Tobacco expert witness, researcher, to speak at Hollings

For the second annual Susan Rosenblatt Lectureship, MUSC Hollings Cancer Center will welcome David Burns, M.D., professor emeritus at the University of California, San Diego.

The lectureship is named in honor of Susan Rosenblatt, an attorney who, with her husband and law partner Stanley Rosenblatt, took on the cigarette manufacturers in lawsuits in the 1990s after seeing the devastation wrought by cigarette smoking.

One of their suits, a class action on behalf of smokers harmed by cigarettes, led to a $144.8 billion judgment against the cigarette manufacturers. Although the award was appealed, requiring class members to go to court individually, the findings in the case have been used in ongoing litigation involving thousands of Floridians ever since.

 

Burns, a pulmonologist, worked with the Rosenblatts on their lawsuits and continues to testify against the tobacco industry. He has also served as an author, editor, senior scientific editor or reviewer for each of the surgeon general’s reports on tobacco between 1975 and 2020 and was senior editor for a series of tobacco control monographs for the National Cancer Institute.

The title of Burns’ talk is “Tracking nicotine and disease: Great progress, but have we lost our way?”

Burns noted that researchers made a grave error when filtered and, later, low-tar and “light” cigarettes came into the market, sold as safer alternatives to nonfiltered, regular cigarettes. Many in the public health community assumed that these products, while not safe, would at least substantially reduce lung cancer risk. They didn’t realize how manufacturers had changed the design of cigarettes, allowing people to compensate by inhaling nicotine and the carcinogens found in tobacco smoke deeper into their lungs.

The result was that adenocarcinoma of the lungs skyrocketed from one of the least common types of lung cancer to the most common type. Unfortunately, it took decades for researchers to figure out what was causing the rise in adenocarcinoma of the lung, since many couldn’t believe it was because of cigarettes, Burns said.

“We were looking for something else because somehow, in our heads, we didn't think that cigarettes could be made more hazardous. And, in fact, they had been,” he said.

Cigarette smoking has been greatly reduced since the 1990s. In fact, Burns said, “We have dropped per capita consumption, which is the total number of cigarettes sold in the United States divided by the U.S. population over the age of 18, to levels that we haven't seen since 1930s.”

However, nicotine vaping represents a new challenge, both to public health advocates and to those seeking to understand its effects.

“At what rate are kids or young adults who are using these products becoming addicted?” Burns asked. “The second question is, are people who are trying to quit able to switch completely to these products or are they using them to sustain their addiction when they can’t use cigarettes? And are they relapsing back to cigarettes after a year or two of using the product?”

Burns noted that researchers typically count as vapers anyone who’s vaped in the last 30 days. But this doesn’t account for the distinction between people who vape every day, because they’ve become addicted to nicotine, and those who might have vaped on a whim, perhaps for social reasons, but not because of addiction to nicotine. Teasing out these distinctions will likely change the resulting estimate of rates of addiction.

“The mistake that we're making is we need to believe what we see, not see what we believe,” he said. “But that’s a common problem in science in general.”

Burns will speak at noon on Oct. 26 in Room 120 of MUSC Hollings Cancer Center, with lunch provided to all attendees. The event will also be viewable via Teams.

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