Lee P N
Br Med J. 1979 Dec 15;2(6204):1538-40. doi: 10.1136/bmj.2.6204.1538.
From 1951 to 1971 male doctors reduced their cigarette smoking more than did men in social classes I and II combined. In 1970-2, 665 male doctors died aged under 65. Had they shown the same improvements in cause-specific death rates over the 20 years as men in classes I and II, 699 deaths would have been expected. This "saving" of 34 deaths in the doctors comprised savings from coronary heart disease (83), stroke (16), and lung cancer (8) balanced by 60 "losses" from three stress-related causes--namely, accident, poisonings, etc (30); suicide (26); and cirrhosis of the liver (4)--plus 13 from other causes. As a relative reduction in mortality from heart disease in doctors (as compared with that in social classes I and II) also occurred during 1931-51--that is, before they began to give up smoking--some of the saving in heart-disease deaths in 1951-71 was probably not related to changes in smoking habits. The relative worsening in mortality from stress-related diseases may have been due partly to a possible adverse effect of giving up smoking if smoking had acted to reduce stress. From these findings, the benefits of giving up smoking may not be so great as has commonly been assumed.
从1951年到1971年，男性医生减少吸烟的幅度超过了社会阶层I和阶层II男性的总和。在1970年至1972年期间，665名男性医生在65岁之前死亡。如果他们在这20年中特定病因死亡率的改善情况与阶层I和阶层II的男性相同，预计死亡人数应为699人。医生群体中这34例“死亡挽救”包括冠心病（83例）、中风（16例）和肺癌（8例）的死亡减少，同时因三种与压力相关的原因导致60例“死亡增加”，即事故、中毒等（30例）；自杀（26例）；以及肝硬化（4例），另外还有13例由其他原因导致。由于在1931年至1951年期间（即医生开始戒烟之前），医生群体中心脏病死亡率相对于社会阶层I和阶层II也出现了相对下降，所以1951年至1971年期间心脏病死亡人数的部分减少可能与吸烟习惯的改变无关。与压力相关疾病死亡率的相对恶化可能部分归因于如果吸烟起到减轻压力的作用，那么戒烟可能产生的不利影响。从这些研究结果来看，戒烟的益处可能不像通常认为的那么大。
