Why did it take so long for the results of his (and other) studies to be accepted and much longer still for the necessary consequences to be draw from them and acted upon?

By exposing the dangers of smoking, Professor Doll's work is credited with saving millions of lives, yet if there had not been so much (and such well-financed) resistance to his findings, and governments had not dragged their feet for so long, millions more lives might have been saved.

Despite Prof. Doll’s findings, billions of dollars continued to be spent year after year, not discouraging, as any sane and rational person might have thought, but actively encouraging people to smoke. I remember first becoming properly aware of the statistics in the 1990’s for Germany, where I lived at the time (more than 40 years after Prof. Doll’s initial report was published).  My response was one of disbelief: 90,000 Germans, a conservative government estimate informed me, died every year as a consequence of smoking; yet 100’s of millions of dollars were still being spent by the tobacco industry on advertising; there were bill boards advertising and vending machines dispensing cigarettes on virtually every street corner; the checkouts of every supermarket displayed and advertised cigarettes. How, at the same time, could they be killing 90,000 people a year? Surely there had to be some mistake?

I went in search of an explanation, which slowly dawned on me: people everywhere are virtually blind to the “insanities of normality “, especially when they have a vested interest in them.

This is an important insight, but one that by its very nature, is difficult to convey to others. Initially I had grave doubts myself: surely it must be me who was mistaken? It is a possibility that I cannot rule out completely and which still causes me to have doubts from time to time.

Because of this blindness and unwillingness to face up to the dangers of cigarette smoking, millions of lives have been lost - sacrificed, not to an evil dictator's insane ideas of racial purity, but to the primacy of powerful economic and financial interests. Yet many more lives are at stake in future - not just from cigarette smoking, but from other, even more dangerous behaviours, which as a society we refuse to face up to, and are thus persisting in.

A simplified, but nevertheless fairly accurate, explanation for society’s blindness and failure to respond rationally to the “insanities of normality “ is that in a sense it is addicted to them. By the time the dangers associated with cigarette smoking were recognised, it was already a "normal" part of life, upon which many people depended in a variety of ways. Most who smoked were psychologically and/or physically dependent, i.e. addicted, to their habit. The tobacco industry depended on it as a source of income, as too, to a greater or lesser extent, did the media and advertising industries, who were also in a uniquely powerful position to influence public awareness and opinion. The tobacco industry also had the financial clout to employ clever but unscrupulous (or ignorant) scientists and lawyers to help fight their corner, rationalising the irrational, defending the indefensible, and justifying the unjustifiable. Then there were those who depended on or simply enjoyed sponsorship or donations by the tobacco industry. Government ministers and MP's were lobbied and rewarded (not to say bribed) for helping to obstruct the necessary legislation. It would be interesting to know the role played by well-known newspapers and magazines: how long they delayed before deciding (or being forced) to put their readers' health and life expectancy before advertising revenue?

But there is no time now for accusations, even if they are justified. It is far more important that we now face up to what happened - and why.

A few million premature deaths a year through smoking, as terrible as it is, is far from being our biggest problem. Non-smokers, at least, can live with that. What we cannot live with (because ultimately it threatens to kill us all) is our fundamentally non-sustainable, growth-dependent economy and the grossly materialistic lifestyles it engenders. This is our biggest, effectively our only problem. Only we are not facing up to it - for reasons very similar to, if not identical with, those which kept us from facing up to the dangers of smoking for so long.

Daily Telegraph, 25 July 05: "Professor Sir Richard Doll"