{"entity":{"id":"paper-doll-hill-mortality-of-doctors-smoking-bmj-1954","kind":"paper","name":"The mortality of doctors in relation to their smoking habits; a preliminary report","aka":[],"tldr":"Doll and Hill wrote to every doctor in Britain in 1951 asking how much they smoked, then waited to see who died. This first report, after two and a half years, is where the prospective evidence on smoking begins.","summary":"Richard Doll and Austin Bradford Hill's first report from the British Doctors Study, published in the British Medical Journal on 26 June 1954. The 1950 case-control paper had been attacked as an artefact of how cases and controls were chosen, so Doll and Hill built the answer the objection required: a cohort assembled before anybody was ill, its smoking habits recorded in advance, followed forward to death.\n\nEurope PMC indexes no abstract for the 1954 article, so OnCo carries no figures from it. The study ran for fifty years; the corpus holds the fifty-year report as paper-doll-peto-50-year-doctors-bmj-2004, and that record carries the figures the design eventually produced.","asOf":"2026-09-25","links":[{"label":"BMJ 1954","url":"https://doi.org/10.1136/bmj.1.4877.1451"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/13160495/"},{"label":"BMJ 2004 reprint of the 1954 report","url":"https://europepmc.org/article/MED/15217868"}],"tags":["lung-evidence"],"related":["paper-doll-hill-smoking-lung-cancer-bmj-1950","paper-doll-peto-50-year-doctors-bmj-2004","paper-wynder-graham-tobacco-bronchiogenic-carcinoma-jama-1950","prevention-roadmap"],"cancers":["lung-cancer","nsclc"],"sections":["prevention"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["richard-peto"],"bottlenecks":["b-prevention-adoption"],"keyPapers":[],"journals":["bmj"],"dependsOn":[],"notes":[],"journal":"BMJ","year":1954,"doi":"10.1136/bmj.1.4877.1451","pmid":"13160495","authors":"Doll R, Hill AB.","paperType":"observational","findings":["No abstract is indexed on Europe PMC; the design (a prospective cohort of British doctors whose smoking habits were recorded in 1951 and whose deaths were then followed) is read from the article itself."],"whatItMeans":"The methodological ancestor of modern cancer epidemiology. Cohort design, exposure recorded before outcome, and a dose-response relationship measured rather than asserted: this is the template every later study of a cancer risk factor follows.","caveats":["A preliminary report at two and a half years of follow-up; the dose-response and cessation results that mattered came from the ten, twenty, forty and fifty-year reports.","British male doctors are not the general population: they smoked, quit and died differently from the people they treated, which is a strength for internal validity and a limit on generalisation."],"changedPractice":true},"route":"/key-papers/paper-doll-hill-mortality-of-doctors-smoking-bmj-1954/","neighbours":{"paper":[{"id":"paper-doll-hill-smoking-lung-cancer-bmj-1950","kind":"paper","name":"Doll and Hill 1950: the case-control study that tied smoking to lung cancer","route":"/key-papers/paper-doll-hill-smoking-lung-cancer-bmj-1950/"},{"id":"paper-doll-peto-50-year-doctors-bmj-2004","kind":"paper","name":"Fifty years of the British Doctors Study: smokers lose ten years of life, quitting gives most of it back","route":"/key-papers/paper-doll-peto-50-year-doctors-bmj-2004/"},{"id":"paper-wynder-graham-tobacco-bronchiogenic-carcinoma-jama-1950","kind":"paper","name":"Tobacco smoking as a possible etiologic factor in bronchiogenic carcinoma; a study of 684 proved cases","route":"/key-papers/paper-wynder-graham-tobacco-bronchiogenic-carcinoma-jama-1950/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"},{"id":"lung-cancer-evidence-roadmap","kind":"roadmap","name":"Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch","route":"/roadmaps/lung-cancer-evidence-roadmap/"}],"cancer":[{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"}],"person":[{"id":"richard-peto","kind":"person","name":"Sir Richard Peto","route":"/people/richard-peto/"}],"bottleneck":[{"id":"b-prevention-adoption","kind":"bottleneck","name":"Prevention we already have is not deployed","route":"/bottlenecks/b-prevention-adoption/"}],"journal":[{"id":"bmj","kind":"journal","name":"BMJ","route":"/journals/bmj/"}]}}