressive banning of advertising and other sales promotion procedures is within the Government's power, and is long overdue. Moreover, the general public is now ready to accept the progressive restriction of smoking in public places. With regard to education, there is certainly a need to make factual information more widely available, though no advice can be so good as " Do not smoke." Epidemiological surveys have consistently shown that the risk of lung cancer in cigar and pipe smokers is less than that in cigarette smokers. But laboratory evidence shows that the condensate from cigar smoke is more carcinogenic for mouse skin than that from cigarette smoke. Thus, as M. C. Pike and F. J. C. Roe recently pointed eut,5 there is insufficient evidence for actually recommending a cigarette smoker simply to change to pipe or cigars. They write: " Only if the change resulted in a reduction of both inhaling, and/or total tobacco consumption, could benefit be expected. Such a reduction is likely to be easier in the case of changing to pipe or large cigars, both of which are physically very different from cigarettes from the point of view of holding in the hands or mouth. However, the popularization of small, cigarette-sized cigars may carry the danger that smokers will smoke them in the same way, and in the same amount, as cigarettes." Most people agree that it is extremely important to persuade young people not to start smoking. Here, however, the Government may perhaps be wise in proceeding slowly because so little is known of how best to tackle the issue. On the other hand, there is already good evidence that if parents or school-teachers wish their children to be non-smekers they are far more likely to achieve this end by their personal example than by exhortation or threats. Above all, doctors have a responsibility in this matter. Until the medical profession clearly and obviously accepts this responsibility, the Government will have a plausible excuse for its inertia.