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.

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