David Hill: I remember, Mike, in Victoria that when the Royal College of Physicians’ report came out in 1962 and the US Surgeon General’s report in 1964, they both generated front page stories in the newspapers here and people commented on it.

We know that changing population health behaviour is very difficult. But I do think that when the first authoritative information came out a lot of people who smoked took action and started to quit. So clearly it registered in the public mind from ’62 and ’64.

Our organisations, yours and the state cancer councils, started doing something in the 1960s. In Victoria, which I know about, and probably in other states too, the Anti-Cancer Council started writing to high school principals and offering to give talks about smoking and health, and going out with 16mm projectors and giving endless talks to high school students.

I think that’s when it started.

Garry Egger:[24] As David pointed out, there was action from state cancer councils from at least 1966. I was still at university then.

Adding to Mike’s comment about politicians, I remember in ’74 Fred Daly[25] from the old Whitlam ministry coming in to see us in the NSW Health Department. He said, ‘You’ll never change smoking. Forget about it. You’re never going to change people’s behaviours’. That was it. They just gave up in those early days.

It’s testament to the anti-smoking movement that, 40 years later, we have one of the most successful public health campaigns ever. I’ve moved on to work in the much more difficult area of obesity. It took 200 years to turn the smallpox epidemic around, and it only took 40 or 50 to start having an impact on smoking. We’ve got the tough nuts now; we’re down to the hard core. But I can’t see it happening with obesity.

Ann Westmore: When you worked on the NSW north coast Quit For Life program in the late 1970s and early 1980s, Garry, what were the smoking rates?

Garry Egger: About 35 to 40 per cent overall.[26]

Simon Chapman: Women were a bit less.

Ann Westmore: Smoking was very prevalent.

Simon Chapman: There have been a couple of very important histories on tobacco and tobacco control in Australia that are treasure troves on the tobacco control movement in Australia, for example Walker’s Under Fire [27] and Tyrrell’s Deadly Enemies.[28]

At the beginning of the twentieth century the states were implementing juvenile smoking suppression acts. They were articulated, particularly to young people, half in terms of a general Lord Baden Powell notion that smoking stunts your growth, but also in a moralistic way - that it’s wrong to defile the temple of the body kind of idea.

Then there is the evolution of the epidemiology. One thing that it’s urgent to do is to go to the College of Physicians library in Sydney. It’s probably worth spending three or four days there examining the papers of Cotter Harvey.[29] He was a respiratory physician at the Royal Prince Alfred Hospital in Sydney and a founder of the Australian Council on Smoking and Health.[30] I’m not sure if he came before or around the same time as Nigel.

His papers include a letter written by the NHMRC (National Health and Medical Research Council) to the {Federal} Health Minister, from 1957 I think, urging the government to take action by advising people that they should not take up smoking. It was just as simple as that.

There was also a good deal of agitation against the idea of health warnings. Certainly the Askin Government in NSW[31] was very opposed to doing anything about it. That was in the early 1970s.

There is a paper I put together with a Masters student when we went through the early retail tobacco journals.[32] There were about five or six of these publications, one of which - the Australian Retail Tobacconist - survives today. We looked at what they were saying about smoking and youth. They were saying a number of things including that the young were great customers to get your hands on. It was frank stuff about how you could attract young people by counter displays and by the way you talked to them. They were also saying don’t be too upfront about this, showing the beginnings of awareness that it was unacceptable to do that sort of thing.

Witness to the History of Australian Medicine