US surgeon general ignites furor with findings on smoking in the workplace

Our plain-English summary of US surgeon general ignites furor with findings on smoking in the workplace, by M. Korcok (CMAJ, 1986).

The study

• Author: M. Korcok
• Journal: CMAJ
• Published: 1986;134(7):801-6
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Free full text

In plain English

This was a news article, not a research study. A freelance writer described the US Surgeon General's December 1985 Smoking and Health report on cancer and chronic lung disease in the workplace, and the reaction to it. According to the article, the report said that workers exposed to asbestos for more than 20 years increased their lung cancer risk fivefold, while male smokers not exposed to asbestos increased theirs 10-fold. The article also stated that an asbestos worker who smokes has a 50-fold increase in lung cancer risk, and a 90-fold increase if smoking more than one pack a day. It reported the report's statement that an asbestos worker who quits for 10 years may still have 25 times the risk of a nonsmoking non-asbestos worker, but less than one third the risk of continuing to smoke. The report concluded that smoking appeared to be the most important cause of chronic lung injury for most US workers. The AFL/CIO labour federation said the report minimized and misrepresented occupational hazards. The article attributed these figures to the 1985 report but gave no study methods, confidence intervals or citations to the underlying studies.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: News article (journalistic report) describing the 1985 US Surgeon General's Smoking and Health report and reactions to it; not original research
• Who was studied: US workers, as discussed in the Surgeon General's report; the article itself studied no group
• Exposure: Cigarette smoking and workplace exposures, including asbestos, cotton, coal and silica dusts and radon daughters
• Main results:
  • The report was described as saying that workers exposed to asbestos for more than 20 years had a fivefold increase in lung cancer risk.
  • Male smokers not exposed to asbestos were described as having a 10-fold increase in lung cancer risk.
  • The article stated that an asbestos worker who smokes has a 50-fold increase in lung cancer risk, and a 90-fold increase if smoking more than one pack a day.
  • An asbestos worker who stops smoking for 10 years may still have 25 times the lung cancer risk of a nonsmoking non-asbestos worker, but less than one third the risk of continuing to smoke.
  • Lung cancer risk in asbestos workers was reported to increase with the number of cigarettes smoked per day.
  • Both smoking and asbestos exposure were reported to increase resistance to airflow in the small airways. Without smoking, this increase did not appear to produce obstruction on standard spirometry.
  • Lung injury from asbestos and other dusts combined with smoking-related injury may produce more disability than either exposure alone.
  • The AFL/CIO criticized the report as minimizing occupational hazards.
• The authors' conclusion: The Surgeon General's report, as quoted, concluded that while many occupational exposures can injure the lungs, smoking appeared to be the most important cause of chronic lung injury for most US workers. It also said occupational lung disease and cancer can be markedly reduced by continuing to clean up workplace fumes and dusts.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Related studies

• Clinical findings among asbestos workers in U.S.: influence of cigarette smoking — Y. Lerman, I.J. Selikoff, et al. (1986)
• Asbestos, asbestosis, smoking, and lung cancer. New findings from the North American insulator cohort — S.B. Markowitz, S.M. Levin, et al. (2013)
• Effects of tobacco smoking on findings in chest computed tomography among asbestos-exposed workers — T. Vehmas, L. Kivisaari, et al. (2003)
• Investigations on the effects of chronic cigarette-smoke inhalation in Syrian golden hamsters — W. Dontenwill, H.J. Chevalier, et al. (1973)
• Behavioral, attitudinal, and physiologic characteristics of smoking and nonsmoking asbestos-exposed shipyard workers — V.C. Li, Y.J. Kim, et al. (1983)
• Low-dose exposure to asbestos and lung cancer: dose-response relations and interaction with smoking in a population-based case-referent study in Stockholm, Sweden — P. Gustavsson, F. Nyberg, et al. (2002)

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