University of California San Francisco
Helen Diller Family Comprehensive Cancer Center

Tobacco Control Program

P.Ling Program Leader Pamela Ling, MD
J.Guydish Program Co-Leader Joseph R. Guydish, PhD, MPH

The overarching goal of the HDFCCC Tobacco Control Program is to reduce the burden of cancer caused by tobacco, locally, in the catchment area, and globally. 

The Tobacco Control Program conducts research under three themes:

  • Theme 1: Biological determinants of tobacco-induced addiction and disease
  • Theme 2: Social and behavioral determinants and interventions for tobacco addiction
  • Theme 3: The tobacco industry as a disease vector and strategies to block it

The Tobacco Control Program is the focal point for UCSF scientists in disciplines ranging from the molecular biology of nicotine addiction through political science. These scientists combine their efforts to eradicate the use of tobacco and tobacco-induced cancer and other diseases worldwide. A strong theme is that science-driven policy and public health interventions are key to ending the tobacco epidemic, as well as biological and clinical science. The role of the tobacco industry has been an important focus.

The specific scientific goals of the Tobacco Control Program are to (1) conduct clinical and laboratory investigations of the mechanisms of nicotine addiction; (2) further understand the effects of tobacco use and exposure to second-hand tobacco smoke, including genetic studies and investigations of racial and ethnic differences in measures of tobacco exposure and tobacco-related diseases; (3) develop and test innovative interventions for tobacco users, especially those in high-risk populations, including youth, individuals co-morbid with mental and substance abuse disorders, chronic smokers, and ethnic minorities; to provide estimates of the economic costs of tobacco use to society and the corresponding benefits of tobacco control programs; to conduct research on tobacco related policy and to continue to study the effects of the tobacco industry, both nationally and internationally, on tobacco use; and to better describe populations with high smoking rates, both in this country and internationally. Rather than being distinct areas of work, these investigations often interact with, and benefit from each other, spanning multiple disciplines. The expertise inherent of the Program membership supports the accomplishment of these goals. 

Links to More Tobacco-Control Resources at UCSF

Center for Tobacco Control Research and Education
The Center encompasses the work of 29 faculty members, their students, fellows and staff, who are committed to research, cessation, training and education designed each year.  This work extends from basic studies of nicotine pharmacology through the health effects of smoking and secondhand smoke to action-oriented policy interventions.

Legacy Tobacco Documents Library
The Legacy Tobacco Documents Library is a digital library of internal tobacco industry documents from the files of top tobacco companies, made possible by the UCSF Library and the American Legacy Foundation. The library offers searching, viewing, and downloading of over 20 million documents, which relate to scientific research, manufacturing, marketing, advertising and sales of cigarettes, among other topics.

UCSF Tobacco Control Archives
Sponsored by the UCSF Library and Center for Knowledge Management, Department of Archives/Special Collections, this is a central, organized source of information with the purpose of collecting, preserving, and providing access to papers, unpublished documents, and electronic resources relevant to tobacco control issues, primarily in California.

Smoke Free Movies
Hollywood stars attract millions of moviegoers. Philip Morris, RJ Reynolds, Brown and Williamson, and other big tobacco companies then addict and kill them, making billions in profits. This site uncovers that story.

For years, the tobacco industry has used and abused the restaurant and bar industry to defend its own billions of dollars in profits. Get the facts on Big Tobacco’s scam.

Reports on Tobacco Control
Online library of reports on tobacco control from UCSF and beyond.

  • Theme 1: Biological determinants of tobacco-induced addiction and disease
  • Theme 2: Social and behavioral determinants and interventions for tobacco addiction
  • Theme 3: The tobacco industry as a disease vector and strategies to block it

Nicotine Levels, Toxicant Exposure, and Tobacco Biomarkers
Neal Benowitz, PhD used biochemical data in large multi-center trials of smokers to study compliance to smoking reduced nicotine cigarettes and the impact of rapid vs. slow nicotine reduction. Despite high non-compliance, smokers reduced their nicotine intake by an average of 60%, supporting the feasibility of mandated nicotine reduction. These data were critical to the FDA’s recently-announced comprehensive tobacco regulatory plan, which includes a decision to regulate nicotine content of cigarettes. Furthermore, Benowitz’s work studying smokers using electronic cigarettes (e-cigarettes) supports the idea that if smokers can completely switch from regular cigarettes to e-cigarettes, risks to health are likely to be markedly reduced, supporting the concept of nicotine harm reduction for recalcitrant smokers.3.4 With Gideon St. Helen, PhD and Peyton Jacob III, PhD, Benowitz published a study of screening urine samples of minority and low-income adolescents at Zuckerberg San Francisco General Hospital (ZSFG) for exposure to tobacco.5 Urinary cotinine measures showed that 87% of adolescents were exposed to tobacco, including 12% who were active smokers, 46% with significant secondhand smoke (SHS) exposure and 30% with light SHS or third-hand smoke exposure. These data suggest that routine screening for such exposure is recommended to improve the health of children in urban hospitals that serve minority and economically disadvantaged populations. 
Social Marketing to Reduce Young Adult Tobacco Use
Pamela Ling, MD works to reduce tobacco use among young adults using social marketing and digital technologies. Young adults (age 18-25) have the highest smoking prevalence of any age group, and cessation by age 30 avoids nearly all the long-term ill effects of smoking. Using lessons learned from tobacco industry marketing strategies, Ling now uses branded social and lifestyle activities to decrease associations between youth culture and smoking, in order to compete with tobacco marketing. She has published results of four large-scale pilot studies of social branding interventions in four states in the Journal of Adolescent Health,6 all of which have found significant decreases in daily smoking during the intervention. Ling is now leading a multicenter controlled trial  of social branding interventions in four cities. The social branding strategy has been adopted by the FDA for its mass media educational campaigns targeting youth priority populations (Hip Hop, Rural/Country, and LGBT). The social branding strategy is also being applied to promote young adult smoking cessation in San Francisco as part of the HDFCCC SF CAN initiative. In this work, Ling’s social brand is deployed to promote and tailor the Facebook intervention designed by Danielle Ramo, PhD to encourage young adult hipsters to enroll in evidence-based smoking cessation services. 
Tobacco Regulatory Science
The UCSF Tobacco Center of Regulatory Science (TCORS) is one of 14 centers nationally, funded as part of a first-of-its-kind tobacco science regulatory program by the NIH with funds passed on from the US FDA. Stanton Glantz, PhD is PI for this four-year $20M grant (P50CA0180890), now in preparation as a competing renewal with a September 2018 funding date. The UCSF TCORS brings together TO Program researchers with the goal of developing models to inform tobacco product regulatory strategies that integrate economic impacts of tobacco use on health costs, consumer responses to pro-tobacco marketing and anti-tobacco messages, and rapid changes in risk due to tobacco use and secondhand smoke exposure. The work of the TCORS supports each of the three TO Program themes. Related to Theme 2, Benjamin Chaffee, MPH, PhD, DDS found that rural male youth are at high risk for tobacco use, particularly smokeless tobacco, often in dual- and poly-use patterns with other tobacco products. He found a very strong preference for flavored smokeless tobacco, suggesting that regulation to limit or eliminate flavored smokeless tobacco would likely reduce youth use. In relation to Theme 3, which aims to understand the tobacco industry as a disease vector and develop strategies to block it, Wendy Max, PhD uses microeconomic models to estimate healthcare costs attributable to the use of different tobacco products. Her work, which is submitted and under review, estimated the total annual US healthcare cost attributable to cigar use at $5.5 billion8, and the cost attributable to smokeless tobacco use at $3.5B.