In April 1994, Elizabeth Raymond, Sven Cnattingius, and John Kiely published “Effects of Maternal Age, Parity, and Smoking on the Risk of Stillbirth” in the British Journal of Obstetrics and Gynecology, now known as BJOG: An International Journal of Obstetrics and Gynecology. The article examines how advanced maternal age, defined as delivery at thirty-five years old or older, cigarette smoking, and nulliparity, or the state of never having given birth, can negatively impact pregnancy. At the time of publication, according to Raymond and colleagues, stillbirths comprised over half of all perinatal, or close to birth, deaths and more than one-third of total fetal and infant deaths in Europe and North America. In the article, Raymond and her coauthors demonstrate how certain risk factors may increase the risk of stillbirth at different stages of pregnancy, which helped set a foundation for future research in interventions to prevent stillbirth.

From 1951 to 2001, researchers at the University of Oxford in Oxford, England, conducted the British Doctors’ Study, a study that examined the smoking habits, disease rates, and mortality rates of physicians in Britain. Two epidemiologists, scientists who study occurrence and distribution of disease, Richard Doll and Austin Bradford Hill, initiated the study, and statistician Richard Peto joined the team in 1971. The objective of the study was to assess the risks associated with tobacco use, and its relationship to lung cancer. The researchers tracked 34,439 male doctors practicing in Britain, and recorded smoking habits, development of diseases including lung cancer, other cancers, respiratory diseases, cardiovascular diseases, and mortality rates. The researchers published updated results every ten years. In 1980, Doll and other researchers concluded a related study on the smoking habits and disease rates of female doctors practicing in Britain. The results of both studies provided evidence that individuals who smoked tobacco were more likely to develop chronic respiratory illnesses, including lung cancer, and cardiovascular diseases.

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