There are fewer nuclear weapons in the world today than there were in 1963 and they have a smaller average yield. As they became more accurate, we reduced the yields. After all, I don't need a 40 lb 155 mm artillery round to kill somebody. If I can plant a cherry bomb flush to your skull it will provide plenty enough energy to do the job.
Cells can mutate due to radiation exposure, or they can die. If they do the latter, they will either not get the opportunity to do the former, or it will become irrelevant if it has already happened.
There is an indescribably complex difference between causing an oncogene and causing someone to grow a third eye or a second nose.
As the "radiation winds start poisoning the air" (for goodness sake, will you please read a non-fiction book and learn something real) and disperse around the Earth, their concentration gets thinner and thinner. The surface area of the Earth is over 500,000,000 square kilometers, or 500,000,000,000,000 square meters. A radiation concentration that begins high enough to be scary is diluted by millions to billions of times. People may face an increased incidence of illness and death, therefore a shorter life expectancy due to cancer, but they won't all drop dead in a few weeks, or a few years. That is why no sane person will ever build a "dirty bomb." The only person or people who it will kill are the idiots who plant it.
The best diplomat I know is a fully charged phaser bank.
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