Susan V. Lawrence is Head of China Programs at the Campaign for Tobacco-free Kids, a Washington, DC-based non-governmental organization that works to reduce tobacco use and its devastating health and economic consequences in the United States and around the world. She divides her time between Washington, DC and China.

The Campaign is a partner organization in the Bloomberg Initiative to Reduce Tobacco Use, launched in 2005 with funding from New York Mayor and philanthropist Michael Bloomberg. The initiative’s work is focused on low- and medium-income countries that together account for two thirds of the world’s smokers. Other partners in the initiative are the Centers for Disease Control Foundation, the Johns Hopkins University Bloomberg School of Public Health, the International Union Against Tuberculosis and Lung Disease, the World Health Organization, and the World Lung Foundation.

Before joining the Campaign for Tobacco-free Kids, Ms. Lawrence worked for 16 years as a journalist, including a cumulative 11 years between 1990 and 2003 as a staff correspondent in China. She served as China bureau chief and later Washington correspondent for the Hong Kong-based newsweekly Far Eastern Economic Review, as a Beijing-based staff correspondent for The Wall Street Journal, and as China bureau chief for the newsmagazine US News & World Report. A fluent Mandarin Chinese speaker, she holds Bachelor’s and Master’s degrees in East Asian Studies from Harvard University and was a Harvard-Yenching Institute Scholar in the History Department at Peking University from 1985-87. 

Her talk is the third in the colloquium series on tobacco control in East Asia, sponsored by the Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, in coordination with FSI’s Global Tobacco Prevention Research Initiative.

Why do community-based education and social persuasion programs for promoting healthy lifestyle and preventing chronic disease sometimes fall short of our expectations? Why are population effects so difficult to engineer and why are they so ephemeral?

This research carried out at USC, the Claremont Graduate University, and collaborating institutions in China integrates across social, behavioral, and neurocognitive sciences to address those questions. We conclude tentatively that the answer to each of the questions may lie in individual and context variability relative to program response, and that in order to more fully address the question of prevention program response variability requires engagement and integration across several levels of science to consider the roles of social groupings, environmental selection and design, social influence processes, and brain biology.

What works in one social, cultural or organizational setting may not be so effective in another. What works for persons with certain genetic and experiential backgrounds may be totally ineffective for persons with different dispositional or personality characteristics. In a series of community/school based prevention trials carried out in markedly different southern California and central China settings, we have uncovered domains of consistent response, and other domains of substantial environment- and disposition-based response variability.

A social influences based smoking prevention program framed in collectivist values and objectives worked to prevent smoking in one cultural setting but not another. And an individualist framed social influences program worked in the setting where the collectivist program did not. But the characteristics of the particular settings, which defined program success or failure, were different from what conventional (e.g., cultural psychology) wisdom would have led us to expect. Furthermore, both within and across cultural settings, the same individual dispositional characteristics moderated or determined program effectiveness, again in ways not predicted by the common cultural and behavioral science wisdom.

In recent studies carried out both in China and the U.S. we have found affective decision deficits, with known neural underpinnings, to account for rapid progression to regular smoking and binge drinking. These deficits are akin to the dispositional characteristics found earlier to moderate prevention program effects. Subsequent brain imaging studies confirm the hypothesized regions of neural involvement. Together these findings hold promise for more effective – situation and phenotype specific – approaches to engendering and sustaining more optimal individual and population health behavior.

Why do community-based education and social persuasion programs for promoting healthy lifestyle and preventing chronic disease sometimes fall short of our expectations? Why are population effects so difficult to engineer and why are they so ephemeral? This research carried out at USC, the Claremont Graduate University, and collaborating institutions in China integrates across social, behavioral, and neurocognitive sciences to address those questions.

We conclude tentatively that the answer to each of the questions may lie in individual and context variability relative to program response, and that in order to more fully address the question of prevention program response variability requires engagement and integration across several levels of science to consider the roles of social groupings, environmental selection and design, social influence processes, and brain biology. What works in one social, cultural or organizational setting may not be so effective in another. What works for persons with certain genetic and experiential backgrounds may be totally ineffective for persons with different dispositional or personality characteristics. In a series of community/school based prevention trials carried out in markedly different southern California and central China settings, we have uncovered domains of consistent response, and other domains of substantial environment- and disposition-based response variability. A social influences based smoking prevention program framed in collectivist values and objectives worked to prevent smoking in one cultural setting but not another. And an individualist framed social influences program worked in the setting where the collectivist program did not. But the characteristics of the particular settings which defined program success or failure were different from what conventional (e.g., cultural psychology) wisdom would have led us to expect. Furthermore, both within and across cultural settings, the same individual dispositional characteristics moderated or determined program effectiveness, again in ways not predicted by the common cultural and behavioral science wisdom. In recent studies carried out both in China and the U.S. we have found affective decision deficits, with known neural underpinnings, to account for rapid progression to regular smoking and binge drinking. These deficits are akin to the dispositional characteristics found earlier to moderate prevention program effects. Subsequent brain imaging studies confirm the hypothesized regions of neural involvement. Together these findings hold promise for more effective – situation and phenotype specific – approaches to engendering and sustaining more optimal individual and population health behavior.

