Oscar Auerbach

Oscar Auerbach, a doctor who stubbed out cigarettes, died on January 15th 1997, aged 92

When Oscar Auerbach established a link between smoking and cancer the everyday world of millions of people started to change. The companionable cigarette, the antidote to the pains of civilisation, the soldier’s solace, the lovers’ token, was now to be shunned. The cigarette that bears the lipstick’s traces no longer seemed so romantic, now that it offered the prospect of premature death. Those who continued to smoke came to feel persecuted, snatching a guilty puff in the street away from the frowns of their abstemious workmates.

Dr Auerbach almost certainly had no idea of the impact his research was going to make. He was the single-minded scientist sometimes depicted in fiction, buried in his work, emerging from his laboratory only to lecture to students at New Jersey Medical School. He did not enter into the so-called “tobacco wars” waged between anti-smoking campaigners and the cigarette firms that fought hard to defend their markets. Indeed, the publicity given to some of his early findings greatly upset him. The New England Journal of Medicine declined to publish them because of its policy of using only previously unpublished results.

The doctor’s findings were published later in other journals, but some tobacco companies pounced on their earlier technical rejection to claim that they were faulty. Sowing doubts about research into the effects of smoking has been a powerful tactic in the industry’s slow and artfully managed retreat. Even now, many years after Dr Auerbach’s work was made public, the tobacco people are far from conceding defeat. In the rich countries it is generally accepted that the tar and carbon monoxide in cigarettes do no good at all to the lungs (or the heart), and sales of cigarettes have fallen dramatically (although Americans alone still smoke more than a billion a day). In developing countries, in China for example, tobacco consumption is increasing. Deaths from diseases linked to smoking, at present estimated at 3m a year, are rising. On the other hand, an incalculable number of lives have been prolonged as a result of the publicity given to Dr Auerbach’s work. It is not a bad memorial.

As often happens when a discovery’s time has come, the idea of a link between smoking and illness was mooted by a number of scientists. In Britain in 1951 Sir Richard Doll and Sir Austin Bradford Hill began a survey of smoking among some 34,000 male doctors which continued until the 1990s. In America there were similar large-scale studies. Dr Auerbach had studied diseases linked to social conditions since he had become a doctor in 1929 after studying in Vienna and New York. In the 1930s he was among those who sought the best treatment for tuberculosis. In the 1950s, while tuberculosis seemed to have yielded to drugs, cancer was unconquered. Dr Auerbach was a practical man. While, statistically, smoking seemed to be a culprit – the more you smoked the greater the chance of getting cancer – he set out to seek medical evidence of the link. In his research, much of it financed by the American Cancer Society, he looked at tissue changes wrought by cigarette

smoking in the lungs of people with cancer. A colleague of his recalled that the doctor might look at 2,000 slides a day. He offered direct, visual proof that cigarette smoke altered cells and that the damage intensified with every puff. Correlation had moved to causation.

In 1964 an increasingly health-conscious American government felt it had enough convincing evidence to take on the cigarette manufacturers. After a report by the surgeon-general on the dangers of smoking, cigarette packets were made to carry a health warning. At first this was the gentle advice, “Smoking may be harmful to your health”. Now it is the no-nonsense “Smoking kills”, in large type. In Britain and some other countries cigarette packets and advertisements have to carry similar labels.

Many of the subsequent findings about smoking came from Dr Auerbach’s research: the possible danger of breathing in someone else’s smoke, the so-called passive smoking; and the good news that if you give up smoking a damaged lung may heal. He trained a pack of dogs to smoke. Of the 86 beagles in the pack, 12 developedcancer. After the New York Times published the story in 1970, every television network in America carried a report of the smoking beagles. The tobacco industry was caught off guard. This story publicised the danger of smoking as nothing else had. The industry rushed to defend itself. Dogs were not the same as humans, its spokesmen said. This was nothing but a “scientific hoax”.

However, there was a public reaction against the use of dogs in the experiment. The sorrowful beagles puffing away touched many a heart. Snoopy, the dog in the “Peanuts” cartoon, was a beagle, for goodness sake. But if Oscar Auerbach has sometimes been remembered as “the beagle man” he hardly noticed. His life was ordered in the laboratory and the lecture room, not in the irrational world outside.