Loading Events
This event has passed.

I pretty much knew that I wanted to go into psychology even in my freshman year of college. During my undergraduate study, I became very interested in conditioned response and in my senior year did a study focused on allowing for the orienting response in galvanic skin conditioning. Quite a long way from my subsequent pursuit of tobacco research. I was invited to go to the University of Wisconsin to study the interstimulus interval in rabbits. However, by then I had changed my perspective and wanted to do research that I saw as having real world significance. An epiphany came when I described the statistically significant results of my conditioning study to a colleague with whom I worked at the George Washington University library. As I told him about the results, he simply asked “so what?” This clearly was not meant as a put down, but rather as an honest query. I decided that I needed my research to be able to address the question of so what.

I came to Stanford in 1968 at time when behavior modification was receiving considerable emphasis. As a first year student I focused on biofeedback but found this frustrating, especially because my equipment kept breaking down. In my second year, Jerry Davison was on the faculty as a visiting professor. I was interested in his research and assisted in an attribution study with smokers who were given a pill and led to believe either that the pill was an active drug or a placebo (in reality it was Bantron which has not been demonstrated to be effective in aiding quitting). Contrary to hypothesis, those led to believe they had received a placebo fared better perhaps because they attributed their success (for those who quit!) to their own efforts rather than to a drug.

Davison used smoking as a vehicle to test hypotheses pertaining to attribution, but I became interested in smoking as a significant area of study in its own right. I was highly fortunate to get in on the ground floor of smoking cessation research. This topic was receiving relatively little attention at the end of the 1960s. I shudder to think of my naivety. I had the idea that given the effectiveness of behavior modification in addressing such defined problems as phobias it would be a cinch to successfully apply these principles to long-term hardcore smokers.

My first forays into smoking cessation research focused on aversive conditioning. I had read the work of Lichtenstein on rapid smoking and Jerome Resnick on satiation or over smoking and compared these two approaches in my doctoral dissertation. I came to the Iowa State University psychology department in 1972 as an Assistant Professor and continued my smoking research. I quickly realized that focusing solely on aversion without any type of post quit maintenance was totally inadequate. For much of my time at Iowa State I conducted individual and group studies comparing different methods of preparation for quitting and more or less intensive maintenance procedures. A number of these studies employed factorial designs with the goal of identifying specific effective elements of treatment. At that time, I had no concept of statistical power—one of my studies included 7 conditions with 70 total participants.

Several years after I came to Iowa State, I was approached by the American Lung Association of Iowa which was interested in taking what were then my smoking cessation clinics public. This led to a partnership in which we took laboratory based methods and offered group programs at low cost as a public service. We trained lay facilitators to conduct the clinics; these often were individuals who had quit through the program. At its peak, we were running over 100 clinics in a year throughout the state of Iowa. I still take pride in this partnership and application of research findings.

In 1988 I was recruited to the University of Minnesota School of Public Health where I became a professor in the Division of Epidemiology. I found this somewhat amusing as I had never taken an epidemiology course. At the University of Minnesota I broadened my cessation research to encompass larger populations—communities, the military, pregnant and postpartum women in managed care settings, and those with medical and psychiatric co-morbidities.

Although I had engaged in tobacco control advocacy while at Iowa State, it was in coming to public health that I came to see the tobacco industry as a disease vector. I concluded that offering cessation help, although critically important and necessary, was insufficient. A comprehensive multifaceted approach is essential (e.g., the WHO FCTC, MPOWER) and such an approach could also increase interest and success in quitting.

In more recent years, my advocacy increased significantly. During my presidency of the Society for Research on Nicotine and Tobacco in 2002-2003 my priority was to increase the global footprint of the society and to recruit scientists from low- and middle-income countries. In 2006 I became heavily involved with the triennial World Conferences on Tobacco OR Health. WCTOH has a unique role in bringing together the various tobacco control stakeholders including researchers, advocates, practitioners, NGOs, and representatives of government. Although I had attended WCTOH since 1979, I never previously had an active role in organizing the conferences.

Despite the fact that low- and middle-income countries are bearing an increasing burden of the tobacco epidemic, almost all of the conferences had taken place in high-income venues. I led the effort to hold the 2009 conference in Mumbai and since that time have served in various roles including as chair or co-chair of Scientific Committees, as chair of Organizing Committees, and as Chair of the Advisory Board to the International Union on Tuberculosis and Lung Disease on WCTOH. After the 2015 conference in Abu Dhabi, I advocated for a closed bid for Africa in 2018 (WCTOH had never taken place in Africa during its 50+ year history) and that conference took place in Cape Town.

Looking ahead, I plan to continue active engagement with WCTOH. I would like to take a step back and reassess the role and impact of WCTOH in order to maximize relevance and impact. This may be especially necessary post COVID and in an environment where future large in-person meetings may be less viable due to climate change. I also am collaborating with Action on Smoking and Health, an NGO based in Washington, DC, on tobacco and human rights. By framing tobacco as a human rights issue we hope to grow the global tobacco control movement. Going forward I expect to continue to combine research and advocacy and to focus on big picture questions including how to bend the curve of the global tobacco epidemic.

Share This Story, Choose Your Platform!

Go to Top