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World No Tobacco Day is observed around the globe every year on 31st of May, drawing attention to the negative health effects of tobacco use which still lead to millions of death around the world.

sir-richard.jpgWhile the role that tobacco consumption plays in the development of cancer is now at least well-known, it was not always so: sixty years ago, cancer was generally thought to be a natural consequence of old age, much like grey hair or wrinkled skin. It was the pioneering work of Sir Richard Doll, Regius Professor of Medicine at the University of Oxford, that showed that smoking was a major cause of the then rapidly increasing epidemic of lung cancer in the UK.

When the results of his study were first published in 1950, the medical community had already noticed that the number of deaths due to lung cancer had been increasing rapidly. But the cause for this increase was not known: Doll himself initially thought that the increase might be due to tarring of roads, as there were known carcinogens in tar. However, careful study showed that the consistent difference between those who had lung cancer and those who didn’t was that the lung cancer patients had smoked.

To convince a still-sceptical community in the 1950’s (when smoking was very common), Richard Doll then enrolled 40,000 British doctors into a new type of study in 1951: all of the participants were asked about their smoking habits, and then followed prospectively over many years, to track the eventual cause of death. This British Doctors Study contributed to our understanding of the effects of tobacco on health for 50 years, as Doll continued to meticulously follow every British doctor that he had originally recruited in 1950 who still lived in Britain.

Courtesy of Cancer Epidemiology Unit, Oxford Courtesy of Cancer Epidemiology Unit, Oxford In large part due to Richard Doll’s efforts, in 1957 the British government because the first government to accept that smoking causes lung cancer. Our understanding of the ill effects of tobacco and smoking have continued to evolve since then, and NDM researchers continue to work on tobacco-related diseases. 

The Richard Doll Building on Oxford University’s Old Road Campus opened shortly before Sir Richard Doll’s death in 2005. It currently houses the Cancer Epidemiology Unit, amongst many other research units.

Richard Peto, Valerie Beral & Richard Doll on roof of Richard Doll Building, Photo courtesy of Cancer Epidemiology Unit, Oxford
Richard Peto, Valerie Beral & Richard Doll on roof of Richard Doll Building, Photo courtesy of Cancer Epidemiology Unit, Oxford Richard Peto, Valerie Beral & Richard Doll on roof of Richard Doll Building, Photo courtesy of Cancer Epidemiology Unit, Oxford A plaque inside the building has the following quote from Doll:

'Death in old age is inevitable, but death before old age is not. In previous centuries 70 years used to be regarded as humanity's allotted span of life, and only about one in five lived to such an age. Nowadays, however, for non-smokers in Western countries, the situation is reversed: only about one in five will die before 70, and the non-smoker death rates are still decreasing, offering the promise, at least in developed countries, of a world where death before 70 is uncommon. For this promise to be properly realised, ways must be found to limit the vast damage that is now being done by tobacco and to bring home, not only to the many millions of people in developed countries but also the far larger populations elsewhere, the extent to which those who continue to smoke are shortening their expectation of life by so doing.'