Pioneer in tobacco research receives first Winslow Medal

Last fall when the World Health Organization began negotiating a new global treaty aimed at curbing tobacco use, particularly among young people, Sir Richard Doll, M.D., D.Sci., looked on with a great deal of satisfaction.

In 1950, Doll published the first convincing evidence that smoking was the cause of lung cancer. This was during an era when a physician might try to calm a patient’s nerves by offering a cigarette. Doll, a smoker at the time, had speculated that rising lung cancer rates might have to do with the increase in the number of cars on the road. Through painstaking epidemiological work, however, he and his colleague Sir Austin Bradford Hill found and documented the link to tobacco.

This and Doll’s lifelong contributions to epidemiology and public health—including the understanding of peptic ulcer disease, the health effects of oral contraceptives and the role ionizing radiation plays in causing leukemia—prompted the Yale University School of Public Health to make Doll the first recipient of the C-E.A. Winslow Medal in mid-October.

The medal is given in honor of Charles-Edward Amory Winslow, who established Yale’s Department of Public Health, as it was known when it was founded in 1915, and is regarded by many in the United States as the founder of the modern discipline of public health. During his tenure at Yale, Winslow expanded the definition of public health from the narrow confines of public hygiene to include the prevention and control of heart disease, cancer, stroke, mental illness and diseases associated with poverty. According to Dean Michael H. Merson, M.D., many important changes occurred during Winslow’s tenure. Bacteriology evolved into microbiology to include parasitology and virology, and public health experts began to recognize the social aspects of sickness.

Merson said Doll was selected as the first recipient of the medal because he is the “foremost epidemiologist of the second half of the 20th century.” Doll’s papers, which are “classics because of the rigor in their study design, the elegance of their analysis, and the clarity of their reporting,” established his reputation as the “epidemiologist’s epidemiologist,” Merson said.

During the course of his career, Doll refrained from speaking out against tobacco companies because, as he said in an interview, “my job was to do the research and make evidence. ... The active research worker has to disassociate himself from the steps that are taken as a result of his research.” But now that he is no longer actively researching the tobacco issue, he is happy to give his opinion on the continued efforts of those in the tobacco industry who market their products to youth.

“It’s like selling heroin,” he said. “One happens to be legal and the other isn’t, but they are both equally morally evil. I don’t object to the manufacture of it. We’re not going to stop that overnight. What I object to is its promotion, encouraging people to use it.”

Doll, who received his medical degree in 1937 and his doctor of science in 1958 from the University of London, considers his work on tobacco to be his greatest professional accomplishment. Formerly the director of the United Kingdom Medical Research Council’s Statistical Unit, Doll was appointed the Regius Professor of Medicine at the University of Oxford in 1969. At Oxford he also directed the Cancer Epidemiology and Clinical Trials Unit, and has continued to work with the unit since his retirement as a professor in 1983.