10 / 80
8
M E D I C U S
A P R I L 2 0 1 6
W
hen I started working
on tobacco in 1973 from
the Royal College of
Physicians of London, public health
campaigns (or “pressure groups” as
they became known) didn’t exist. The
then-novel approach we developed
with ASH (Action on Smoking and
Health), entailed a rigorous emphasis on
sound science, clear priority objectives
and policy targets, bringing health
organisations together in coalitions – and
a combination of senior medical figures
and youthful energy.
In retrospect, I am amazed by the
generosity of those senior figures. They
knew they wanted a campaign to change
attitudes among media, communities
and governments, but they weren’t sure
what that meant. They showed faith in
a young man with long hair and purple
suits who took them into confrontation
with the powerful and exceptionally well-
connected tobacco industry and into a
new kind of advocacy that generated
public attention, assorted threats
from tobacco companies, and attacks
from the industry’s political and other
fellow-travellers.
They provided wisdom, guidance,
and unwavering support. I recall as a
turning point my decision to start asking
questions at tobacco industry Annual
General Meetings. I had bought one share
in each major company so that I could
attend their showpiece events and ask
innocuous questions – such as how many
deaths their products had caused during
the year. I was worried that my Board
might not support this, so didn’t tell them
and thought I might lose my job.
I need not have worried. Their only
question was whether they could go to
the AGMs themselves. In passing, those
AGMs brought me two wonderfully
enjoyable episodes. After one AGM,
the Chairman of Rothmans privately
offered me funding to work on any
campaign of my choice other than
tobacco; a few years later, an angry
shareholder got up to berate the same
company about falling sales, pointed
across the room and shouted angrily,
“and that’s the bugger that’s doing it”.
More than 40 years later, the basics have
not changed. Cynical industries still
knowingly promote harmful products;
many governments and decision-makers
are still more interested in supporting
harmful industries than in protecting the
public’s health; there is still a need for
active campaigners.
We have also learned that a few
campaigners supported by professional
organisations and health groups can
over time achieve remarkable results,
despite powerful and massively funded
opposition. And happily, there are still
senior health and medical figures
willing to stand up for the health of the
community – as the AMA has often
shown.
But alongside those senior figures
(who, alas, now include me!), we need
new generations of public health
campaigners to carry the batons.
They can bring the energy, innovative
thinking, passion and resilience that
campaigning needs, and importantly an
understanding of what influences public
and political thinking in an era where new
technologies rule, and the opposition is
even more cynical, dishonest and
sophisticated.
Succession planning is needed in
campaigning as elsewhere. I hope that I
and my generation can be as supportive
as my mentors of the 1970s – and as
willing to allow others to take the lead.
Passing on batons doesn’t mean
disappearing from the scene. There
is much work to be done; we can
encourage, train, offer whatever lessons
we have gleaned from our experience,
write, and even make the occasional
foray into media and advocacy. But
we must also learn to stand back from
some of our roles, and support the next
generations of campaigners as they
develop new approaches, take risks,
become “go to” people – and field the
4am media calls!
The British American Tobacco company,
whose products have caused millions
of deaths, recently tweeted: “Passion is
what excites and inspires us. It’s what we
look for in graduates.”
Whether it is tobacco, alcohol, Aboriginal
health and disadvantage, obesity or any
number of other important causes, I
can only urge young doctors and health
professionals to show their passion
by becoming involved in public health
campaigns. We need you to take over!
■
Professor Mike Daube AO
Professor of Health Policy
Curtin University
But alongside
those senior
figures…we need new
generations of public
health activists to take
up the challenges
Passing on the
public health baton
C O MM E N T