Antismoking Advocate for the World: Dr. Judith Longstaff Mackay

by Anne Ahlman, MPT

Published 1/21/04 (references and links updated 11/1/20)

Dr. Mackay is a life-long proponent of health, and is fearless when it comes to standing up for her beliefs. Her family background ideally suited her to become a strong and independent trailblazer. Born in North Yorkshire, her mother was one of the first women to attend university in England, and her father was a naval captain, decorated in World War II with the Distinguished Service Cross.[1]

Dr. Mackay earned her medical degree at the University of Edinburgh at the early age of 22, and shortly thereafter began working in clinical medicine in Hong Kong after learning how to speak the local language. She soon found that clinical practice in Hong Kong brought her into contact with patients of all ages with tobacco-related problems, including lung disease, cancer, and heart disease.

She quickly saw that treating the outcome of the disease process, rather than being able to prevent the disease at its source, was inadequate: at the time, public safety education about the prevention of tobacco-related illness was nearly unheard of, not just in Hong Kong but throughout most of Asia. Tobacco use in Hong Kong and neighboring China was prevalent in men and on the rise in both women and children, with no legislation against cigarette advertising, no health warnings on tobacco products, no tobacco taxation policy, and no rules to restrict tobacco sale to minors.

Extent of the Problem

Dr. Judith Mackay

Tobacco has been a significant world vice since the early 1600s. Originating in the Americas, tobacco is ingested via cigarette, cigar, pipe, snuff, chewing tobacco, and even enema. Despite the many known associated health risks and increased death rates, world tobacco consumption is on the rise, and it is a highly addictive substance. It has been through the unrelenting efforts of passionate health advocates like Dr. Mackay that loss of life has not been more widespread. Although in developed nations cigarette usage is declining through advancing legislation and public health education, the new markets targeted by the tobacco companies are developing nations and youth. Once a child becomes addicted to tobacco, the habit is extremely difficult to break–something the tobacco companies count on! Tobacco companies are extremely influential politically, and do a booming business in international trade.

Until recently, the public has been blissfully unaware of the true dangers of tobacco, not realizing its widespread reach. Statistically, more people will die from tobacco than from AIDS, car accidents, murder, suicide, and legal and illegal drug use combined.[2] Armed with this knowledge, and with characteristic determination, Dr. Mackay began the process of educating the public about tobacco’s risks from her base in Hong Kong. She steadily formulated alliances throughout Asia, usually receiving no monetary compensation for her efforts.


Initially, she was instrumental in bringing about a ban on smokeless tobacco products in Hong Kong, and helped form Asia’s first tobacco control agency. Subsequently, she became the founding Executive Director of the Hong Kong Council on Smoking and Health (COSH). Over time there was a deluge of requests from neighboring countries clamoring for her assistance, so she formed the Asian Consultancy on Tobacco Control in order to share her expertise.

Over the years, Dr. Mackay has implemented many tobacco control programs, and focuses on the empowerment of nations to regulate this global health threat. She has helped developing countries draft legislation, provided workshops, written for medical journals, and granted television and radio interviews, all with the goal of promoting health education and tobacco control in targeted countries. She currently works closely with the World Health Organization (WHO) as a senior policy advisor, and travels the globe continuing to educate and assist countries in their fight against tobacco.

She has won many awards and commendations, including the United States Surgeon General’s Medallion, the WHO Commemorative Medal, the 2000 Healthrack “Fries” Prize, and the Luther Terry Award for Outstanding Individual Leadership–she has even been awarded an OBE (Order of the British Empire) from Queen Elizabeth in 2008 in recognition of her anti-tobacco work.

Soft-spoken yet direct, Dr. Mackay is a tireless crusader and advocate of preventative health, and is influential in saving the lives of millions against the scourge of tobacco. She regards it as a particular honor to have been identified by the transnational tobacco companies as “one of the three most dangerous people in the world”! Dr. Judith Mackay continues to be a guardian angel for the masses in the fight against smoking, a major cause of preventable disease.

Related Links


  1. The Doctor-Activist. Physicians Fighting for Social Change. Bassuk EL (ed.). Plenum Press, New York. 1996.
  2. The Tobacco Atlas. Mackay J, Eriksen M. World Health Organization. Myriad Editions Limited, Hong Kong. 2002.

About the Author

Anne Ahlman is a medical writer/editor and physical therapist. She has a keen interest in all aspects of healthcare, and has written a book on physical therapy: Naked Elbows: A Physical Therapist’s Reflections on Patient Care, Intuition, and Healing.

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