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A Tobacco Act for the UK?
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This type of work, which feeds into policy, into development, and into practical programmes, is needed on a greater scale. It is difficult, requires an interdisciplinary approach, and has little to offer in the way of scientific kudos. UNICEF, whose great virtue, and vice, has been its commitment to prompt and large-scale action for children without always thinking far ahead, is to be congratulated on combining its traditional approach with such a radically innovative one, to ensure that what is begun now can be continued in-aself-supporting way in the future.
David Bradley
Obituary Tim McElwain
impossible to think of cancer medicine without Tim (Mac) McElwain being foremost in one’s mind. He took the specialty from conception to adulthood with a force that few others could equal. He was the Cancer Research Campaign Professor of Medical Oncology at the Institute of Cancer Research and honorary consultant physician at the Royal Marsden Hospital. He died suddenly on Nov 26, aged 53.
management was best illustrated by his close involvement with BACUP (British Association of Cancer United Patients), both as a trustee and as chairman of the specialist advisory group, which made this organisation so important in the humane and caring understanding of patients with cancer. It was a feature of the two decades of his work at the Marsden that he instilled in the ever-increasing number of medical oncologists and other cancer workers who came through the Marsden a sense of recognition, direction, and purpose. Thus he formed the Association of Cancer Physicians-an achievement that alone would assure his place in the history of cancer medicine. The generation of oncologists that he trained are now to be found throughout the world. He was a prolific writer and had acquired from his father skills of writing which were to leave his colleagues awed. The day after he died, lunch at the Marsden, and certainly in many other places, was taken in stunned silence. He was a great spirit. There aren’t many people who, as a student, would say "let’s go out to lunch" and then hire a 30-seater plane and fly to Meet et Chandon-what a tragic loss for his family, friends, colleagues, and medicine.
Ray Powles
It is
Born in New Zealand, he went to school in Australia and did not to England until a young man. He trained at St Bartholomew’s Hospital Medical School and during this period won a handful of prizes, qualifying with honours. He had immense social as well as intellectual presence and managed, for a reason associated with one of life’s pleasures, to enter the Guinness Book of Records. He took up rowing and his mighty presence sent a shudder of respect through the Barts Hospital Boat Club and probably the rowing world. An oar, snapped like a matchstick, still hangs on his study wall and symbolises the power he brought to much of his later work. He worked as a houseman for Gordon Hamilton-Fairley, who had just been appointed as consultant at Barts and was arguably the founder of medical oncology in Britain. At that time Gordon was negotiating with David Smithers and Peter Alexander at the Royal Marsden Hospital and Institute of Cancer Research at Sutton to develop the hospital so that it could treat cancer comprehensively on a scientific basis. It was natural in 1970 that Mac should move to Sutton and become Gordon’s senior registrar. When Gordon was killed in 1975, Mac had already become a consultant physician and was beginning to attract money and staff to Sutton. At this time the haematological malignancies and lymphomas were the only diseases for which there seemed to be any hope of cure with medical therapy, and his main personal interest stayed in this area. He undertook important work in the development of treatment for children with leukaemia, and became chairman of the Medical Research Council Childhood Leukaemia Working Party. Foremost among his interests was the humane care of the patients; and with this in mind he developed better and much less toxic methods, now widely used, for treating lymphomas. Subsequently, on the basis of extensive laboratory work, he became convinced that the then dogma of always giving cytotoxic drugs in combination was wrong. He devised ways of giving high doses of cytotoxic chemotherapy as single agents-an approach that is the basis of whole new areas of work, including bone marrow transplantation. These principles were applied to multiple myeloma, and for the first time remissions were seen in this terrible disease. In the mid-1970s he had the foresight to move the momentum of medical oncology at the Marsden Hospital into the area of solid tumours. He quickly attracted a group of people who formed a nucleus that covered all aspects of the medical treatment of cancer, including childhood disease. He was appointed the Cancer Research Campaign Professor of Medical Oncology in 1983, and on countless committees, often with one short sentence, he influenced the future of cancer treatment. Mac’s interest in all aspects of patient come
Noticeboard A Tobacco Act for the UK? "Some overflowing ashtrays are more poignant than others", declared Prof John Moxham at a meeting of the British Thoracic Society (BTS) earlier this week. The ashtray he had in mind was one in the coffee room of the operating theatre suite at King’s College Hospital, London. The butts, he said, belonged to the surgeon and theatre staff who that day had amputated a leg from a patient with peripheral vascular disease caused by smoking. The patient, said Professor Moxham, must have received a confused message from the tobacco-smelling breath of the attendants who put him to sleep for his operation and those who roused him in the recovery
room.
