Trends in cigarette consumption in Australia.

Historical trends are presented showing an increase in total cigarette consumption but a fall in the number of adult male smokers. The prevalence of smoking among children appears to have increased. The role of tobacco advertising and reduced cigarette prices are discussed. The need to prevent children from taking up smoking is emphasised, and recent data show that the earlier a child begins to smoke, the higher will be the subsequent daily cigarette consumption.

Lung cancer and passive smoking at work: the Carroll case.

Passive smoking is now an acknowledged risk to health and this has given rise to a public health liability for employers. More and more workplaces are becoming smoke free, but past practices mean that there is an increasing number of individuals seeking compensation for health damage caused by passive exposure to smoke. The case brought by Sean Carroll, a bus driver, against his employer, the Melbourne Transit Authority, was the first suit in Australia seeking compensation for lung cancer caused by passive smoking. Evidence at the hearing of the case indicated that there was at least a 75% probability that Carroll's cancer was attributable to passive smoking at work. Carroll accepted $65,000 in an out-of-court settlement. The case should prompt other victims of passive smoking to seek compensation and move more employers to ban smoking from the workplace.

Conventional treatment and its effect on survival of malignant pleural mesothelioma in Western Australia.

Analysis of the survival of all 81 cases of pathologically confirmed malignant pleural mesothelioma in Western Australia between January 1957 and December 1980 has revealed a median survival from diagnosis of 5.1 months (mean 7.8 months). The average time between presentation and diagnosis was 3.4 months. Survival was better in younger subjects and subjects selected for surgery but was unrelated to sex, symptoms at onset, history of asbestos exposure, tumour morphology, therapy other than surgery or year of presentation. The selection of subjects at earlier clinical stages for surgical intervention is considered to account for their longer survival. The outlook for patients with this disease remains poor and there is still no optimism for future advances in therapy.

Changes in tobacco advertising in Western Australian newspapers in response to proposed government legislation.

The number of cigarette and tobacco advertisements in the major Western Australian newspapers was counted for the six-month period June to November in the years 1981 and 1983. The latter period covered the introduction of the Western Australian Government's Tobacco (Promotion and Sales) Bill 1983 and the debate surrounding it. The change in the volume of cigarette advertising in Western Australia in those two years was compared with that which occurred in comparable Queensland papers in the same period. Three major factors emerged: (i) the volume of cigarette advertising was much higher in Western Australia in 1983 compared with 1981; (ii) the volume of advertising increased markedly in Western Australia when legislative action was threatened, and remained at very high levels until the Bill failed; and (iii) the number of cigarette advertisements placed in the Queensland papers surveyed fell between 1981 and 1983. The findings are presented in support of the view that the tobacco industry made a powerful and organized attack to defeat the proposed legislation; the means it adopted to do this are discussed.

The incidence of pneumoconiosis, mesothelioma and other respiratory cancer in men engaged in mining and milling crocidolite in Western Australia.

Previous employees of a mining company, engaged in mining of crocidolite at Wittenoom Gorge in Western Australia between 1943 and 1966, have been traced to determine their incidence of asbestos-related diseases. Of 6200 male employees, 220 (3.5%) have developed pneumoconiosis and 26 have developed pleural mesothelioma. No cases of peritoneal mesothelioma have been identified. Prior to 1978, 60 men had died from respiratory cancer other than mesothelioma, compared with 38.25 expected from the mortality experience of all Western Australian males. The incidence of pneumoconiosis and mesothelioma and the mortality from other respiratory cancer all increased with duration of employment, interval from first employment, and level of occupational exposure, indicating a strong relationship between intensity of asbestos exposure and these diseases. The mortality ratio for respiratory cancer, excluding mesothelioma (1.57), was nearly twice that for all nonrespiratory causes of death, suggesting a two-fold increase in mortality from respiratory cancer compared with all Western Australian males. Variation of mortality from respiratory cancer by duration of employment and occupational exposure suggests that at least 30% of respiratory cancer deaths other than mesothelioma may be due to asbestos exposure. The major part of this excess is accounted for by respiratory cancer occurring in men with previously diagnosed pneumoconiosis.

Epidemiology of malignant mesothelioma in Western Australia.

Crocidolite was mined and milled at Wittenoom Gorge in Western Australia from 1943 to 1966. Between 1960-1964 and 1980-1982, the estimated incidence of malignant mesothelioma in Western Australia rose from 0.6/100 000 in men and less than 0.1/100 000 in women, aged 35 years or older, to 6.6/100 000 in men and 0.7/100 000 in women in this age group. Overall, 97 (70%) of 138 patients with malignant mesothelioma had definite or probable exposure to asbestos; 76 of these (55%) to Western Australian crocidolite. Of the latter 76 patients, 56 had worked in the mine or mill at Wittenoom and 4 had non-occupational exposure in the Wittenoom area; the remaining 16 had been exposed to crocidolite elsewhere in the State. There were only 4 (3%) patients with malignant peritoneal mesothelioma, of whom three had been exposed to crocidolite.