The demise of most medical journals and the transformation of the remaining rump has been predicted for years, not least in my book The Trouble With Medical Journals, which I wrote in 2003 and was published in 2006. One major factor has kept journals going: the fact that they are the main (if inadequate) device for scoring academics. But the appearance of Plan S, a programme by funders to make all research open access, and the rapid rise of preprints was already threatening the ancien régime before the pandemic arrived. Now the requirement to publish fast and make everything related to the pandemic accessible for free is shaking journals further. The role and future of journals will be discussed today with the editors of The BMJ and JAMA on a webinar of the Royal Society of Medicine, but here I want to concentrate on just one question about the future—whether paper journals will survive?

In Mike Berners-Lee’s book on the carbon footprint of everything, I read about the carbon footprint of newspapers, which triggers for me a question of how much longer paper versions of scientific journals will continue. There are other reasons apart from their carbon footprint why paper journals are likely to end, including cost and severe limitations, and it is probably more a question of when rather than whether.

Let’s start with carbon. Berners-Lee writes: “A quality paper every day of the week adds up to 270 kg CO2e per year, even if you recycle them all. That’s equivalent to flying from London to Madrid one way.”

Journals like The BMJ, Lancet, and Nature are weekly not daily, and they are not as thick as what Berners-Lee calls “a quality paper” (I hate quality being used as an adjective), but they are thicker than the Guardian Weekly, of which Berners-Lee writes the following:

“Opting for a slimmed-down weekly paper, such as the Guardian Weekly, is one good way to reduce emissions. Another is to get your news online. If you do this for an hour a week on a 50-watt laptop and if we multiply that by, say, 5 to take account of the production of the laptop, the running of your network and the electricity consumed by all the hubs and servers around the world that support the websites you browse, it still comes to around half the impact of the Guardian Weekly.”

It’s also worth noting that journals are thicker than the Guardian Weekly and come in packets, and Berners-Lee wrote his book when a much smaller proportion of electricity was generated from renewables and laptops were less energy efficient. The carbon saving may thus be greater than Berners-Lee estimated. Further, if readers send their discarded journals to landfill rather than recycle them then their carbon footprint more than doubles

Then the sad truth of a journal like The BMJ is that it is sent to many people who belong to the BMA but don’t read the journal. I estimate that perhaps 10% of recipients never read the journal, and the majority read only a small part of it. Most doctors also receive many other journals—specialist journals and journals from their colleges. College journals are often thicker than The BMJ and yet, I suggest, are even more poorly read. People usually read only a small proportion of even the journals they subscribe to: I subscribe to the Economist, but most weeks read only about a fifth of it at the most.

The cost of printing, warehousing, and distributing paper journals is a high proportion of their costs—perhaps 10-20% of traditional science publishers’ gross revenue. For newspapers, most of which are no longer profitable and many of which have disappeared, costs are even higher: 25%-35% for paper and printing and 30%-40% for distribution. Newspapers can be potentially made profitable overnight by ceasing printing paper versions, and publishers of paper scientific journals can similarly increase their profits—or save themselves—by ceasing publishing on paper. Financial problems caused by the covid-19 pandemic may hasten this change.

Many scientific journals are already available only electronically—all those, for example, published by the Public Library of Science and Biomed Central and all new journals; and some journals that did have a paper form now exist only electronically. Indeed, The BMJ is best described as an online journal with various paper versions that contain subsets of what is available electronically. Many readers of journals, particularly younger ones, read only online and through apps. For years I taught a class on medical journalism at Imperial College, and I would ask students each year what they read: 15 years ago several read paper newspapers and publications; now none do.

Publishing scientific papers is old-fashioned in that it restricts length and does not allow access to the full dataset. It does not make sense in the electronic world to restrict length when it means leaving out details of what was done and does not leave space for the many caveats that always accompany science. Brevity may be appreciated by casual readers, but there are few casual readers: those who really care about the science want every scrap of detail, including access to the full dataset.

I should confess here that I prefer to read paper journals, particularly journals like The BMJ and Lancet that are much more than a collection of scientific papers, and I read them more than I read journals online. Indeed, if I want to read an article very carefully I will often print out the paper version of an online article, partly so that I can make marks on the paper version. There is some evidence from neuroscience that reading on paper allows for deeper reading, but I wonder if this might be a generational effect. I prefer reading novels to reading scientific journals, and, in contrast to my preference for paper journals, I prefer to read the novels on a Kindle.

Publishers and editors are nervous about stopping producing paper version of journals for fear of losing readers, particularly subscribers, and advertising; and there are strong sentimental ties to paper. But as older readers die and advertisers follow the eyeballs to online versions, paper versions will look ever more anachronistic, and their carbon footprint and cost will consign paper journals to history.

Richard Smith was the editor of The BMJ until 2004.

Competing interests: None declared.