25 July 2005

Recalling Sir Richard Doll

Sir Richard Doll died July 24 at John Radcliffe Hospital in Oxford, England. Doll was the British epidemiologist who, with Austin Bradford Hill, ran the “British Doctors Study”, which established the link between smoking and lung cancer.

The study was begun in 1951, and was one of the earliest prospective epidemiological studies. Doll and Hill wrote to every registered physician in the United Kingdom, and tracked the responding two-thirds (more than 34,000!) for 50 years. (Thanks to Wikipedia for providing the citation for the final report: Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observation on male British doctors. BMJ (2004) 328:1519-33.) But because they had so many respondents, they were able to draw nearly immediate conclusions about the association of smoking with several serious diseases.

It is interesting to recall how the tobacco industry responded to studies like the British Doctors Study. They disputed the scientific significance of the link, often by deploying friendly (i.e., paid) consultants. Action on Smoking and Health cites a variety of fascinating industry documents documenting this – for example, Project Whitecoat, in which Philip Morris paid a group of scientific witnesses to obfuscate the second-hand smoke issue. They also argued that regulations on smoking would devastate the economy.

Does that sound familiar? The parallels between the smoking-and-health “controversy” and the climate change “controversy” are striking. And, in that they illustrate our continuing failure to learn from history, downright scary.


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