Transcript ANTISMOKING CRUSADER SIR RICHARD DOLL AUTHOR . Dr. A. K. AVASARALA MBBS, M.D. PROFESSOR & HEAD DEPT OF COMMUNITY MEDICINE & EPIDEMIOLOGY PRATHIMA INSTITUTE OF MEDICAL SCIENCES, KARIMNAGAR, A.P.. INDIA: +91505417 [email protected].

ANTISMOKING CRUSADER
SIR RICHARD DOLL
AUTHOR
.
Dr. A. K. AVASARALA
MBBS, M.D.
PROFESSOR & HEAD
DEPT OF COMMUNITY MEDICINE &
EPIDEMIOLOGY
PRATHIMA INSTITUTE OF MEDICAL
SCIENCES, KARIMNAGAR, A.P..
INDIA: +91505417
[email protected]
SIR RICHARD DOLL
(October 28, 1912. TO July 24, 2005)
•Epidemiologist
•Activist
•Researcher
•Public health
lobbyist
SIR RICHARD DOLL
• 1912: Born in Hampton, England, on 28
October
• 1937: Graduated from St Thomas's Hospital
Medical School in London
• 1939-45: Served in the Royal Army Medical
Corps
• 1946: Started work at the Medical Research
Council
• 1951: Co-authored a paper suggesting
smoking causes lung cancer
• 1954: Co-authored a paper confirming the
link between smoking and lung cancer
• 1956: Awarded an OBE
GLOBAL RECOGNITION
• 1962: UN award for cancer research
• 1974: New York Academy of Science
Presidential Award
• 1981: Bruce Medal, American College of
Physicians
• 1983: Gold Medal, British Medical Association
• 1986: Royal Medal from the Royal Society
• 2000: Gold Medal from the European Cancer
Society
• 2002: Norway's King Olaf V award for
outstanding work on cancer
• BBC NEWSTUESDAY, 22 June, 2004
WHAT ELSE CAN ANYBODY
ACHIEVE
• Every human being wishes to become
somebody but not a nobody.
• Sir Doll fulfilled his earthly mission by his
yeomen service to the people of the world
through his breakthrough research on ill effects
of smoking.
• He did not stop there , he fought for that cause
selflessly in courts.
HIS MIND
•Relatively speaking,
I was always more
interested in prevention
than in therapy.
•
DURING BBC INTERVIEW
FAMILY BACKGROUND
• Richard Shaboe Doll was born in 1912 in
Hampton, the son of Henry Doll and
William Amy Shaboe, into a background of
some affluence, despite his father’s
having had to abandon medical practice
because of multiple sclerosis.
• Richard Doll married, in 1949, Joan Mary
Faulkner, also a doctor, who died in 2001;
EDUCATION
• He first went to Westminster and lost
his chance to go the Trinity College,
Cambridge, after bungling his
mathematics scholarship exam, and
instead went to St Thomas's Hospital
Medical School.
• Doll was educated at Westminster
School and St Thomas’s Hospital,
from which he graduated in 1937.
BEGINNING OF HIS CAREER
• The war closely followed his membership
of the Royal College of Physicians, and
his service in the RAMC was spent largely
as a medical specialist on a hospital ship
in the Mediterranean, until he was found to
have tuberculosis.
• After the war, Doll returned briefly to St
Thomas’s to research asthma, only to
become disillusioned.
TURNING POINT
(PROMPT FOR RESEARCH)
• His disillusionment drew him away from
clinical practice and towards a career in
research.
• Moving to the Central Middlesex County
Hospital in 1946, working in the emerging
field of epidemiology, he sought to find the
causes of a disease combining his
knowledge of statistics with his knowledge
of Medicine.
RESEARCH CAREER
• He joined Dr Francis AveryJones’s unit at the Central
Middlesex Hospital with an
attachment to Sir Austen
Bradford-Hill’s statistical
research unit of the Medical
Research Council.
MAJOR ACHIEVEMENT
• SMOKING &
LUNG CANCER
RESEARCH
HIS GROUNDBREAKING
RESEARCH 1950
• His 1950 study, which he
wrote with Austin Bradford
Hill, showed
THAT SMOKING WAS "A
CAUSE, AND A MAJOR
CAUSE" OF LUNG CANCER.
