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The change in the type of cigarette would have had only a moderate effect on the overall hazards of smoking, for although it should have reduced the hazard of lung cancer 12,13 it may well have had little effect on mortality from the other main diseases caused by tobacco, particularly those that depend on deep inhalation, such as chronic obstructive lung disease6 and ischaemic heart disease.43 What seems to have been more important15,38 is the maturing of the epidemic of deaths of British men from smoking with those who reached later middle or old age in the 1970s and 1980s having had a longer history of regular consumption of cigarettes than men of the same ages would have had during the 1950s and 1960s