SMOKING OUT TOBACCO - Moores Cancer Center

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IF SMOKING WERE A SIMPLE PROBLEM, THE FACTS ALONE WOULD BE INCENTIVE ENOUGH FOR PEOPLE TO QUIT. TOBACCO USE IS RESPONSIBLE FOR ROUGHLY A THIRD OF ALL CANCER DEATHS IN THE UNITED STATES, INCLUDING ALMOST 90 PERCENT OF LUNG CANCERS AMONG MEN AND MORE THAN 70 PERCENT AMONG WOMEN. IT IS ALSO A MAJOR CAUSE OF CAN- CERS OF THE MOUTH, LARYNX, PHARYNX, ESOPHAGUS, KIDNEY, BLADDER, PANCREAS AND UTERINE CERVIX, NOT TO MENTION HEART DISEASE AND STROKE. SMOKING OUT TOBACCO But because it is a complex issue, enmeshed in biology, psychology, culture and marketing, addressing it requires a multitude of strategies. The Moores UCSD Cancer Center has long been at the forefront of efforts to understand the many facets of tobacco use. Nearly $6.5 million per year is spent on the Center’s tobacco-related research. David Burns, M.D., professor of medicine and family and preventive medicine, and a UCSD faculty member for 26 years, edited the Surgeon General’s reports on smoking from 1975-86. John Pierce, Ph.D., director of the Center’s Cancer Prevention and Control Program and former chief epidemiologist in the federal government’s Office of Smoking and Health, conducted a study in the early 1990s that was central to successful efforts to retire Joe Camel and end marketing of tobacco products to adolescents. For 12 years, Elizabeth Gilpin, M.S., of Pierce’s group, has led their effort to evaluate California’s statewide tobacco control program. Their data have generated some 130 scientific papers, which have been cited more than 1,000 times. With these credentials, it’s no wonder that UCSD’s Tobacco Prevention and Control Program, the nation’s largest, remains at the vanguard of tobacco prevention, cessation and policy efforts. Here is an overview of some recent and current projects. STOPPING SMOKING BEFORE IT STARTS Because research suggests that biology predisposes some people to tobacco addiction, Pierce, professor of family and preventive medicine, and his group have been exploring ways to prevent adolescents from experimenting with tobacco in the first place. Among the questions they are currently investigating are whether the high rate of smoking among today’s college students is related to their exposure to the Joe Camel ads, and whether the current lack of tobacco advertising to adolescents is resulting in a major decline in smoking among 12- to- 15 year olds. Reports on these two issues are due out next year. In addition, Pierce and his group have received a major NCI grant to examine the effect of parenting skills on problem behaviors, including smoking, in adolescents. “There’s a lot of good research evidence that those parents who have good, strong, common sense parenting skills are less likely to have kids who get involved in prob- Cancer Center News 4
lem behaviors such as substance use, premature sexual behavior, juvenile delinquency, and the like,” says Lisa James, project director for the parenting study. “The basic premise of the study is that if we can impart those skills to parents, we will be able to show that parents with those basic skills will have kids who are less likely to get involved in those problems, including smoking.” In the study, researchers are taking a random national sample of 2,000 families with oldest children between 11 and 13 years old. Half will go through 12 sessions of telephone counseling, adapted from the Adolescent Transitions Program, a proven curriculum for enhancing parenting skills and reducing problem behaviors in teens. The study is adding tobacco-specific elements to the Adolescent Transitions Program curriculum, including advice for establishing a smoke-free home; rules about watching R-rated movies, where a lot of tobacco use is apt to be shown; strategies for helping teens come up with refusal skills if they are offered tobacco; and behavior contracts for remaining smoke-free. Follow-up calls every three months will track participants’ progress. The control group will not receive the counseling but will be surveyed every six months. GIVING IT UP For those who have already taken up smoking, UCSD is home to a well-established and successful program to help them quit. One of the Cancer Center’s biggest success stories, the state-funded California Smokers’ Helpline is the outgrowth of a 1990 pilot program that went statewide in 1992. The Helpline, which has been widely replicated, now provides free telephone counseling to 60,000 Californians annually who are seeking assistance with quitting smoking. It provides callers with trained counselors in six languages — English, Spanish, Mandarin, Cantonese, Korean and Vietnamese — and also has TDD phone lines, and a line for people using chewing tobacco. Since its inception, it has helped nearly 300,000 people. Shu-Hong Zhu, Ph.D., associate professor of family and preventive medicine, who runs the Helpline, also conducts research into many different aspects of smoking cessation. He is currently finalizing a study on the Helpline’s effectiveness in reaching a diverse group of teen smokers, and in a recent study reported in Health Psychology he examined the habits of low-rate smokers — those who smoke only a few cigarettes a day — to determine what factors influenced their decision to smoke so little. He found that many of them used to smoke more but were able to cut down, and that environ- Continued on Page 9 Ad from the statewide tobacco control program UCSD Participates in NATIONAL LUNG SCREENING TRIAL The Cancer Center is participating in a landmark national study of the effectiveness of spiral CT scans and standard chest X-rays in detecting lung cancer early. Researchers are seeking current smokers, or those who have quit smoking within the past 15 years, or who have a history of longtime and/or heavy smoking. The goal of the study is to determine if early detection can reduce the national death toll from lung cancer, which kills an estimated 155,000 Americans each year — more than breast, prostate and colon cancers combined. In the UCSD study, volunteers ages 55 to 74 will be selected by chance to receive either a chest X-ray or a spiral CT scan once a year for three years. The tests are free. Researchers will contact participants periodically until 2009 to check on their health. For more information, call the Cancer Center’s Clinical Trials Office, 858-657-7020. 5 Cancer Center News
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