Day 023 - 13 Sep 94 - Page 05


     
     1        A.  Yes.
     2
     3   MS. STEEL:   Is it not true that there have been quite a number
     4        of experiments on animals where, after being fed a high
     5        fat or a high energy diet, the animals have developed
     6        cancers?
     7        A.  Yes, that is absolutely true.  I have never denied
     8        that.  In fact, I quoted it in my evidence.
     9
    10   Q.   Right.  Other types of studies which support the link
    11        between smoking and lung cancer, does that include all the
    12        types of studies we were talking about yesterday,
    13        population studies and prospective studies?
    14        A.  The way the research in cigarette smoking developed,
    15        it was actually difficult to do population studies because
    16        it became quite clear after the first study that was done
    17        which looked at British doctors in this country by Richard
    18        Doll and Hill, that it was not relevant, in fact, to look
    19        at population studies, though there were studies which
    20        indicated that people who did not smoke got lung cancer
    21        very rarely.  I mean, lung cancer, you know, -- you are
    22        maybe too young to appreciate the difference -- the
    23        relationship between cigarette smoking and lung cancer was
    24        not known until the 60s, 50s, 60s, and cigarette smoking
    25        is a relatively new phenomenon in the world.  One has been
    26        able to follow the development of lung cancer, which is
    27        now the commonest single cancer killing us in this
    28        country, and that parallels quite graphically the increase
    29        in the rate of smoking.
    30
    31        What we are seeing now with changes in the patterns of
    32        smoking habits, for example, men are tending to give up
    33        cigarette smoking.  Lung cancer deaths in men have begun
    34        to plateau or even fall; whereas more women are smoking,
    35        and we are seeing now a substantial increase in lung
    36        cancer death rates among women.  It is these sorts of
    37        pieces of evidence which are more convincing about
    38        cigarette smoking, and why it was not really appropriate
    39        to do population experiments that have been necessary in
    40        other forms of illness, like cardiovascular disease or
    41        bowel cancer and breast cancer.  When you have an obvious
    42        factor -----
    43
    44   MR. JUSTICE BELL:  Leave it there.  You will be asked another
    45        question.
    46
    47   MS. STEEL:   Just so this is clear in my mind, I want to know
    48        the type of studies that you are saying point at lung
    49        cancer from smoking; animal studies you have said?
    50        A.  There are some animal studies; there are studies which 
    51        have looked at groups of people and tried to compare 
    52        people who were similar in many respects, but the 
    53        difference was that one group smoked and the other group
    54        did not.
    55
    56   Q.   So case-control studies?
    57        A.  Some were case-control studies in that sense, but like
    58        the British doctor study (which is the classical one)
    59        which looked at a group of people who were doctors, so
    60        they were not necessarily typical of the population as a

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