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Last Updated: Friday, 5 January 2007, 11:02 GMT
Risks of smoking
The British Medical Journal is launching a competition to decided the greatest medical breakthrough.

Present-day medical experts are championing discoveries from the last 166 years.

Simon Chapman, professor of public health at the University of Sydney is backing the discovery of the risks of smoking.

The first warnings about the dangers of smoking tobacco emerged in the 18th century, just 200 years after the substance was brought from America to Europe.

Smoking is on the decline in many countries

In 1701, the French physician Nicholas Andry de Boisregard warned people taking in too much tobacco could suffer a withering of their "noble parts".

And in 1771, the Encyclopaedia Britannica recorded the case of "a person who through excess of smoking had dried his brain to that degree, that after his death there was nothing found in his skull but a little black lump, consisting of mere membrane".

But it was in the 1950s that two major studies outlining the dangers of smoking were published; one by the US scientists Ernst Wenderand Evarts Graham and the other by the UK's Richard Doll and Austin Bradford Hill.

An "avalanche" of research and evaluation of the risks linked to cancers and cardiovascular diseases followed.

It has been estimated that between 1950 and 2000, 62 million people or 13% of all deaths in developed countries were caused by smoking.

While the percentage of people who smoke in developed countries has fallen over that time, although levels of smoking in developing countries is rising.

Professor Chapman says: "Smoking may well continue to be a major health problem in much of the world."

But he says the WHO's framework convention on tobacco control, signed by 140 countries, will lead to "unprecedented worldwide controls" on the tobacco industry.

In the year that smoking will be banned in public places in England, he adds: "The force of these events, first set loose by researchers in 1950, means that the endgame for smoking may well be just 20 years away in the vanguard of nations where smoking is currently in freefall."

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