Secondhand smoke (SHS) is a known cause of cancer, heart disease, respiratory disease, and other ailments. However, these diseases have a multiplicity of causes. Defendants claim SHS exposures are "low" and other sources created the illness. Plaintiffs claim "high" exposures to SHS caused their disease. In the world of toxic torts litigation involving allegations of injury from secondhand smoke, how does the expert witness use multidisciplinary science and technology in the investigation and establishment of facts and evidence in a court of law? Cases have been brought on behalf of railroad conductors, casino dealers, flight attendants, laborers, nurses, barbers, bartenders, prisoners, office workers, and even condo owners. How have they fared in high stakes litigation, and what does it take to prove a case?

James Repace, MSc., is a biophysicist and an international secondhand smoke consultant who has published 83 scientific papers, 70 of which concern the hazard, exposure, dose, risk, and control of secondhand smoke. He has received numerous national honours, including the Flight Attendant Medical Research Institute Distinguished Professor Award, the Robert Wood Johnson Foundation Innovator Award, the Surgeon General's Medallion, and a Lifetime Achievement Award from the American Public Health Association. He holds an appointment as a Visiting Assistant Clinical Professor at the Tufts University School of Medicine, and is a consultant to Stanford doing research on secondhand smoke in casinos. He is a former senior policy analyst and scientist with the U.S. Environmental Protection Agency, serving on both the Air Policy and Indoor Air Staffs, Office of Air and Radiation, and in the Exposure Analysis Division, Office of Research and Development. He served as a consultant to the Occupational Safety and Health Administration, U.S. Department of Labor, on its proposed rule to regulate secondhand smoke and indoor air quality. He was also a research physicist at the Naval Research Laboratory in the Ocean Sciences and Electronics Divisions. His degrees are from the Polytechnic University of New York; he has also pursued post-masters' studies at the Catholic University of America in Washington DC.

Abstract:  In this era of catastrophic terrorism and heightened concerns about pandemic influenza and other emerging diseases, unprecedented resources have been allocated to improving medical and public health emergency preparedness.  Investments in such preparedness, however, can impose significant opportunity costs, particularly when the investments are focused on improving consequence management capabilities.  Enhancing preparedness and response capabilities in economically efficient, proportionate, and politically sustainable ways thus becomes a critical component of any longterm effort to address the threats we face.  Dr. Hatchett will speak about the challenges of developing medical countermeasure for CBRN threats and preparing communities for infectious disease emergencies, using these examples to raise more general issues about the relative benefits of specific v. "broad-spectrum" strategies and countermeasures, decision-making under conditions of uncertainty, and our efforts to "get ready" for nuclear terrorism and pandemic influenza.

Dr. Hatchett is Associate Director for Radiation Countermeasures Research and Emergency Preparedness at the National Institute for Allergy and Infectious Disease, overseeing a program that develops drugs and devices to prevent or mitigate the effects of radiation exposure. 

In 2005-06, he served as Director for Biodefense Policy at the White House Homeland Security Council, where he was a principal author of the Implementation Plan for the National Strategy for Pandemic Influenza and helped set policy and devise strategies to mitigate the consequences of a pandemic.  Dr. Hatchett previously served as Senior Medical Adviser in the U.S. Department of Health and Human Services (HHS) Office of Public Health Emergency Preparedness, where he worked on a wide range of biodefense issues, including the delivery of mass prophylaxis to urban populations, the development of disease containment strategies, and the role of modeling in the formulation of public health policy. 

Dr. Hatchett completed his undergraduate and medical educations at Vanderbilt University, an internship and residency in Internal Medicine at New York Hospital - Cornell Medical Center, and a fellowship in Medical Oncology at the Duke University Medical Center.

Rose McDermott is a Professor of Political Science at Brown University.  She is currently a fellow at the Center for Advanced Studies in the Behavioral Sciences at Stanford University.  She holds a Ph.D. in Political Science and an M.A. in Experimental Social Psychology, both from Stanford University. She held a National Institute on Drug Abuse Post Doctoral Fellowship in Substance Abuse Treatment Outcome Research at the San Francisco VA through the University of San Francisco Psychiatry Department.  Professor McDermott has also held fellowships at the John M. Olin Institute for Strategic Studies and the Women and Public Policy Program, both at Harvard University. Professor McDermott's main area of research concerns political psychology in international relations. She is the author of Risk Taking in International Relations: Prospect Theory in American Foreign Policy (University of Michigan Press, 1998), Political Psychology in International Relations (University of Michigan Press, 2004), and Presidential Illness, Leadership and Decision Making (Cambridge University Press, 2007). She is co-editor of Measuring Identity: A Guide for Social Science Research, with Rawi Abdelal, Yoshiko Herrera, and Alastair Iain Johnson (Cambridge University Press, forthcoming).

She has written numerous articles and book chapters on experimentation, the impact of emotion on decision making, social identity, and evolutionary and neuroscientific models of political science.  She is currently involved in a series of projects investigating the endogenous sources of aggression, and a book project on pandemic disease.

Herbert Abrams is a professor of radiology, emeritus, at the Stanford School of Medicine and a member-in-residence at CISAC, where he directs the Project on Disabled Leadership. He was Professor and Director of Diagnostic Radiology at Stanford from 1960 to 1967, and was then appointed and served as Philip H. Cook Professor and Chairman of Radiology at Harvard University from 1967 to 1985. He returned to Stanford in 1985 as Professor of Radiology in order to spend most of his time in research in CISAC. Dr. Abrams' present focus is on presidential disability and its potential impact on decision making.