Stephen B. Gruber, director of the USC Norris Comprehensive Cancer Center, said his mother remembers the exact minute when his father decided to quit smoking.
“I was 2 years old, taking a nap next to my father, who was reading The New York Times and smoking a cigarette,” he recently told attendees at the Tobacco, Proposition 29 and the War on Cancer symposium held on May 30 on the Health Sciences campus. “He put out his cigarette, threw away his pack and told my mother that it was his last. He had just finished reading an article about the surgeon general’s report on the direct link between smoking and cancer. That story taught me that information is power.”
The power of information to shape health-related behavior was the main message of the symposium held in the Aresty Auditorium. The audience included students from the Francisco Bravo Medical Magnet High School.
In particular, speakers focused on tobacco policy and health, including youth advertising trends and California’s Proposition 29 initiative, which would impose an additional $1 tax per pack on cigarettes and an equivalent tax increase on other tobacco products to fund research for cancer and other tobacco-related diseases.
“This is an important issue for all of us who are involved in supporting the health of our community,” said Carmen A. Puliafito, dean of the Keck School of Medicine of USC, who welcomed attendees. “We must have a discussion of the facts surrounding the use of tobacco in our society and the role Proposition 29 passage might mean in reducing cancer deaths.”
John Pierce, professor of family and preventive medicine at the University of California, San Diego, led the audience through the history of tobacco control in California and how it correlates with tobacco-related disease and death.
“There is no other behavior that is so thoroughly associated with another disease as smoking is with lung cancer,” Pierce said. “There are 440,000 deaths in the United States each year that are attributable solely to smoking; another 46,000 deaths from heart disease and 3,400 deaths from lung cancer occur each year to nonsmokers who are exposed to cigarette smoke.
In 1964 the surgeon general reported that smoking causes cancer, and for the next 40 years, California led the nation in tobacco-control measures, Pierce told the audience. These policies took four approaches: increase cigarette prices through excise taxes; restrict tobacco industry marketing; Introduce comprehensive programs with mass media anti-smoking campaigns and locally run interventions; and create policies for smoke-free environments.
However, since 2002 California has fared below average in control measures.
According to Pierce, price increases are a deterrent of youth smoking. By raising the cost of a pack of cigarettes, he said, Proposition 29 would reduce youth smoking by an estimated 13.6 percent (228,000 teenagers) and reduce adult smoking by an estimated 3.15 percent (117,900 adults).
The more than $700 million expected to be generated on an annual basis in the first few years is earmarked for grants and loans for cancer research and the creation and running of research facilities in California.
“This money would be the equivalent of what California research institutions currently receive from the National Institutes of Health,” Pierce said. “It would allow us to spend $7 per person to keep teens from starting and to help adults to quit smoking. However, the tobacco industry currently spends $42 per person to get people to start.”
Robert Jackler, Sewall Professor and chair of the Department of Otolaryngology at the Stanford University School of Medicine, told attendees that the tobacco industry is doing exactly what it has always done in marketing — aiming its message directly at young people. “Almost no one starts smoking after the age of 20, and there’s a reason for that,” he said.
Jackler showed a variety of print and broadcast tobacco ads aimed at youngsters. “Whatever is happening in society, the tobacco industry will graft off of it,” he said. For example, when the baby boomer generation emerged after World War II, tobacco advertisements began to show mothers with babies.
According to Jackler, tobacco ads target boys and girls through the use of sports heroes and the use of the color pink, respectively. “Joe Camel was created specifically to market to young people,” he said. “In a study on character recognition, it was found that by the age of 6, there was no difference in recognition between Joe Camel and Mickey Mouse.”
To help slow the tide of teen smoking, Jackler suggested banning tobacco advertising and promotion in the United States, as other countries have. “Regulation doesn’t work, as industry usually finds a way to escape the intent of regulation,” he said. He also suggested increasing the cost of cigarettes, as “teens are exquisitely price sensitive.”
Symposium attendees also heard firsthand experiences of throat and tonsil cancer survivors during a short panel discussion led by Uttam Sinha, holder of the Watt Chair in Head and Neck Cancer Research and chief of the Department of Otolaryngology-Head and Neck Surgery at the Keck School.
Panel member Joe Lapides, co-president of the USC Norris Cancer Hospital head and neck cancer patient support group, was a smoker for 30 years before being diagnosed with cancer of the left tonsil. Seven years after his three surgeries, chemotherapy and radiation, he told the audience he still feels aftereffects and must work on his ability to speak.
“My goal is to help one person every day to not go through what I went through,” he said.