LUNG CANCER WORK
• After surveying lung cancer
patients in 20 London hospitals
finding that smoking was the only
thing common to them, implicated
smoking as the overwhelming
cause of lung cancer.
FIRST FAMOUS REPORT 1950
• Sir Richard Doll authored his famous
report in 1950 that claimed "the risk
of developing the disease
increases in proportion to the
amount smoked" and concluded that
“it may be 50 times as great among
those who smoke 25 or more
cigarettes a day as among nonsmokers".
FAMOUS REPORT 1950( contd)
• The report was published in the British Medical
Journal in 1950, and helped bring awareness
to what many scientists today are still trying to
prove.
• The report concluded ,"The risk of
developing the disease increases in
proportion to the amount smoked. It may
be 50-times as great among those who
smoke 25 or more cigarettes a day as
among non-smokers."
• They concluded that it was rare for a nonsmoker to suffer from the disease.
BRITISH DOCTORS STUDY(1954)
• In 1954 a follow-up study
showed prospective
mortality in a sample of
40,000 doctors, followed
over 20 years.
FINAL FOLLOW-UP REPORT
• It concluded that men born between 1900
and 1930, who smoked only cigarettes
and continued smoking throughout their
lives, died on average about 10 years
younger than lifelong non-smokers.
• Those who gave up at 60, 50, 40 or 30
improved their life expectancy by,
respectively, about three, six, nine or 10
years
HIS LATER PRONOUNCEMENTS
• 1981 --Incidence of cancer of the lung by
late middle age is more than 10 times
greater in regular big smokers than in
lifelong non-smokers".
• 1983--Two years later, as director of the
Imperial Cancer Research Fund
Epidemiology Unit at Oxford, Doll reported
that smoking cigarettes was responsible
for 30 per cent of deaths from cancer of all
kinds;
HIS QUOTE ON SMOKING
EFFECTS
• In 1991 he said: "Young people say
smoking cannot be all that bad or the
Government would never allow it to be
promoted in the way it does…
• I accept that millions of pounds are at
stake, but no price can be put on the
misery and suffering of smokers who die
of cancer and of their families and friends
who are forced to watch one of the most
painful ways of dying."
IMPACT OF DOLL’S STUDY
• Change in the public’s attitude to smoking
was slow coming.
• Although cigarette commercials were
banned from British television in 1965 and
from radio in 1971, billboards and
newspapers were permitted to carry
advertising until February 2003.
PUBLIC HEALTH IMPACT OF
HIS STUDY
• In 1954, some 80 percent of
British adults smoked.
• Half a century later, that figure
was down to 26 percent, largely
because of the fear of cancer
and other smoking-related
diseases.
• Hats off to Sir RICHARD DOLL
PASSIVE SMOKING &LUNG
CANCER
• In 1986 Doll supported the findings of
research which suggested that lung cancer
could also be caused by "passive"
smoking,
• During the 1990s he was prominent in the
campaign to persuade the Government to ban
tobacco advertising.
CONGRESS ASSENT
• It was only in 1981 finally that the
Congress accepted that "incidence
of cancer of the lung by late middle
age is more than 10 times greater
in regular big smokers than in
lifelong non-smokers".
CONTINUOUS CRUSADING
• Doll, who later became director of the
Imperial Cancer Research Fund
Epidemiology Unit at Oxford, reported
that cigarette smoking was responsible
for 30 per cent of deaths from cancer of
all kinds.
• In 1986 he further extended his theories
to "passive" smoking, and campaigned in
the 1990s to persuade the Government
to ban tobacco advertising.
COMMITTED PUBLIC HEALTH
CRUSADER
• Always one to be involved with the public
concern of health, Doll's pronouncements often
made the headlines.
• He appeared in court cases against companies
that were accused of public health offences and
in lobbies against government policies that
permitted companies to get away with health
damaging products.
