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i (ll~~ ~l I,, F // -//-7S l)I~. 1_ - Prepared qvesi;ions for Sir Ric?~ard Dol.l :.-_,.^~'rt; `-- ~ l'nt;ervicw - Br•is'cene _i?1 EWv ?_(a)-- -~~) . 1TOss r~;uz ~°.s rclatirE, to intcrzie.:s wii;h Sir ic,'ci14ua Doll ~c')' - :,Pt'1±::+lJTY. 7, _ Article publ.i_s.:eci on results of the - Horyn Opinion Poll findin:_=c on . "i5po91sorshi.T•~7 of .~`,~po'rti1'g, u, C12ii i&r al kci:lv].{ 1CE". hl'YENDIZ 4 - CAJ±iU report on "S.:o?:lr•g ar,c? Your S'-a!lri:'' - - pUZ)'Il:f1G:d in Rac1:ig•C-r ::ecl, magazine 4

CO)'1' 4 ]J.th hovcviibr.i•, 19,7S- S(Il;la?S't'I;IY M1'f'1'l:C,1T. PC)f: iD(7T.L, 'LN'F1;It1'.Lli1t'ETti:cnty or so years .n{,o two sets off invcsti-T;atoi•s on opposite sides of the Atlantic rchort-ed, their scparat-c findings of a statistical associati:cn bcticeen ci-,rarette smoking and disease, notably lung canccr.- I'rofcssor Sir Richard Doll, a member of the British team of Doll -and Ilill, has rcinai-ncd identified over all those years with the anti-smokinti cause. He is in Brisbane forr a seminar on "Cancer.and Tipid'emiology". QUESTION: Dr. (or perhaps Professor) Since epidemiology is bound to fi--ure prominently in this interview, would you kindly expl.ain its meaning briefly? (Reply by Doll) QL'ES'TION: I i d like to refer you to an article you wrote a fetw montrhs ado in the Journal of the Royal Co7.] c:oe of Gencr•al Practitioners in which you expressed your view as an C'pldcmioloo''ist on the effect of changes in the environment on the health of the communi ty. You made what I thought was a heartening statemen` for smokers that mortality from lung cancer in England and! 19;il:es was on the decline. I be:li eve that a decli.nc has also occurred in Germany and that it is true of the 55-64 age o oup in Australia. What do you think the i*cason for the trend? ,Ir

I 1911E•`";1'L(1N; :c.: you trrcrt;c "i"li yuut ar1;.i.s:lc, ltutt' ccrrrtr t mort;tl"i:Ly futs bec:n clc creur;:i;nd ruicder G(d yc:':w•:; ut• age for i:he p;tst 10 years whi.le cit;tlrcL.Le snto(c inr: has nott decreased significantly ittn the t;cncrall populat;ion„ }iasn 't the time come to take sontc of the heat out o£ the anti"-cig"aretlie campaign? QUliSTI(9'r: In your article in the Journal of the Royal Co]•].egc of Genera]: Practitioners you diticusscsci in carefully clroscn tcrms tlie possibL]ii ty that the reduction in lung cancer mortality at young ages • is so large that it encourat,cs the hope that the change to filter tipped cigarettes and the reduction in tar content of the smoke is having an effect an<t, I acld'k'.itll emphasis, e1irrespect:ilva, of •a change in size and number of cigarettes consnmecl. "' Do you foresee the time khcn it may `**50~5 41 be possib]"c to make a more specific jr.rd'qment than that? QUESTION: If tlic preference for f-il_L"er tipped, Iowtar residue cigarettes is contribuLing to a Iuno, cancer decline, Austr;:,lian smokers must bc well placed Irecause Australia has one of the h•igliesL• filter tipped markeL"s in the wvrlr[ and t)lu tar measctreme.nes of Australian cibaret:,es are among the l.owestt in the worlcl7 ~I111:57111)4: Somc people, .TI believe, arc not cnUi.nc.ly saLi.r:fi:c d: . tlt:il: the role of i:ncluslirial pol•lut.ion in t:hc. cautint•.i.on ol' 1.rur~; c:utcCt• l.itrs hr'c•tt ,jur:Lly cvalul•ecl. An :trLi.clrs :in the Medical .Jrxtt•rtctl: ol' Alteal:r:rl•La i.ra Flctrclt tari;::: yr.:rr n:;:;crl.r a! Llo:rG (,li-rc are 1',rtrl.l" a nri',I I i.orn~ d i:/"f r i r•1rtt pru t Iltat.:t rtt•:<' in t ltc! ],ra:;c•r• ':t i 1>

