Day 023 - 13 Sep 94 - Page 06
1 whole, but they were a group that could be identified as
2 having many similarities. They were a similar social
3 class, for example, they had similar professional work,
4 things like that; their life styles were likely to be
5 similar in many respects, and yet there was one group that
6 smoked and one group did not. One could see quite a
7 marked distinction between them in terms of outcome from
8 lung cancer. From then similar studies were carried out
9 looking at groups of people in a more general way within
10 the population.
11
12 MR. JUSTICE BELL: So those studies were both case-control
13 studies and prospective studies, were they?
14 A. Yes, they were.
15
16 Q. I suppose one thing you can say about smoking, whether
17 they are honest or not about it, but people do know
18 whether they have ever smoked or not?
19 A. Yes.
20
21 Q. I suppose some people's recollection may be better than
22 others, but do you have a view on whether it is easier for
23 a patient to recall smoking habits than dietary habits or
24 can one not make a generalisation?
25 A. I would think there is no doubt it is much easier to
26 make -- well, to judge whether you have smoked or not. As
27 we were saying yesterday, it is actually sometimes very
28 difficult to recall one's diet, even something that one
29 ate a week ago, so I think recollections of diet are very
30 difficult. This is one of the problems which I think is
31 inherent in the studies that have been carried out. The
32 methodology is difficult; whereas you can say to people:
33 "Have you smoked?" And many of the patients that we deal
34 with today, for example, gave up smoking five or six years
35 ago, but they at least can recollect they did smoke before
36 that. It is a relatively simple factor to remember.
37
38 MS. STEEL: It might be harder for them to remember how many
39 they smoked?
40 A. Yes, indeed, but other work has actually shown there
41 is a dose relationship, as you were talking about. The
42 more cigarettes you smoke the greater the risk, so there
43 does not appear to be any safe number of cigarettes.
44 There may be a safe number of drinks you can drink, for
45 example, but there are not a safe number of cigarettes to
46 smoke.
47
48 Q. In terms of some aspects of your diet, people might be
49 able to remember certain things quite well, might they
50 not, for example, if they have never eaten meat or if they
51 stopped eating meat at a certain point, or if they knew
52 they used to gorge themselves on cream cakes every week.
53 I agree that it is, you know, difficult for you to
54 remember exactly what you ate a week ago, but there are
55 certain aspects of your diet you might very well recall
56 easily.
57 A. I think what you are suggesting though are major
58 changes in diets. If somebody decides to give up meat,
59 that often is not something that happens just like that.
60 People actually make a conscious decision to do that.
