Lives of the fellows

Michael Anthony Hamilton Russell

b.9 March 1932 d.16 July 2009
BM BCh Oxon(1957) FCP(SA)(1963) MRCP(1964) DPM Lond(1968) MRCPsych(1971) FRCPsych(1980) FRCP(1982)

Michael Anthony Hamilton Russell was a psychiatrist and public health scientist, best known for his work creating treatments to help people stop smoking. He first identified the role of nicotine in cigarette addiction in 1971 far ahead of the prevailing wisdom of the time.

Born in Cape Town, South Africa, his mother was English and his father, James Hamilton Russell, was chairman of an advertising agency and a member of the South African parliament. Educated at the Diocesan College in Cape Town, he studied medicine at Oxford University and Guy’s Hospital. He had initially intended to study law but, as he said in an interview later in life, he found ‘constitutional history... so boring that I switched to medicine.’ Qualifying in 1957, he did house jobs at Guy’s, before going back to South Africa in 1960 with a view to becoming a GP. There he joined the staff of the Groote Schuur Hospital and was inspired by Henry Walton, for whom he was a registrar, to specialise in psychiatry. He said of this decision ‘I found learning to understand people’s thoughts, feelings, and behaviour much more interesting than dealing with abortions or caesarean sections, or indeed the functioning of their hearts, bowels, liver or stomach’.

Disliking the political situation in South Africa, he returned to the UK in 1964 to train at the Maudsley Hospital, where he spent four years as registrar, then senior registrar. Impressed by the work of Mike Gelder who was having some success treating transvestites with electric aversion therapy he decided to do a pilot study of its effects on smoking. He then took up a research post in the addiction unit of the Institute of Psychiatry and published his landmark paper ‘Cigarette smoking: the natural history of a dependence disorder’ (Brit j med psych 1971, 44, 1-16). Proceeding from this research, he decided that he needed to measure blood nicotine levels and recruited a biochemist, Colin Feyerabend, to devise a method of doing so. By 1974 they were able to measure not only the intake by smokers but the chemical exposure of passive smokers.

In 1973 he was appointed a senior lecturer at the Institute and honorary consultant psychiatrist to the Maudsley. Five years later, the Medical Research Council (MRC) invited him to apply for a grant and named him as one of their external scientific staff. They supported his research for the next 20 years.

Having decided that it was the tar in the cigarettes that was killing people, he was an early advocate of nicotine containing harm reduction methods. A Swedish acquaintance, Ove Ferno, had been working on a formula for nicotine gum, which, when he tried it in 1971, Russell decided was ‘foul’. Four years later, the flavour was much improved and he began his own work on a similar product. Soon he was able to show, by results at the Maudsley smoker’s clinic which he founded, that the gum was to prove the first reliable smoking cessation product. Together with Ferno, he later developed an effective nicotine nasal spray.

Alongside his work on nicotine replacement products, he was very aware of the need for non-pharmacological interventions. He published, with three others, the results of a trial examining the effectiveness of brief advice by GPs given during regular consultations ‘Effect of general practitioner’s advice against smoking’ (BMJ, 1979, 2, 231-5). From this beginning, he moved towards the concept of an integrated smoking cessation service combining advice, pharmacological therapy and professional support. This was to provide a blueprint for the NHS stop smoking clinics and the standard for assessing their success rates was named the Russell Standard in his honour. Martin Jarvis, who joined Russell’s team in 1978, said of him that ‘those two sides of his work, the pharmacological side and also the behavioural psychology side, were totally interlinked from the word go’.

In 1986, he was appointed professor of addiction at the Maudsley and continued there until his retirement in 1998. The author of numerous publications on the psychological and pharmacological aspects of tobacco smoking, he was known to be demanding of his team but a warm and generous friend.

Early interests were swimming – he won a half-blue at Oxford – and rugby, playing in the first team for the United Hospitals. He later said that he thought that being in the team had given him an advantage at Guy’s in that he got good house jobs. Later on he enjoyed sailing and reading.

In 1962, he married Audrey Ann née Timms, a nurse whom he met working at the Groote Schuur Hospital. Her father, Archibald Bert, was a mining engineer. They had two sons, James and Nicholas. He spent his last few years in retirement in Cape Town, suffering from Alzheimer’s disease. Audrey and their sons survived him.

RCP editor

[The Guardian www.guardian.co.uk/science/2009/aug/04/obituary-michael-russell - accessed 16 November 2009; Lancet 2009 374 1236; Addiction 2004 99 9-19]

(Volume XII, page web)

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