The invitation to contribute this piece to the Journal was disconcerting. I told the Editor I felt previous contributors to the Power of One series were all distinguished retirees. What was he trying to tell me? I have just turned 51, but it seems some believe I have been around forever and should write a retrospective piece.

Recently, I was leaked a staff training CD-ROM from British American Tobacco (Australia). Five senior executives sat in front of the camera blubbing about the inexorable fall in smoking rates and how, as the plug had been pulled, this could only get worse. As the remaining water drained from the pool, they tried to inspire their staff by talking up hopes of snatching profit from brands that smokers were inspired to believe were at the luxury end of the market. Luxurious carcinogens! It was desperate stuff, but heartening all the same.

In the early 1960s, nearly 60% of men and 30% of women in Australia smoked.1 Today, daily smoking by adults has fallen to under 20% for the first time,2 and shows no signs of having bottomed out. In NSW, lung cancer in men has been falling for 18 years and female lung cancer has stopped rising.3 National death rates from coronary heart disease fell by 59% in men and 55% in women between 1980–2000, in large part because of changes in risk factors like smoking.4

Along with vaccine uptake, the fall in the road toll and arresting the HIV/AIDS epidemic, the fall in the smoking rate is one of the major public health achievements of the past 40 years.

Innocents sometimes introduce me as "the person" who is responsible for the revolution in the way smoking is now regarded. This nonsense derives from their youth, mixed with thoughts of David and Goliath — as if a single individual could ever be said to be responsible for turning around something as complex as community and political perceptions of smoking.

The metaphor of being pecked to death by ducks provides a more apposite description of the way things work in public health. Strategic pecks that irritate and distract gradually build to a point where those under attack — in this case, the tobacco industry — develop a debilitating siege mentality.

While the public appetite for dragon-slayer mythology demands there should be individuals who stand over public health carcasses, many, often unsung, people have oxygenated the huge changes achieved in smoking in Australia.

A BUGA UP refacing, circa 1983.

Today, smokers huddle in doorways and excuse themselves from meetings. To smoke with equanimity is increasingly to wear a badge of immaturity, low education or resigned addiction. Thirty years ago, it was very different. The tobacco industry had infected smokers with the thought that they had a monopoly on all that was interesting, convivial and sensual. Epidemiological revelations rather ruined all that; but it was advocacy that ensured the translation and transition of epidemiologists' conclusions into policy and law reform.

In the late 1970s, I was bored witless in my first job as a community health educator, employed by the NSW Health Commission. While I gave interminable Rotary Club talks to half-sozzled businessmen about the "drug problem", tobacco advertising adorned every conceivable public space. Drug pushers were very publicly jailed while tobacco industry executives were quietly knighted. So, in 1978, with a few colleagues, I formed MOP UP — Movement Opposed to the Promotion of Unhealthy Products.

We put out a precocious press release and in the next week were covered by the Sydney Morning Herald as "the latest pebble in the shoe of sin industries".5 We engineered the removal of Paul Hogan from the Winfield advertising campaign;6 "MOP UP's slingshot cuts down the advertising ogre" read one headline. MOP UP re-energised the debate about tobacco advertising that Nigel Gray (then head of the Anti-Cancer Council of Victoria) and Cotter Harvey (founder of the Australian Council on Smoking and Health) had started in the 1960s.

At our first meeting — held in the lecture theatre of the Sydney morgue in Camperdown — someone stood up and declared, impatiently, that our political letter-writing plans were pathetic and that, if we had guts, we would take more direct action. BUGA UP, the graffiti movement, was born and over the next eight years revolutionised ordinary people's understanding of the politics of tobacco control.7 My modest involvement was to take ongoing responsibility for the billboard on a shopfront directly opposite the entrance to News Ltd, but my admiration for the dozens of courageous people who risked much over a decade of civil disobedience is boundless. We held a 20-year reunion in October this year. (For a powerpoint collection of BUGA UP's 'greatest hits' see http://tc.bmjjournals.com/cgi/content/full/11/3/DC1).

Truth in advertising: the German brand West shows a smoking Olympic athlete "lighting the fire" of a stick-figure woman in front of Australia's Uluru, about the time of the 2000 Sydney Olympics.

