Dr Tom Smith: Then and now

Are we healthier now than we were in the 70s?

It depends on how you define health. In the 70s, the Queen sent around 1,000 centenarian telegrams a year - today, the figure is closer to 20,000. However, I doubt that will continue. Look at the crowds at Wembley for the famous (I'm a Scot), or notorious (if you are English), football match in 1977, when the Scots (who won 2-1) brought down the crossbar and took home a smidgen of turf - there's not a fat fan to be seen. Now look at football crowds today - at some matches there are 40,000 beer bellies. That is a huge change, and will lead to early deaths from strokes, heart attacks and diabetic complications. We also see a lot of liver disease in young women - unheard of even 10 years ago. That's due to new drinking habits.

Has the pill helped or hindered us?

Helped - a lot. It arrived in the mid-60s, when women were overburdened with unwanted pregnancies and chronic illnesses due to multiple births, and with financial and marital worries that seriously affected their mental health. I was a hospital house surgeon in Birmingham at the time, and write from the heart about the tragedies I saw daily. The pill and the Abortion Act made a huge difference. The pill has never been without its dangers - the early years brought mini-strokes and blood clots, and later we heard concerns about breast cancers - but on balance it has been a great benefit medically, and for women's sexual and social lives.

· Do you have a question for Dr Smith? Email doctordoctor@guardian.co.uk

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