The point of the story is that the National Health Service needs an effective smoking policy, and achieving one is to be an objective of a new pressure group of British doctors, which was launched at the BTS meeting. The group’s primary aim, however, is to lobby the Government to introduce, within five years, a Tobacco Act to control smoking. Canada, Australia, and New Zealand, in response to pressure from the medical profession, have already introduced legislation that bans or severely limits cigarette advertising. In Canada, for instance, where all tobacco advertising has been banned from newspapers and magazines and tobacco sponsorship severely restricted, a single violation carries a penalty of$250 000. In the UK, however, despite constant efforts by groups such as ASH (Action on Smoking and Health) and the British Medical Association, all that has been achieved is a voluntary agreement between the Government and the tobacco industry which most observers (but not the Government) regard as a failure. The Royal College of Physicians first called for firm Government controls on smoking in its 1962 report, Smoking and Health. In its fourth report, published in 1986, the College noted sadly that very few of its recommendations had been adopted, although "as more and more suffer the consequences of this unnecessary habit the urgency for action remains as strong as ever". The Tobacco Act outlined by Professor Moxham would encompass: restrictions on tobacco advertising and promotion; restrictions on tobacco sales to children; wider restrictions on smoking in public; an increase in tobacco tax; inclusion of information on tar content on cigarette packets; and evaluation of anti-smoking clinics. The pressure group will be formed initially by chest physicians, and to begin with the BTS will provide support services and offices. But the plan is to draw doctors from other specialties into the group and ultimately to work together with other organisations in a united attack against tobacco.
This type of work, which feeds into policy, into development, and into practical programmes, is needed on a greater scale. It is difficult, requires an interdisciplinary approach, and has little to offer in the way of scientific kudos. UNICEF, whose great virtue, and vice, has been its commitment to prompt and large-scale action for children without always thinking far ahead, is to be congratulated on combining its traditional approach with such a radically innovative one, to ensure that what is begun now can be continued in-aself-supporting way in the future.
David Bradley
Obituary Tim McElwain
impossible to think of cancer medicine without Tim (Mac) McElwain being foremost in one’s mind. He took the specialty from conception to adulthood with a force that few others could equal. He was the Cancer Research Campaign Professor of Medical Oncology at the Institute of Cancer Research and honorary consultant physician at the Royal Marsden Hospital. He died suddenly on Nov 26, aged 53.
management was best illustrated by his close involvement with BACUP (British Association of Cancer United Patients), both as a trustee and as chairman of the specialist advisory group, which made this organisation so important in the humane and caring understanding of patients with cancer. It was a feature of the two decades of his work at the Marsden that he instilled in the ever-increasing number of medical oncologists and other cancer workers who came through the Marsden a sense of recognition, direction, and purpose. Thus he formed the Association of Cancer Physicians-an achievement that alone would assure his place in the history of cancer medicine. The generation of oncologists that he trained are now to be found throughout the world. He was a prolific writer and had acquired from his father skills of writing which were to leave his colleagues awed. The day after he died, lunch at the Marsden, and certainly in many other places, was taken in stunned silence. He was a great spirit. There aren’t many people who, as a student, would say "let’s go out to lunch" and then hire a 30-seater plane and fly to Meet et Chandon-what a tragic loss for his family, friends, colleagues, and medicine.
