![[Navigation Map2]](images/hsph.gif)
HSPH Student Targets Tobacco
"Seventy percent of the cigarettes manufactured in the United States are exported for sale in other countries," said Sean David, master's student in the Department of Health and Social Behavior. "It's been estimated that by 2020, 10 million people will die each year from smoking-related diseases. Seven million of those will be in developing countries. When the US exports tobacco, we export death."
David wants to prevent some of these deaths. He intends to do so through a public awareness campaign and through research. The awareness campaign was designed and implemented through an organization he cofounded, IMPACTT--the International Marketing and Policy Analysis Consortium Targeting Tobacco. The research is, in part, accomplished through the Tobacco Marketing and Policy Research Group, a working group within the Harvard Center for Society and Health and advised by William DeJong, lecturer in the Department of Health and Social Behavior. David, who describes himself as "an old-fashioned family doctor," moved from his home in Seattle to undertake a medical residency at Dartmouth. It was there that he was struck by the enormous health consequences of tobacco. "As part of my residency," he said, "I had to assess the health needs of a city. I chose Littleton, New Hampshire. I was disgusted to learn that one of the top three causes of death in Littleton was smoking-related diseases. As I learned more about smoking, I began to understand what a major cause of national, and global, disease burden tobacco represents.
"If we can cut smoking prevalence even a little, say by one percent, we can save thousands of lives. By fighting tobacco, I can save lives. I can make a difference, on both a population level and as a family practitioner."
While at Dartmouth, David met an undergraduate student, Neil Resnick, through campus activities at divestiture of school funds from tobacco companies. The two shared a passion to prevent tobacco-related death and suffering. Together, they created IMPACTT.
"We based the group in Boston so that I could attend HSPH and learn more about practicing public health at a population level," said David. At the school, he and DeJong designed a project incorporating IMPACTT, an expanded health communications campaign, and ongoing research projects focusing on the health problems of tobacco.
The research component is necessary to provide ammunition for the communications campaign and for influencing public policy, according to David. "One of the reasons the tobacco bill of 1998 didn't pass was because there wasn't enough public support," said David. "In order to create public support, we need to do the research that will provide policy makers with the tools they need to pass legislation. We need to know what will get people excited about and supportive of anti-tobacco legislation."
Americans, of course, do understand that tobacco is unhealthy, and smoking prevalence has been declining for years. David is concerned, however, that as the American market for tobacco shrinks, the international market is increasing, often with the powerful influence of the US government.
"America has done a lot to protect its citizens, including children, from smoking--we have age requirements for purchasing tobacco, warning labels on cigarette packs and advertisements, and regulations on where advertisements can be placed," said David. "Yet I don't think most Americans understand that our tobacco companies are virtually unregulated when it comes to selling tobacco in other countries. Or that the US government has been complicit in opening Asian markets to US tobacco--against the wishes of Taiwan, Korea, Japan, and Thailand."
David ran a series of focus groups to discover the extent of people's knowledge of tobacco's health effects and marketing practices, and to ascertain levels of support for different kinds of legislation. The results of these meetings are now being used to develop a set of questions for a national poll. Those results, in turn, will be used to develop effective anti-tobacco messages to relay to the American public.
David is not sitting on his hands, waiting for these results. Putting into practice lessons that David has learned in DeJong's "Developing Radio Communications" course, IMPACTT has arranged for former Surgeon General C. Everett Koop to record a series of public service announcements with the message that the US is exporting death to its trading partners in the form of tobacco.
Following graduation in June, David will continue his anti-tobacco efforts through IMPACTT and a through an ongoing alliance with the HSPH-based Tobacco Marketing and Policy Research Group. He is also developing a family practice residency program that he hopes will be adopted by HMS.
Members of the Tobacco Marketing and Policy Research Group. From left to right: William DeJong, Neil Resnick, Michael Williams, Sean David, Rebecca Pettengill, and Gina Escamilla.
