Epidemiology of smoking related diseases which physicians encounter in their office practice.

T he practicing physician can no more ignore the smoking habits of his patients than he can avoid the process of diagnosing the illness that brings that patient to him. Even if there were no associations, causal or contributory, between smoking and disease, the average practitioner would find that over half (51.0 per cent) of his men patients and one-third (33.2 per cent) of his women patients aged 17 years and over are regular cigarette smokers.’ This may be compared with the prevalence of cigarette smoking in the United States as derived from the Current Population Survey for February 1955.2 In that year, 49.8 per cent of men and 23.6 per cent of women aged 18 years and over were regular cigarette smokers. Thus, in one decade, women smokers increased approximately 50 per cent with but a slight increase for the men. The women can thus be seen to be rapidly approaching the men in prevalence of the cigarette smoking habit, and for both sexes, this habit constitutes one of the most common exposures to an environmental hazard. These smoking prevalence data represent the patterns for the population irrespective of illness. When one considers the high degrees of association between cigarette smoking and mortality and morbidity from such diseases as lung cancer, chronic bronchitis and emphysema, cancer of the larynx, coronary heart disease, cancer of the bladder and esophagus, and cerebrovascular disease and between other forms of tobacco use and cancer of the buccal cavity, it is logical to conclude that an even greater proportion of all patients seen by the practicing physician will present a history of current regular smoking. The gravity of the situation which we now face can be expressed in several ways. In 1965, of the 1,828,136 deaths from all causes, 866,340 (47 per cent) were from diseases associated with tobacco