Ray Powles
It is
Born in New Zealand, he went to school in Australia and did not to England until a young man. He trained at St Bartholomew’s Hospital Medical School and during this period won a handful of prizes, qualifying with honours. He had immense social as well as intellectual presence and managed, for a reason associated with one of life’s pleasures, to enter the Guinness Book of Records. He took up rowing and his mighty presence sent a shudder of respect through the Barts Hospital Boat Club and probably the rowing world. An oar, snapped like a matchstick, still hangs on his study wall and symbolises the power he brought to much of his later work. He worked as a houseman for Gordon Hamilton-Fairley, who had just been appointed as consultant at Barts and was arguably the founder of medical oncology in Britain. At that time Gordon was negotiating with David Smithers and Peter Alexander at the Royal Marsden Hospital and Institute of Cancer Research at Sutton to develop the hospital so that it could treat cancer comprehensively on a scientific basis. It was natural in 1970 that Mac should move to Sutton and become Gordon’s senior registrar. When Gordon was killed in 1975, Mac had already become a consultant physician and was beginning to attract money and staff to Sutton. At this time the haematological malignancies and lymphomas were the only diseases for which there seemed to be any hope of cure with medical therapy, and his main personal interest stayed in this area. He undertook important work in the development of treatment for children with leukaemia, and became chairman of the Medical Research Council Childhood Leukaemia Working Party. Foremost among his interests was the humane care of the patients; and with this in mind he developed better and much less toxic methods, now widely used, for treating lymphomas. Subsequently, on the basis of extensive laboratory work, he became convinced that the then dogma of always giving cytotoxic drugs in combination was wrong. He devised ways of giving high doses of cytotoxic chemotherapy as single agents-an approach that is the basis of whole new areas of work, including bone marrow transplantation. These principles were applied to multiple myeloma, and for the first time remissions were seen in this terrible disease. In the mid-1970s he had the foresight to move the momentum of medical oncology at the Marsden Hospital into the area of solid tumours. He quickly attracted a group of people who formed a nucleus that covered all aspects of the medical treatment of cancer, including childhood disease. He was appointed the Cancer Research Campaign Professor of Medical Oncology in 1983, and on countless committees, often with one short sentence, he influenced the future of cancer treatment. Mac’s interest in all aspects of patient come
Noticeboard A Tobacco Act for the UK? "Some overflowing ashtrays are more poignant than others", declared Prof John Moxham at a meeting of the British Thoracic Society (BTS) earlier this week. The ashtray he had in mind was one in the coffee room of the operating theatre suite at King’s College Hospital, London. The butts, he said, belonged to the surgeon and theatre staff who that day had amputated a leg from a patient with peripheral vascular disease caused by smoking. The patient, said Professor Moxham, must have received a confused message from the tobacco-smelling breath of the attendants who put him to sleep for his operation and those who roused him in the recovery
room.
The point of the story is that the National Health Service needs an effective smoking policy, and achieving one is to be an objective of a new pressure group of British doctors, which was launched at the BTS meeting. The group’s primary aim, however, is to lobby the Government to introduce, within five years, a Tobacco Act to control smoking. Canada, Australia, and New Zealand, in response to pressure from the medical profession, have already introduced legislation that bans or severely limits cigarette advertising. In Canada, for instance, where all tobacco advertising has been banned from newspapers and magazines and tobacco sponsorship severely restricted, a single violation carries a penalty of$250 000. In the UK, however, despite constant efforts by groups such as ASH (Action on Smoking and Health) and the British Medical Association, all that has been achieved is a voluntary agreement between the Government and the tobacco industry which most observers (but not the Government) regard as a failure. The Royal College of Physicians first called for firm Government controls on smoking in its 1962 report, Smoking and Health. In its fourth report, published in 1986, the College noted sadly that very few of its recommendations had been adopted, although "as more and more suffer the consequences of this unnecessary habit the urgency for action remains as strong as ever". The Tobacco Act outlined by Professor Moxham would encompass: restrictions on tobacco advertising and promotion; restrictions on tobacco sales to children; wider restrictions on smoking in public; an increase in tobacco tax; inclusion of information on tar content on cigarette packets; and evaluation of anti-smoking clinics. The pressure group will be formed initially by chest physicians, and to begin with the BTS will provide support services and offices. But the plan is to draw doctors from other specialties into the group and ultimately to work together with other organisations in a united attack against tobacco.