i --3- Stv.'cl-)•. t)tatI s a whoLe Ivt 1110 r'k . I,o.IJLuLniitLltuir: :u^c lu oclucc:d by a Intr'tn-ng Cil'ct,t:c. QLDESTIO;c: L'<IiTlicr I mentioned your article in which you mentioned thst filters and~ reztucr.d trar contcaat. were probably contrihut.int;, to the ma1•lcc:dly reduced lung cancer ra.tes iri Cn-llancL and' 1'!ul-c ;. Is it rlot possible tltat: rigorous pursuit of yo.- Clean Air Act is playing a more important than reduced tar contenC of cic~atrcttccs? part QUESTION: , Does the decreased mortality from lung cancer add' credence to the theory that overall mortali from all cancers does not vary greatly ac.t;l thar. what happens is that for reasons that cannot- bdd ex.plained the disease strikes in cycles at different organs? COMME1:T: I should explain that I asked that qur:stion ' because I read somc time a_,o a statement byan ~ American doctor that while cancer cx the lung going up in the U. S. , cancer of the st-umcch r::a -X going down and he didn't kno+a why. fle slpecular" that the cancer of the l.uno~ upsurte woulct probably correct itself just as cancer of l:he stomach was doing. figured promi-ncntly in recent smokint; and health QUGS'fI1Dti~: A Professor Philip Burch of Lecci;: Uni.vcrs,ity, hra discussions in the U.K. Ile seems to have conc:luded thaL' ttte claim that luup; cancer is al.moat, entirc.ly due to ci6 n y arcl,•L.e sniok.i.n„ i..; cattt::l:ropltic and corrspic:uou:-: howler"?

i I i I .. %_• .:-1 -./ fllll:?if 1'WN': I'i'cof cn~or Ifcrr•c:li !;ay:+ Llrat, nnl, ii 1! hr: r r.cr 1 I.y I uol.ccl clirc:lily i,ni:n l.frc: tiulS.L,u^t, 1ic: a,:c:cclitc.cl (,lirt lryf>c~Chi>:i.r:. t:hnt a cau:tial. I F.rrlc cxi.tit.,ti bc~:LtJCCn lnmg, carac,ci• rar() . smolcin";. Why has he re jccted it? QUESTID`d: Last year you and Professor Burch set out in ,'rNew Scientist" your conflictj_:n- vicc.•s on smokin- ancf lung cancer and the editor of that prestigous journal, Dr. Bernard Dixon, i;rote an editorial explaining his reasons for publ.ishin_- the two articles. The final sentcirce in the editoriul read: "There is no place here for blind i•aaaiicisr^r. i F Do you think there has been a fanatical element in th, " long ardumcnt about smoking? QUEST101`': I am especially interested in the comment you made - in your "Ne.o Scientist" article that no one who has made any serious study of the figures (on lung cancer, that is) ha:s ever doubted that much of the recorded increase has been artificial ctua: to better diagnosis. My special interest arises from: (1). You arc in disagreement with the 1971 l:unort of the I:oyal College of Physicians (P$3) which rejected the proposition that improved di_a,:3osis cxPlaincd the increase in lunE;, cancer casr:>. (2)) Dr. misel Gray, Director of the Anti_-Canccar Council of Victori.a, has written ( Canc_er 1+ociay, that the increase in lung cancer cannol> be capJ.:ri.na:cd by irrrprovecl di,cgnostic ahili.Cy. Asl;udy clonc at a I;ri::bcuic ifospiLal ( i.t' c,^as (3) t the Yt>i.ncctiti Alr.sanclra) xluocec>.cl •a very hi;;lr lYCrcc iiC:rv_;cr al.' di:.xgiiost•i.c error wit)t ctutcct•. .../5 r

A chccl: car•r•i.cill tjc.rl; nC l'.lrc {1o<:L(cr~c }Io5(ri'l;tcll iin New )`ur3c 1>u2i .lu.ng c,irlr.r,r- cti.:chuc>ti(.icI error without autopsy at a level in czz:css of.' 50~. 4 t~IUESTlO°I: We have in this country a mounting campai_gn l;o divide the entire Aust,r•alian community into smokers and non-smokers :,nc1-to bring the two into social collision. f' hel i.eve niuch the :,amc thing is happening in CI)c U.K. thrr,,c.,h an organisation known as ASII, an acronym standing for Action on Smoking and Health. Do you see that strategy as being he71pCu1 to the anti- smoking campaiorn?. QUESTION: ' In Australia we are experiencing an increasing outcry for protection agaim-:t pas.si_ve smol:inc;•, i, e. , a non-smole¢r e s inhal:.tion of smolce cre: ti,sd' by others. Ifere again contr•oversy r.x_ists. lt seems to me that the tests which provolaecl' t:hc: current reaction were based on estrone„ „ unventilated conditions not experienced :im day to day life. Iias it in fact been establiished that exhaled cigarette smoke harms non-smokcrs or is it mcrely an anno ancc which simle courtes y y .V could ovorcomc? 9h1I.S'P:L(1'.': An aspect of` the smoking and health statistics that cont.i.nues to ptti•r.lc a lot of pcnp):a is that the data do not show Lhe consistency that woulcd help gct rid of the puzzle. For eaaml>:te, Amct•i•r..an>: are said t.o nmoke twice a.ti much as tlte lintjiti{i Izul, have ahoicl-• ha.l.iI, the Iun.; cat.rcer ralic.. Furl:hor•, a meclica). Coofft•,y 1)c:ur, ha:: pcllpd c• .....~(i. 2 0250254~0

i 4 \/ f'r.•csm Lltc ll.l:. who it:tvc ac,:Lt.Lc:d :iai Sottl.lt AI'rica, . N(.w "l.nalruul, Atistr.cl..i.a attcl, I laiink Cattctclct, Lctrui,u to r:ntoke ntoi•e but have lower luro,; catao:ccr r•aLcs' than the j`o11: they left back home. I[ow are tltes, contradic:tiotas exhlcti_ncd? QUESTION: I•11)at explanation is there of the apparent pa?•adox tha't the overwhelmin;; niajority of do not develop Iuti,y ¢raur:ca: wher•cas some non- smokers do?