“Lung cancer continues to be the leading cause of death in both men and women in the US, with over 158,900 deaths in 1999. Worldwide, lung cancer kills over 1 million people a year. Extensive prospective epidemiologic data clearly establish cigarette smoking as the major cause of lung cancer. It is estimated that about 90% of male lung cancer deaths and 75–80% of lung cancer deaths in the US are caused by smoking each year” (Hecht, 1999). Clearly, lung cancer is an important and widespread disease that constitutes a major public health problem. This was not always so. Some 150 years ago, it was an extremely rare disease. In 1878, malignant lung tumors represented only 1% of all cancers seen at autopsy in the Institute of Pathology of the …show more content…

Originally, cigarettes were hand rolled and this made them expensive. In 1876, the cigarette manufacturer Allen & Ginter offered a prize for the development of a machine that would speed up the process. When James Albert Bonsack developed a machine that could make 70,000 cigarettes in a 10 h day, Allen & Ginter did not want to use it—partially out of fear that the machine would produce more cigarettes than the market demand justified. James Buchanan Duke had no such qualms; he acquired 2 of the machines and went on to commercial success. In 1889, “Buck” Duke became president of the new American Tobacco Company.

World War I helped to popularize the smoking of cigarettes. Soldiers in the trenches smoked to relieve stress, and so did many civilians, including an increasing number of women at home. General John J. (“Black Jack”) Pershing reportedly stated: “You ask me what it is we need to win this war. I answer tobacco as much as bullets.” In the following decades, smoking continued to be “enjoyed” by hundreds of thousands until, after the first report of the Surgeon General in 1964, public awareness woke up and smoking became recognized as the hazard it is. The trend in lung cancer incidence slowly decreased and, at least in men, appeared to flatten out.

There was, however, one lung cancer where it had been obvious for a long time that it might be caused by an external agent. As early as 1500, attention was called to this particular condition. In two