Tobacco War: "d0e14883"

The California Tobacco Survey: TCS “Fires” John Pierce

From the inception of the Proposition 99 programs, the Legislature had funded a statewide prevalence survey, the California Tobacco Survey, to monitor the program's impact on smoking and to identify which elements

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of the program seemed to be most effective. The survey was conducted for DHS by the University of California, San Diego, and directed by Professor John Pierce. Pierce and his colleagues had a record of finding politically unacceptable results beginning in 1991, when they reported that the media campaign contributed to a 17 percent drop in smoking when Governor Wilson was trying to eliminate the campaign on the grounds that it did not work. Nevertheless, on December 8, 1997, TCS wrote Pierce and his co-investigator, Elizabeth Gilpin, to inform them that TCS was amending their contract “in order to extend the time period through June 30, 2000 and to augment the contract by $3,052,332.…Essentially, the contract extension is for: the conduct of, analyses of, and reporting on the 1999 California Tobacco Survey; the conduct of, analyses of, and reporting on the longitudinal assessment of adolescent smoking initiation study; and the completion of reports and additional analysis of the 1996 California Tobacco Survey.”^[94]

Six months later, TCS reversed itself. On June 15, 1998, TCS wrote the UCSD investigators to tell them that TCS “will not be renewing your contract to conduct the 1999 California Tobacco Control Survey nor do we plan to fund your proposed longitudinal study of adolescent smoking initiation.”^[95]

In the intervening months, Pierce and his coworkers had submitted a draft report on the California Tobacco Survey concluding that, after 1994, the California Tobacco Control Program had lost its effectiveness. TCS pressured the research group to make changes to the report. Over time, the working relationship between Pierce's group and TCS deteriorated. After TCS abruptly notified Pierce that the contract would not be renewed, Pierce observed:

As I reflect on our experience with the State over the past year, I can only conclude that the decision to terminate our contract was politically motivated. Our difficulties with the Department of Health Services staff began when we did two things:
a) Identified the coincidence between the halting of the decline in smoking behavior and the diversion of money from the specific health education accounts mandated by the Tobacco Tax Initiative.
b) Based on probabilities obtained from previous national and California research, we projected that smoking rates in 15-17 year old adolescents in California were likely to increase by 14% between 1996 and 1999.^[96]

Pierce's report concluded that the initial success of the program, between 1989 and 1993, did not persist into the late period, 1994-1996. The

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report suggested that a combination of reduced program funding, increased industry advertising and promotion expenditures, decreases in tobacco prices, and increased political activity contributed to the shift.^[3]

DHS asserted that Pierce's contract was not canceled because of the work's quality but because Pierce was “too difficult to work with.”^[97] Members of DHS's own Evaluation Advisory Committee, who supported the quality of Pierce's work, also questioned the decision to terminate the contract but received no better explanation.^[98]^[99] Mike Cummings, a cancer researcher from New York and chair of the Evaluation Advisory Committee, wrote Bal and Johnson on June 22, 1998:

Finally, as co-chair of the Evaluation Advisory Task Force, I would like to express my deep dissatisfaction with the way the situation with Dr. Pierce was handled. First, it became apparent at the June Evaluation Advisory Task Force meeting that not all Task Force members were briefed on this situation and the concerns raised about Dr. Pierce's report. This situation was unfair both to Dr. Pierce and to our task force. Second, it is apparent that the decision to terminate Dr. Pierce's contract was made before the task force meeting for reasons unrelated to the scientific issues that were brought before the task force for discussion. It is an embarrassment that task force members first learned about the contract termination from Dr. Pierce and not from CDHS. The task force should have been notified of this decision before the meeting so that our time could have been used more productively to advise CDHS about future plans for the California Tobacco Survey. Third, it appears that you were attempting to use our task force to raise concerns about the UCSD report in an effort to strengthen your case to terminate Dr. Pierce's contract. Our task force members, who volunteer their time to your program, should never have been put in this position.^[99] [emphasis added]

An editorial in the San Diego Union-Tribune captured the general outrage that greeted Pierce's firing:

Earlier this month, a report by UCSD researchers came to light which concludes that California's anti-smoking campaign is coughing and wheezing for want of state support. This prompted the state agency that commissioned the report to start taking potshots at the messenger. Welcome to the world of power politics, where special interests generally prevail against the public interest… .
What we have here is not a failure to communicate, but a refusal to capitulate. This report is scientifically sound while politically embarrassing to the folks in Sacramento looking to undermine the anti-smoking campaign. They and their tobacco buddies are doing whatever it takes, including attacking the integrity of respected scientists, to gut a program approved by the voters. And that is despicable.^[97]

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Cook, the chair of TEROC, however, refused to put the issue on the TEROC agenda when Glantz requested that she do so. She responded, “I have considered the various facts and assertions that have been made and have studied the responsibilities of TEROC, and have concluded that it is an internal administrative matter which the Committee should not get involved in.”^[100] Cook's decision to ignore Pierce's termination was all the more remarkable in light of an article by Pierce and his colleagues that appeared in the Journal of the American Medical Association the day before TEROC met; the article confirmed that the California Tobacco Control Program had declined in its effectiveness beginning in 1994.^[3] These findings were widely publicized in the press on the morning of the TEROC meeting, but no one at the meeting mentioned the news coverage or Pierce's termination.^[101-104] The courage to challenge the politicization of the media campaign did not extend to the evaluation process, even though TEROC's central purpose was to evaluate the campaign and report back to the Legislature on how to improve it.