Michael A. H. Russell 1932-2009

On 16th July, 2009 one of the leading pioneers of the study of nicotine addiction, Professor Michael AH Russell, died of a heart attack in South Africa. Mike Russell’s obitiuary was published last week in the Guardian newspaper (London, UK) and the link is provided below. That obituary provides an excellent description of Mike’s style, achievements and the enormous influence he had on our understanding of the nature of tobacco use as primarily addiction to nicotine. I joined Mike Russell’s smoking research unit at the Institute of Psychiatry in London as a newly qualified clinical psychologist in 1989 and worked there for 5 years, so I’d like to take this opportunity to make a personal comment on Mike Russell.

I arrived at the “temporary” prefabricated building at 101 Denmark Hill in Camberwell, South London, as a clinical psychologist interested in doing research on human behavioral health issues but with no specific interest in smoking. I had a vague idea that Mike Russell and Martin Jarvis were leaders in their field and I thought smoking would be a good topic to do a PhD on because there were so many smokers in the UK (over 30% of British adults). At the time I had no idea that I was joining a group that was the world leader in researching tobacco addiction. So when I arrived I naively asked Mike Russell if he could give me some reading material showing that smoking was really bad for health. Mike was clearly a bit irritated by my question, and proceeded to dump four U.S. Surgeon General’s Reports and two Royal College of Physicians reports on my desk. Each one had about three hundred pages. He said, “If that’s not enough for you I have more in my office”. So I quickly learned that at this research group we would all be expected to have studied and understood the basics on our own. We would not be spoon-fed information but rather expected to pick it up in the course of our reading, research work, and particularly by listening carefully to the discussions of research issues with more experienced colleagues.

The primary forum for these discussions was the “dreaded” Friday meeting. The research group would meet every Friday morning, with everyone expected to attend. If someone had a research idea they wanted to propose, or a research report they planned to publish, they had to circulate it to the team by the previous Wednesday and expect it to be critiqued and defended at the Friday meeting. Although a little intimidating, this proved to be an excellent way for junior researchers to learn the business of doing research on tobacco addiction. It also provided a way for Mike and Martin Jarvis to monitor how the research projects were progressing and ensure that papers being submitted for publication were of a high quality. In a later interview, Mike referred to the Friday meetings as follows:

“I think we were all frank with what we thought. We were not unduly aggressive; sometimes people hit a little hard, perhaps, but then most of them were tough enough to take it. Ultimately I think we did function as a group. We all knew what each other was doing and thinking and all had a hand or say in things and I think that makes a difference.”

I think, quite unusually, Mike encouraged all members of the group to come up with their own research projects. He described it in the interview as follows:

"If they wanted to try it, even if I did not believe wholly in it, they could try it and then we would see whether it worked or not......I think our regular Friday meetings were important."

It was some years later that we discovered that a report had found the Institute of Psychiatry’s research to be the most cited of comparable research institutes in the world and many of its most cited research papers came from the smoking research group.

Mike led the research group by example. He had an eye for selecting the most important next question that needed to be answered, and for designing a study to answer the question. But he did not micro-manage at all. Rather he preferred to hire bright researchers and let them “get on with it”. I was very fortunate to start my research career working under such great leadership and with such a talented group.

Mike’s research covered a number of areas of tobacco research, from studies of passive smoking to brief anti-smoking advice by family doctors. But the part that influenced me most was his work on nicotine addiction. My favorite quote of his was:

“There is little doubt that if it weren't for nicotine in tobacco smoke, people would be little more inclined to smoke than they are to blow bubbles or light sparklers.” (1974)

On many of the topics he studied, Mike was way ahead of the rest of the world in clearly seeing the correct policy implications. On many of these, the rest of the world has now caught up, but there is one that for some reason many in public health still don’t get. On a number of occasions Mike wrote very clearly about the rationale for providing smokers with clean nicotine: if people smoke for nicotine but die from the other toxins in the smoke, let them have their nicotine in a much safer form. For example, in 1991 he published an article in the British Journal of Addiction (now called simply “Addiction”) on “The future of nicotine replacement”. In that article he stated,

“It is argued here that it is not so much the efficacy of new nicotine delivery systems as temporary aids to cessation, but their potential as long-term alternatives to tobacco that makes the virtual elimination of tobacco a realistic future target….A case is advanced for selected nicotine replacement products to be made as palatable and acceptable as possible and actively promoted on the open market to enable them to compete with tobacco products.”

Here Mike spelled out a realistic science-based vision for the virtual elimination of tobacco. I hope that now, at the time of Mike’s death, the rest of the public health community (and particularly the public health community in countries outside Britain, like the United States and China) might take the opportunity to revisit not only Michael Russell’s achievements as a scientist, but also his recommendations for policy that follow from that science.

http://www3.interscience.wiley.com/journal/119360103/abstract

But perhaps now is not the time for me to get on my soap-box about such things. So instead I’d like to acknowledge my gratitude for his kindness and inspiration as a mentor and as a person. He always enjoyed talking about his family, and I recall he had a custom that once his sons reached a certain age he took them on a planned adventure trip. One of these was a very serious mountain-climbing expedition. Although I hope that’s not my own kids’ choice for adventure, I remember thinking “what a great idea, I must try to do something like that with my own kids”. Now that I have a teenager, I realize its no small achievement to have a teenager who is even willing to go on an adventure trip with their dad!

There was one other important lesson that I think Mike passed on not just to me but to a great many researchers who passed through his smoking research group. And that lesson is that if there is a health problem that is really important, in that it causes serious diseases and deaths in a large proportion of the population, then it makes perfect sense to really focus one’s career on trying to help solve that health problem. So Mike’s ideas live on in those he inspired to focus on tobacco as a health problem needing solutions. I am thankful for that, and the world is a much healthier place for it.

The link to the obituary in the Guardian is given below:
http://www.guardian.co.uk/science/2009/aug/04/obituary-michael-russell

I’d also thoroughly recommend reading a fascinating “Conversation with Michael A.H. Russell” that was published in the journal Addiction in 2004 (volume 99, p9-19). The published interview provides an insight into Mike and his career, but also into some of the events and experiences that shaped his style and thinking. I hope the journal might consider making that article freely available to non-subscribers.

Russell MA. Conversation with Michael A. H. Russell. Addiction. 2004Jan;99(1):9-19.