§ Mr. Bellinghamasked the Secretary of State for Social Services how many persons died from smoking-related diseases in the Norfolk North-West constituency in each of the last five years.
§ Mr. WhitneyIt is not possible to be precise. Most deaths associated with cigarette smoking arise from three diseases: lung cancer, chronic bronchitis and "heart attacks" due to obstruction of the arteries of the heart. However, the proportion of deaths attributable to smoking from each of these diseases varies. Furthermore, smoking is also implicated in certain other conditions where no estimate of the numbers of the deaths caused by smoking is available—for example, obstruction of the arteries of the lower limbs.
In 1983 the Royal College of Physicians in its report "Health or Smoking?" estimated that at least 90 per cent. of deaths from lung cancer, chronic bronchitis and obstructive lung disease are attributable to smoking. The total number of deaths from the main conditions involved is given in the table.
Norfolk, North-West Constituency (1984 boundaries) 1981 1982 1983 †1984 Malignant neoplasm of Trachea bronchus and lung (ICD* 162) 66 58 54 57 Bronchitis and Emphysema, Chronic airways obstruction, not elsewhere classified (ICD* 490–492, 496) 42 36 46 66 * International Classification of Diseases 9th revision.
† Figures for 1984 are not comparable with earlier years because of a change in coding rules.
In the same report the Royal College of Physicians also estimated that perhaps 20 per cent. of deaths due to
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§ Mr. WhitneyThe table shows the number of deaths which occurred in National Health Service (NHS) and non-NHS psychiatric hospitals (including mental handicap hospitals) in England and Wales for persons aged 50 and over for the latest five years, where the underlying cause of death was a respiratory or chest-related disease.
The figures for 1984 are not comparable with earlier years because of a change in coding following a rule of the World Health Organisation. In 1984 some deaths previously coded to bronchopneumonia (ICD 485) have been allocated to other chronic conditions mentioned on the death certificate.
obstruction of the arteries of the heart were related to smoking. The medical term for this condition is "ischaemic heart disease", but it is nowadays very often referred to as "coronary heart disease". The total number of deaths from this condition for the North West Norfolk constituency is as follows, but the proportion of these directly attributable to smoking is less certain as this is only one of a number of causes that give rise to obstruction of the arteries of the heart.
Year Ischaemic Heart Disease (ICD* 410–414) 1981 321 1982 277 1983 288 1984† 284 * International Classification of Diseases 9th revision.
† Figures for 1984 are not comparable with earlier years because of a change in coding rules.
The Royal College of Physicians' estimate of at least 100,000 smoking-related deaths in 1981 is based upon a total of 70,000 deaths from lung cancer, bronchitis and obstructive lung disease and 180,000 from coronary heart disease; that is, it encompasses conditions not included in the ICD categories, such as various other cancers, other vascular diseases, myocardial degeneration and so on.
Because of changes in area coding, figures are not available for 1980.