XX. Meeting at The 14th World Conference

The 14th World Conference on Tobacco OR Health connected people from many parts of the world. It also represented a real opportunity to see how these communities of scientists and activists are connected generationally. We can now assume that tobacco causes many chronic diseases. Accumulation of this knowledge is the bedrock on which the foundation of anti-tobacco advocacy is built. Science provides the means for testing hypotheses (Does it work or not?), estimating effect sizes (How much of the substance produces what effect?), maintaining the knowledge, and drawing inferences based on what we have learned. The assumptions that we can now make about the harmful effects of tobacco are built on the experience and findings gleaned over the previous half century of scientific work – much of it brilliantly thought out and meticulously executed, right here in India.

Dr. Prakash C. Gupta, President of the Conference, Director of Healis Sekhsaria Institute for Public Health, my main colleague here, and the official host for my Fulbright Fellowship, began working with a remarkable team of people led by the legendary Dr. Fali Mehta back in the mid 1960s. Many of these people, mainly dentists and oral pathologists (including Dr. Bhonsle, shown on the TIFR campus looking at the sunset 45 years after he was first hired), were Dr. Mehta’s students. In a very real sense they grew up with one another: attending each others’ weddings; rejoicing in the births of their children; thinking, planning, and analyzing data; and finally doing what needed to be done with the new-found knowledge. Over the years I have visited them in their homes and they have come to stay with Jane, Christine, and me in the US.

Though some have died and others have left India, their legacy is something that lives on in many ways. I love to tell the story of the Basic Dental Research Unit/ Epidemiology Research Unit, Tata Institute of Fundamental Research because it is a classic in combining excellent epidemiology, clinical practice, and laboratory-based basic science. It is through the work of this group, conducted over three decades in various parts rural of India, that we now understand the process of malignant transformation by which oral precancerous lesions become oral cancer. This formed the basis of our understanding of the basic process of tobacco carcinogenesis and led to intervention trials in many of these same parts of India over the next decade, and now are being conducted all over the world. This work also formed the basis for our investigations, in some of these same parts of India (Bhavnagar District in Gujarat, Ernakulum District in Kerala, and Srikakulum District in Andhra Pradesh) into the role of diet on which we collaborated and published in the 1990s and into the first couple of years of this century.

Seeing the Healis Sekhsaria Institute for Public Health booth at the Conference was a treat for experiencing the generations coming together to educate and make the world a better place, as an opportunity to actually feel the energy of this expansive group, and to see Dr. Bhonsle’s incredible traveling tobacco paraphernalia show.

This meeting, which spanned a half century of work and brought people together from around the world, provided a rare occasion to pause and reflect. Some newer members of the team (including Glorian Sorensen from Harvard, whom I introduced to Prakash nearly a decade ago) never met the original members, other than Prakash. Neha, pictured by Dr. Bhonsle’s traveling tobacco paraphernalia show, met some of them at the 14th World Conference. The team picture that you see here may very well be the only one that shows members of the original team with people who have joined as recently as this year. Some of these new members are younger than the children of the original cohort (some of whom also attended) and, has been the case from the beginning, remarkable people from all over the world are attracted by the magnetic pull of all that is good about these remarkable people and their calling.