Smoking and health 50 years on from landmark report

Fifty years ago on Tuesday, a key report was published that marked the beginning of a change in our relationship with smoking.

Although there had been previous warnings linking smoking and lung cancer, it was the 1962 study by the Royal College of Physicians, Smoking and Health, that really broke through to the public and politicians.

Attitudes in the intervening 50 years have changed enormously.

But in 1962, very few people took the dangers posed by smoking cigarettes seriously.

That view is captured perfectly by some footage from the BBC archive, a report on the Tonight programme into the RCP study.

One man who says he smokes between 20 and 25 cigarettes a day is - by today's standards - amazingly fatalistic.

"Quite honestly, I think that the end of one's life is probably more in the hands of almighty God you know, than in my own hands or the hands of the tobacco manufacturers."

The reporter asks another man whether the enjoyment he gets from smoking is worth the risk.

"I think so, yes. If I'm going to die, I'm going to die, so I might as well enjoy life as it is now."

Watching the footage now, it seems impossible that people could have been so blase about the risks smoking poses to their health.

The 1962 RCP report was launched in a blaze of publicity, using what was then a new technique - the press conference.

But the report's authors needed to be innovative to get their message across to a public - and politicians - who probably didn't want to hear it.

After all, most of them were smokers

In 1962, about 70% of men and 40% of women in the UK smoked.

And they smoked everywhere - on trains and buses, at work, even in schools and hospitals.

Fast forward 50 years and how times have changed.

The busy street outside the pub or office is now the smokers' domain.

And today about 21% of men and women smoke.

Smoking has become a minority occupation.

Lasting legacy

Prof John Britton, chair of the the present-day RCP's tobacco advisory group and director of the UK Centre for Tobacco Control Studies, says the 1962 report has had a lasting legacy.

"Modern tobacco control policy as promoted by the World Health Organization and used internationally, is really based on recommendations that are in that report.

"So 50 years later we're still, in many countries in the world, just starting to deal with recommendations that were made there.

"It really set the scene for effective tobacco policy and led the world."

The landscape changed profoundly and relatively quickly.

In 1965, cigarette advertising on television was banned in the UK while in 1971 health warnings appeared on cigarette packets.

Further restrictions followed, culminating in the ban on smoking in enclosed public places like bars, pubs and restaurants, introduced in 2006 in Scotland and the following year in the rest of the UK.

But there has been a social change in smoking too, says Dr Penny Tinkler of the University of Manchester.

"If you go back to the 60s for men, it was cross-class, and for women, it was cross-class but with particular emphasis among those who were comfortably off.

"It's really shifted over the decades in terms of who is smoking so now instead of being associated with affluence, it's more associated with disadvantage.

"In part it's because people who can afford to give up, or people who have a better quality of life, can give up.

"It's always been harder to give up if things have been difficult so it's not surprising those people in difficult circumstances are less inclined to give up."

Smokers, once comfortably in the majority, now find themselves on the outside.

Alien views

A small group huddled in front of a Manchester office block reflected the feeling among many smokers that they are now marginalised.

"Sometimes you do feel a bit of an outcast if you're out in a restaurant or in a pub or something," said one woman.

"I'm not happy, I'm not proud of it. I won't encourage my children to do it - I go outside at home," said her colleague.

How alien those views would have seemed to the smokers of the 1960s.

But more change is coming.

From next month tobacco products will be banned from public display in big supermarkets. Ministers are seriously considering plain packaging for cigarettes.

And 50 years on, tobacco still has a powerful hold over millions of lives.