SMOKING KILLS

Conrad Keating (Signal Books, £17.99)

How many of people have heard of Richard Doll, or, indeed, of epidemiology? This word — new to me until I read this book — means the science and distribution of diseases, and the name of Richard Doll is little known outside Oxford.

Keating, who is writer-in-residence at the Wellcome Unit for the History of Medicine, has written the authorised biography of the man who probably saved tens of millions of lives.

Born in 1912, Doll grew up at a time when life expectancy was far shorter than now and when medical students could expect at least one of their group to die of tuberculosis. He qualified as a doctor, but his deepest interest was mathematics, and his ambition was ‘to use statistics for the common good’. He became a Communist in the 1930s (he left in 1957) because of his deep concern for the health inequalities caused by poverty, and had a fine war record. Later he and his wife founded the Independent Adoption Society because non-Christians were unfairly banned from adopting children.

But his ground-breaking work began after the war, when cigarette smoking had replaced TB as the chief cause of premature death. For several decades most people, including experts, refused to believe this. Doll himself gave up smoking early on in his researches, and lived to be 92. A most cautious and conscientious scientist, he looked at the impact of asbestos, Agent Orange, fluoride, radiation and the contraceptive pill, but concluded that tobacco was much more dangerous than them all. His study of the smoking habits of British doctors, which ran for 50 years, proved beyond doubt that lifelong heavy cigarette-smokers had a 50 per cent chance of dying of lung cancer. And now we think that the habit isn’t glamorous, but disgusting.

He was a man of flinty integrity, who refused to take the closed scholarships to Oxbridge offered by his school and gave away his consultants’ fees to Green College which he helped to found. Keating’s book deals with his public, much more than his private life, but still, non-specialists will find it fascinating. I was particularly interested to read about Dr Alice Stewart, who pointed to the dangers of X-raying pregnant women.

Another public benefactor, another name you probably didn’t know.