No ifs or butts

It was 1960. A young medical student at the University of Edinburgh took out her first cigarette, lit up and puffed smoke into the cool Scottish air. Her throat was a bit dry but, at that moment, the 16- year-old finally felt like an adult, a very 'cool' adult. Almost half a century later, when 65-year-old Judith Mackay recalls that episode at her tranquil countryside house in Sai Kung, she laughs it off, but her tone turns serious as she explains why it helped her understand a young person's urge to smoke.

Such knowledge is particularly important to Yorkshire-born Dr Mackay, the world's leading anti-tobacco lobbyist and advocate, and one of Hong Kong's few public health experts to become a global name.

'I was away from home for the first time and I was very young,' she says of her first smoking episode. 'I thought smoking was sophisticated and was a doorway to becoming an adult.'

She was 'fortunate', she says, that she quit after only three months because her asthmatic roommate couldn't stand the smoke.

'I really understand how young people feel. They smoke to be an adult, to be rebellious, to look cool. This is why school programmes don't work. They tell children if they smoke, they will get cancers or lung diseases at the age of 60 or 70; it is completely meaningless to them,' she says.

For the past 25 years, Dr Mackay has been pushing for changes in countries where smoking is regarded as a lifestyle choice rather than a health hazard. And in recognition of those efforts, she will be made an OBE by Queen Elizabeth in a ceremony at Buckingham Palace today.

In her official capacity, she is the senior policy adviser to the World Health Organisation and senior adviser to the World Lung Foundation (WLF). The latter is responsible for taking care of the multimillion-dollar grant from Bloomberg Philanthropies, a fund set up by New York Mayor Michael Bloomberg to encourage tobacco control in poor countries.