When I first started in tobacco control, people at parties would occasionally give me wide berth as a probable teetotal morals crusader who would soon move to turn the music down and pluck sweets from children's mouths. MOP UP, and especially BUGA UP, changed all that. Understanding that the tobacco industry is a pariah of the corporate world rapidly became a litmus test for a whole set of values about the abhorrence of putting profit above all else. Today, one never hears a tobacco industry executive in the media. As my colleague Stan Glantz, professor of medicine at the University of California, San Francisco, has said: "They are like cockroaches; they spread disease and don't like to be seen in the light." No respectable politician would now ever risk public association with these executives, and this change in business community status has facilitated the incremental adoption of a legislative program that puts Australia in the forefront of nations trying to reduce tobacco's health toll.

Those heady days and my first degree in media sociology gave me a taste for the nature of news values. They blooded me for a career where I have tried to translate epidemiologists' conclusions into discourses that gel with community concerns, and then needed to truncate them into soundbite-length summations if they were to have any hope of making the news.

I have always had enormous respect for the power of the news media to influence the way that communities think about issues. My honours thesis on imagery in advertising for psychotropic drugs in medical journals was tabled into the Senate Hansard by Peter Baume in 1979.8 That lit a fire within me: there were ways in which academic work could climb out of its (mostly) cosseted sanctuary and thus get to influence political debates.

A luxurious Sunday for me is an undistracted day of writing. Since 1976, I have published over 370 original articles, editorials, letters and commentaries in peer-reviewed journals and another 105 in throwaways. I have written 10 books and large reports. A few of these have become citation classics in my field,9-11 but if I was to nominate my most influential writing without hesitation I would name some of my 93 newspaper opinion pieces, my 130 letters to newspapers or some of my extended radio and TV interviews during critical periods of advocacy for change, like the tumultuous period of advocacy required after the Port Arthur gun massacre in 1996.

Years of watching my citation rate splutter upward and 11 years of editing an international journal (Tobacco Control) have taught me that scholarship, for all its importance, exists in intellectual backwaters and rarely influences practice, public or political opinion. Colleagues boast of a paper being cited a few hundred times or of speaking to 5000 people at an international conference. In my opinion, a gloves-off opinion piece in a morning newspaper, followed by a round of interviews on breakfast radio, on the day that a vital public health political decision is to be made will be read, and often discussed, by incomparably more people than a journal's readership.

Advocacy, by its nature, involves contested debates — there are always losers when change occurs; so often, they are determined to resist change, and angry when it happens. Public health advocacy often requires pushing governments to act and being critical of inaction. This can brand advocates as troublemakers, with all that can go along with that. I have known David Hill, now the director of the Anti-Cancer Council of Victoria, since 1978 and count him as a close friend. A few years ago, when I was feeling a little disconsolate at being plainly excluded from some key national committees appointed by a minister for health whom I had occasionally criticised, David counselled me to consider that every cause needs different people to work "inside and outside the political tent". He said that those on the inside greatly appreciated that someone with my judgement and determination was outside helping keep policy agendas alive that would otherwise be at risk of neglect, being largely off-limits to those working on government committees.

Winner of the Lung Slayer Award. This portrait, of a 34-year-old man with emphysema, was a rejected entry in the 1984 John Player Portrait Award, National Portrait Gallery, London. An alternative exhibition was held on the footpath outside the gallery (that's me holding the painting).

Most days I pinch myself in disbelief that I get paid to do what I would gladly do for nothing as a citizen. My 20 years (1982–2002) as a director and chair of the Australian Consumers' Association (Choice magazine) count as an experience I value enormously. I have swapped tactics with some of the most tenacious exponents of rat-cunning advocacy that you could ever hope to meet.

Today, I have seven researchers working with me on a critical history of the tobacco industry as revealed through their internal documents (see http://tobacco.health.usyd.edu.au/). Each day, I see their growing incredulity at what they are discovering and the way this translates into passion about carrying on this work, using scholarship as an instrument of shame that drives policy change. The other day we found an item that read "Australia is a laboratory for the global anti-smoking network. Both anti-smoking policies and the individuals who promote them are exported from Australia and stimulate anti-smoking activities worldwide."14 It's been a huge privilege to be a part of that.