{"entity":{"id":"paper-peto-smoking-cessation-lung-cancer-uk-bmj-2000","kind":"paper","name":"Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies","aka":[],"tldr":"Quitting works, and it works even in middle age. Men who stopped at 30 had a 2 percent lifetime risk of dying of lung cancer, at 40 it was 3 percent, at 50 it was 6 percent, and those who carried on had 16 percent.","summary":"Peto, Darby, Deo, Silcocks, Whitley and Doll related United Kingdom national trends in smoking, cessation and lung cancer since 1950 to two large case-control studies, one centred around 1950 and one around 1990: 1,465 case-control pairs in the 1950 study, and 982 cases with 3,185 controls in 1990.\n\nThe paper is the reason cessation, rather than prevention alone, became a health service activity. It is also the cleanest demonstration in the literature that the risk from a cumulative exposure is not fixed at the moment of exposure: stopping changes the future even after decades of smoking.","asOf":"2026-09-25","links":[{"label":"BMJ 2000","url":"https://doi.org/10.1136/bmj.321.7257.323"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/10926586/"}],"tags":["lung-evidence"],"related":["paper-doll-peto-50-year-doctors-bmj-2004","smoking-cessation-after-diagnosis","prevention-roadmap"],"cancers":["lung-cancer","nsclc","sclc"],"sections":["prevention","early-detection"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["richard-peto"],"bottlenecks":["b-prevention-adoption","b-global-access"],"keyPapers":[],"journals":["bmj"],"dependsOn":[],"notes":[],"journal":"BMJ","year":2000,"doi":"10.1136/bmj.321.7257.323","pmid":"10926586","authors":"Peto R, Darby S, Deo H, et al.","paperType":"observational","findings":["Cumulative risk of death from lung cancer by age 75 rose from 6 percent at 1950 rates to 16 percent at 1990 rates in male cigarette smokers, and from 1 percent to 10 percent in female smokers.","For men who stopped at ages 60, 50, 40 and 30, the cumulative risks of lung cancer by age 75 were 10, 6, 3 and 2 percent.","By 1990 cessation had almost halved the number of lung cancers that would have been expected if the former smokers had continued.","Stopping before middle age avoids more than 90 percent of the risk attributable to tobacco.","For men in early middle age the prevalence of smoking halved between 1950 and 1990 but the death rate from lung cancer at ages 35 to 54 fell faster still, indicating some reduction in risk among continuing smokers."],"whatItMeans":"The single most quotable number in tobacco control: quitting at 30 avoids almost all the risk, quitting at 50 avoids half of it, and it is never not worth stopping. It is also the argument for putting cessation support inside a lung screening appointment rather than beside it.","caveats":["National statistics combined with two case-control studies forty years apart, not a randomised comparison of quitting against continuing.","Risks are quoted in the absence of other causes of death, which overstates what an individual smoker experiences.","United Kingdom figures; the shape holds elsewhere but the absolute risks track each country's smoking history."],"changedPractice":true},"route":"/key-papers/paper-peto-smoking-cessation-lung-cancer-uk-bmj-2000/","neighbours":{"paper":[{"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/"}],"technology":[{"id":"smoking-cessation-after-diagnosis","kind":"technology","name":"Smoking cessation in cancer patients","route":"/technologies/smoking-cessation-after-diagnosis/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-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/"},{"id":"sclc","kind":"cancer","name":"Small-cell lung cancer","route":"/cancers/sclc/"}],"section":[{"id":"early-detection","kind":"section","name":"Early Detection & Screening","route":"/fronts/early-detection/"},{"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-global-access","kind":"bottleneck","name":"Most of the world has almost no cancer care","route":"/bottlenecks/b-global-access/"},{"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/"}]}}