OTHER WORKS
OTHER WORKS
1. Alcohol increases risk for breast
cancer
2. Oral contraception
3. Peptic ulcers and electrical power lines
4. Aspirin protection against heart disease
5. studying the early epidemiology of AIDS,
even calling for the introduction of
widespread confidential testing
PEPTIC ULCER WORK
•
WORK AT AVERY JONES UNIT& HILL’S
STATITISTICAL RESEARCH UNIT OF MRC
PRESENTED PAPERS ON
1. DUODENAL ULCER :- Stress & strain not
risk factors for duodenal ulcer formation
2. CLINICAL TRIALS FOR THE TREATMENT OF
GASTRIC ULCER :- showing the value of bed
rest only in the healing of gastric ulcer but
not diet, alkali, anticholinergic drugs and
admission to hospital
CONTRACEPTIVE PILL.
• From the 1950s onwards Doll published a
steady stream of reports into both the causes
of disease and the side-effects of new
medicines.
• In 1968 he published a study on the sideeffects of the contraceptive pill.
• This suggested that women taking the Pill
faced a nine to 10 times increased chance of
developing a blood clot in their legs, but
dismissed suggestions by some American
researchers that the Pill caused a cancer-like
change in the cells of women.
CTSU ,OXFORD
• RESEARCH INTO CARCINOGENS.
• At CLINICAL TRIAL SERVICE UNIT (CTSU) of
oxford university ,
Doll and Richard Peto conducted
research
• And concluded that environmental
pollution might amount to only 2 per
cent of cancers worldwide — blaming
tobacco, diet and infections for 75 per
cent of them.
DOLL&PETO
DIET & CANCERS
• He also suggested that the
carcinogenic effects of smoking could
be affected by diet;
• Smokers who consumed above
average levels of beta carotene - a
vitamin present in carrots - could
lower their risk of lung cancer by an
estimated 40 per cent.
ALCOHOL & CANCERS
• Alcohol, on the other hand, was implicated
as a cause of cancer in upper respiratory
and digestive tracts;
• The adverse effect was far greater in
smokers because tobacco opened the way
for alcohol to attack.
• He suggested that cancer deaths could
be cut by 35 per cent by smokers
regulating their food and drink intake.
HARMFUL EFFECTS OF
NUCLEAR RADIATION.
• The harmful effects of
nuclear radiation.
• The worldwide nuclear
test ban treaty stemmed
partly from this work
TEACHER’S ROLE
• Alongside his work at the Medical
Research Council, Doll continued to
teach.
• For 20 years until 1969 he was an
associate physician at the Central
Middlesex Hospital.
• He was a lecturer at the London School
of Hygiene and Tropical Medicine for six
years until 1962.
GREEN COLLEGE AT OXFORD
• Regius Professor of Medicine in 1969 and
established single faculty medical college ,
Green college.
• Doll enhanced Oxford’s reputation for
teaching and research
• When Doll retired from Green College in
1983 he left a flourishing foundation and a
happy society whose increasing reputation
owes much to the guidance of its first
warden and his wife, Dr Joan Faulkner.
HONOURS
• He was named an Officer of the
Order of the British Empire in 1956,
• Was knighted in 1971 and
• In 1996 was made a Companion of
Honor - a select group limited to 65
persons at any one time - for
services of national importance.
AWARDS
• Awarded Saudi Arabia’s King Faisal
International Prize for medicine for their
continuing work on smoking-related
diseases.
• “Doll also held honorary degrees from 13
universities.
THE SAD DEMISE
MONDAY, JULY 25, 2005 09:45:05 AM
• LONDON: Sir Richard Doll, the British scientist
who first established a link between smoking
and lung cancer, died today at age 92, Oxford
University said.
• The epidemiologist, whose research was
credited with preventing millions of premature
deaths, died at the John Radcliffe Hospital in
Oxford after a short illness, according to the
university, where Doll worked at its Imperial
Cancer Research Center. The exact cause of
death was not immediately released.
May His soul rest in everlasting
and eternal peace.
•
How does one mourn the passing of a
giant?
• A legendary researcher and teacher who
inspired all the doctors who read his work,
even those who never heard or saw or met
him?
An irreparable loss to Medicine, to Science, to
Humanity and verily, to this Earth.