perceived by colleagues as spending less time with their

patients.
Smoking and Lung Cancer. Lung cancer killed more
Americans than any other type of malignancy, causing
some 160,000 deaths a year during the decademore than
breast, colon, and prostate cancer combined. While some
cases of lung cancer occurred in nonsmokers, at least 87
percent were associated with cigarette smoking. The fiveyear survival rate for those diagnosed with lung cancer was
15 percent. Norman Edelman, chief medical officer of the
American Lung Association, put the issue plainly: If you
smoke a pack a day for 20 years or more, you have a 50 percent chance of dying from smoke-related disease. There
was a distinct correlation between the length of time one
smoked and amount one smoked and the long-term health
effects. The benefits of quitting smoking were also clear:
within ten years of abstinence, half of the cancer vulnerability disappeared.
Sources:
Michael R. Bloomberg, The Way to Save Millions of Lives is to Prevent Smoking, Newsweek, 152 (29 September 2008): 4850;
Geoffrey Cowley and others, The Deadliest Cancer, Newsweek, 146 (22
August 2005): 4249;
Linda Sarna and others, Nurses, Smoking, and the Workplace, Research
in Nursing & Health, 28 (February 2005): 7990;
Karen Springen, Light Up and You May Be Let Go, Newsweek, 145 (7
February 2005): 10.

VACCINES AND AUTISM

Causes. In 1998 Andrew Wakefield of the Royal Free
Hospital in London, England, stated that autism was
caused by the MMR (measles, mumps, and rubella) vaccine. His claim was based on results in eight of twelve children and was published in Lancet, a highly respected
medical journal. Although scientists noted that they could
not prove an association between MMR vaccines and
autism, Wakefield condemned use of the vaccine, which led
to newspaper headlines and stories that scared the public.
Studies were conducted to investigate the connection, as
well as the effect of the preservative thimerosal, a mercurycontaining compound. By 2003 most childhood vaccines
no longer contained thimerosal. By 2004 problems with
Wakefields research began to surface. It appeared some
children in his study had autism before they received their
vaccines. Also, many were clients of an attorney working
against the vaccine makers. The failure of Wakefield to disclose this relationship, and the fact that he had been
retained and paid by the lawyer, were clear violations of
research ethics. In March 2004 ten of the twelve coauthors
of the Lancet article retracted their suggestion of a connection between MMR vaccines and autism. Wakefield did
not retract. In 2005 Wakefield was charged with professional misconduct by Britains General Medical Council.
On 28 January 2010 his license to practice medicine was
revoked. On 2 February 2010, Lancet formally retracted the
paper from the published record.
Repercussions. In the United States, pending legal
cases arguing that MMR vaccines caused autism were

380

Dr. Andrew Wakefield passes supporters as he arrives

to face a disciplinary panel of the General Medical
Council in London on 16 July 2007. Wakefield was
found guilty of professional misconduct for falsely
correlating the MMR vaccination with autism
( Sang Tan/AP Photos).

combined to be heard by a special Vaccine Court beginning on 11 June 2007. It issued a ruling on 12 February
2009 that neither thimerosal-containing vaccines nor
MMR vaccines caused autism. Many parents and activists remained unconvinced, in spite of a 2004 Institute of
Medicine (IOM) study and others debunking a vaccine
correlation. The use of MMR and other childhood vaccines fell owing to this controversy; subsequently, there
was an increase in diseases such as mumps, measles,
whooping cough, and Haemophilus influenzae infections
in numbers not seen in the United States in decades,
including deaths from these diseases.
Sources:
Sharon Begley and Jeneen Interlandi, Anatomy of a Scare, Newsweek (2
March 2009): 4247;
thelancet.com (2 February 2010);
A. J. Wakefield and others, Ileal-Lymphoid-Nodular Hyperplasia, NonSpecific Colitis, and Pervasive Developmental Disorder in Children,
Lancet, 351 (1998): 637641.

AMERICAN DECADES: 20002009

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