Medicine and the Public: The 1962 Report of the Royal College of Physicians and the New Public Health

Abstract

The 1962 report of the Royal College of Physicians on smoking was a significant event in the history of smoking. Its significance was, however, more than smoking-specific: the RCP committee's appointment, its membership, its work, and the manner of its publication signified the changes within social medicine, and within the medical profession more generally, in postwar Britain. Doctors assumed the right to speak to the public and to government on matters of individual health, and a new risk-based public health was in the process of formation. A public health “policy community” formed, and governments began to assume responsibility for advising the public on health matters. The use of research in the report, and of social research in response to it, was important in the emergence of evidence-based medicine within public health. The paper argues for greater attention to the change in public health epitomized by the report in current debates on the concept of the 1960s “permissive society.” It was the harbinger of a new style of “coercive permissiveness” in health.

Maurice Seevers, the stimulants and the political economy of addiction in American biomedicine

“…7 Justly famous for marking the emergence of a new voice for public health, that British report recognized smoking as a cause of heart disease and cancer, considered smoking an addiction on par with alcoholism in that habitual smokers crave their regular and typically high dose, and called for strong tobacco control measures such as steep taxes (Royal College of Physicians, 1962;Berridge, 2007). These features of Smoking and Health alone testify that public health opinion leaders could conceive of tobacco as genuinely and importantly addictive in 1962.…”

Prävention chronischer Herz-Kreislauf-Krankheiten

“…Diese Zurückhaltung beruhte v. a. auf deren Ablehnung eines staatlichen Gesundheitssystems und einem befürchteten Verlust wirtschaftlicher Unabhängigkeit. Mit der ärztlichen Standespolitik ging der Fokus auf individualmedizinische Prävention in den Hausarztpraxen einher [8,6]; zusätzlich behinderte die föderale Struktur des Gesundheitswesens die Einbringung zentraler Gesetze zum Ausbau bevölke-rungsbezogener Präventionsmaßnahmen. Mehrmals angestrengte Reformen scheiterten [7,25].…”

“…Sowohl Regierungen als auch die Ärzteschaft vermieden es, die Öffentlichkeit über ihre Lebensweise zu belehren, da direkte Handlungsanweisungen zum Verhalten des Individuums in den Jahrzehnten nach dem Zweiten Weltkrieg mit Kriegspropaganda assoziiert wurden [6]. Darüber hinaus galten Rauchen und anderes, langfristig gesundheitsschädigendes Verhalten in den 950er Jahren in der Regierung noch nicht als Gesundheitsproblem [7].…”

“…Regierung und Ärzteschaft gewannen ein neues Bild von der Bevölkerung, die jetzt als Konsumenten gesehen wurden, die aktiv von individuellen Lebensstilrisiken überzeugt werden mussten [6]. Dieser Mentalitäts-wandel drückte sich auch in der Gestaltung von Informationskampagnen aus.…”

Climate change and health: time to adopt environmental probity?

“…5 Following this report there was a change in the relationship between doctors and society. 6 Given the evidence and the importance of the message, the medical profession felt empowered to take a stance and speak directly with society and to lobby the government for political action aimed at minimising the effects of tobacco consumption. Doctors were in the vanguard of behaviour change by stopping smoking and advocating the same for their patients.…”