From the Editor's Desk

It is fascinating to consider that at the turn of the century lung cancer was perceived as a relatively rare condition, and it was not until the 1930s that clinicians began to appreciate this disorder more commonly. Alton Ochsner Medical Institutions' founder and namesake, Dr. Alton Ochsner, was one of the first physicians in the United States to establish the relationship between cigarette smoking and lung cancer, and was far and away the most perseverant in informing the medical establishment and the American public about its dangers. Throughout his career, Dr. Ochsner continued his dedication to the fight against cigarette smoking. We fittingly dedicate this third issue of The Ochsner Journal to tobacco and health, in this 60th anniversary of his landmark paper that firmly described the relationship between inhalation of tobacco smoke and bronchogenic carcinoma.

We lead off with a short description of the first large-scale legal challenge to the tobacco industry by its master architect, the Honorable Mike Moore, Attorney General of the State of Mississippi. His proposed broad legislation, which would have greatly reduced the incidence of new (teenage) smokers, was recently defeated in Congress, though new restrictions in cigarette advertising have been passed. As Mr. Moore concludes, “the battle is not over!” We get the feeling from this article that recent settlements made by the tobacco industry are merely the tip of the iceberg. A chronicle of the long uphill climb that Dr. Ochsner had to contend with in getting the message across that tobacco was responsible for lung cancer follows. The author, Dr. Alan Blum, a family practitioner and former student of Dr. Ochsner, is the Director of the University of Alabama's Center for the Study of Tobacco and Society, and the Founder and Director of the national anti-smoking program Doctors Ought to Care. Next, the world-renowned cardiovascular surgeon, Dr. Michael DeBakey, presents a keynote discussion on the progressive growth in medical knowledge linking cigarette smoking to lung cancer. Dr. DeBakey was a student of Dr. Ochsner in the 1930s when their clinical research resulted in a landmark medical paper, which is held by many physicians to be the first scientific report of the association between smoking and lung cancer. The entire text of this paper, as it originally appeared in Surgery, Gynecology, and Obstetrics in February of 1939, follows Dr. DeBakey's masterful historical account. Dr. Edward Frohlich, Vice President for Continuing Medical Education, Alton Ochsner Medical Foundation, describes the origination of the Alton Ochsner Award Relating Smoking and Health. This prestigious award was initiated in 1986 to honor individuals whose scientific work has had a major impact on the overall scientific knowledge and medical practice that links cigarette smoking to health. As one can see from Dr. Frohlich's list, the award has recognized a wide range of important clinical and basic science discoveries. Julia Cook, Co-Director of Molecular Genetics, Division of Research, describes the molecular advances that have been made in our understanding of the relationship between inhaled carcinogens and the eventual development of lung cancer. As Dr. Cook concludes, better understanding in this area can ultimately lead to the design of drugs that inhibit the cellular pathways to lung cancer.

This issue would not be complete without highlighting measures that can be taken to diminish cigarette smoking, starting with Dr. Leonard's Hudzinski's description of The Alton Ochsner Center for the Elimination of Smoking, one of the first programs of this kind in the United States. An article on the importance of medical intervention by Drs. Richard Milani and Carl Lavie of the Department of Cardiology outlines ways that physicians can confront the issue of smoking with their patients. Sadly, the authors mention that only half of current smokers report ever having been asked by their physicians about their smoking status or having been urged by them to quit. Imelda Coleman, PharmD, describes the currently available pharmacologic treatments to facilitate smoking cessation. Finally, continuing with the theme of smoking and health, the reader will notice that the Scanning the Literature section is focused exclusively on this topic.

We hope that you will find this issue to be as provocative and interesting as did the team of individuals who have brought it to you! Please take a moment to let us know what you think by sending in the self-addressed, postage paid card.