The man who warned the world about smoking

ORIGINALS

Fifty years ago, almost no one suspected cigarettes had anything to do with England's soaring rates of lung cancer. Most people, Richard Doll included, thought smog was to blame.

It was 1948, and Doll, a young doctor with a mathematical bent, had recently been hired by his government to help find out what was behind the grisly trend. Like others, he knew that the automobile's rise neatly matched Britain's increase in lung cancer deaths, which had ballooned fifteen fold in just 25 years. Motor exhaust, he guessed, was making the country's renowned stew of air pollutants more toxic.

To prove it, Doll proposed to compare people who got lung cancer to those who didn't and then tease out the differences between them. But to be meaningful, such a study required a cast of thousands. Striking out across London, still bomb-ravaged only three years after V-Day, Doll doggedly negotiated with 20 hospitals to inform him of new lung cancer cases. Within a year and a half, he'd studied nearly 2,500 patients, 709 of them with lung cancer. The results smashed Doll's expectations. Pollution did not explain the increase in lung cancer deaths; city and country dwellers suffered at the same rates. Smoking did.

In a report published in 1950, Doll stuck his neck out. Smoking causes lung cancer, he said. And the more you smoke, the higher your risk. Almost immediately,Doll was dismissed by the British government, which feared that taking a stand against smoking would incite what it called cancer phobia.

Doll was so alarmed by his findings that he quit smoking halfway through his study. Since then, millions of his countrymen have done the same. In 1947, 86 percent of British adults smoked. Now 35 percent do.

Still, smoking killed 3 million people worldwide last year, 419,000 of them in the United States alone.

Is Doll disappointed that so many continue to smoke? "That's the wrong way to look at it," says the 82-year-old epidemiologist. "Millions and millions of people have changed an ingrained habit. That is really quite extraordinary."

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By Anthony Schmitz

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