To view the webcast of the symposium, visit ht.ly/bfR6I.


By Amy E. Hamaker

According to Stephen Gruber, director of the USC Norris Comprehensive Cancer Center, his mother remembers the exact minute when his father decided to quit smoking.

“I was two 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. “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 on May 30 in the Aresty Auditorium. The audience included students from the nearby Francisco Bravo Medical Magnet High School.


From left: Heinz-Josef Lenz, professor of medicine and preventive medicine in the division of medical oncology at the Keck School of Medicine; Robert Haile, professor of preventive medicine at the Keck School of Medicine; Charles G. Smith with the American Cancer Socitey; Carmen A. Puliafito, Keck School of Medicine of USC; Jane Warner, president and CEO of the American Lung Association in California; Stephen B. Gruber, director of the USC Norris Comprehensive Cancer Center; Uttam K. Sinha, associate professor of otolaryngology at the Keck School of Medicine; John Pierce, distinguished professor of family and preventive medicine at UC San Diego; and Robert Jackler, Sewall Professor and chair of the department of otolaryngology at Stanford University School of Medicine. Photo by Jon Nalick

In particular, speakers focused on tobacco policy and health, including youth advertising trends and the upcoming California Proposition 29, which would impose an additional $1 per pack tax 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,” said Pierce. “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 first 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 real 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 annually expected to be generated in the first few years is earmarked for grants and loans for cancer research and the creation and running of research facilities within California.

“This money would be the equivalent of what California research institutions currently receive from the National Institutes of Health,” said Pierce. “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 directly at kids. “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 high school and college-age youth. “Whatever is happening in society, the tobacco industry will graft off of it,” he explained. 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 through the use of sports heroes and girls through the use of the color pink. “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 six 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 many other countries have done. “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, Watt Chair in Head and Neck Cancer Research and chief of the Department of Otolaryngology-Head and Neck Surgery at the Keck School.



From left,  Cancer survivors John Ready, Del Shilling, Rick Gridley and Joe Lapides share their stories. Photo by Jon Nalick

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 speaking ability. “My goal is to help one person every day to not go through what I went through,” he said.

To view Stanford University’s collection of more than 7,000 print, broadcast and social media tobacco advertisements, visit http://tobacco.stanford.edu.=