March 7 saw the 40th anniversary of the publication of Smoking and health, the report that could be said to have started it all off. The pioneering epidemiological work of the late Austin Bradford Hill and his younger collaborator Dr (now Sir) Richard Doll, and American colleagues such as Wynder and Hammond, formed the scientific foundations on which the first report of the Royal College of Physicians of London was constructed. That review of the then relatively new but rapidly expanding body of evidence of the devastation we now know smoking causes to health, led directly to the first US Surgeon General's report on the subject.

Ali Shahali from Iran won first place in the World's Fastest Clown 2001 international cartoon competition with his cartoon. The competition aimed to reflect the dangers of tobacco and attracted entries from 47 countries. View the other finalists at www.worldsfastestclown.com/finalist.html

It was appropriate that Sir Richard, now in his 90th year (but still working a fuller week than many people half a dozen decades his junior), was at the college for the launch of a short report aptly entitled Forty fatal years. Published jointly with Action on Smoking and Health, the campaigning body set up by the college immediately after its second smoking report in 1971, it catalogues what on the one hand can be regarded as among the most important advances in public health in the history of the UK, the USA, and many other industrialised countries, but on the other hand, when viewed in global terms, may come to be regarded as the most scandalous waste of human life ever allowed to happen.

Even as the president of the college and Sir Richard were making their brief speeches, just a few miles away public relations experts were starting another day's work to make people think that one of the world's biggest tobacco firms has now reformed and is socially responsible, and that its chief executive is a skilled and caring member of society, fit for public honour and possibly for further, high profile appointment in British public life.