UCSD Expert Is Smoking’s Archenemy

Two years ago, former Del Mar Mayor Dick Roe was combing the nation for an expert witness who would testify in support a controversial--and, eventually, ill-fated--ballot measure to ban outdoor smoking in Del Mar.

During a trip to the U.S. surgeon general’s office in Washington, Roe learned that Dr. David M. Burns, one of the nation’s most highly regarded experts on the health effects of tobacco, lived right in his back yard.

Since the late 1970s, Burns, an associate clinical professor at the UC San Diego Medical Center in Hillcrest, has served as a senior editor and reviewer of the surgeon general’s smoking reports. Former U.S. Surgeon General C. Everett Koop recently presented Burns, 42, with the prestigious Surgeon General’s Medallion.

Given Burns’ national reputation, Roe was concerned that he would be unwilling to dedicate time to a relatively unimportant anti-smoking campaign in Del Mar. But, “to my delight, the man was personable, easy to talk to and he was more than willing” to appear as an expert witness, Roe said.

Roe’s description fits with Burns’ reputation as an anti-smoking advocate with impeccable public health credentials and a sincere, down-to-earth style.

“David is fabulous; he leaps tall buildings in single bounds,” said John Pinney, executive director of Harvard’s Institute for the Study of Smoking Behavior and Public Policy.

Pinney first recruited Burns to work for the surgeon general’s office as an editor of the 1979 report on smoking that is credited with reviving the nation’s then-flagging interest in the eradication of tobacco use.

“David was absolutely indispensable in making that report happen,” Pinney said. “He has the most complete and balanced understanding of anyone in the country on the medical and scientific basis for smoking policies.”

Burns, a pulmonary medicine specialist at UCSD since 1976, was a high school senior in Boston when the first surgeon general’s report was issued in 1964. A decade later, with a Harvard Medical School degree in hand, he began a two-year stint as a medical officer with the ill-funded National Clearinghouse for Smoking and Health in Atlanta.

Although the 1964 surgeon general’s report awakened the nation to the growing controversy over tobacco use, by the late 1970s research into the dangers of smoking had waned. Consequently, there was little competition for the editing job offered by Pinney.

But Burns’ interest in science, medicine and regulatory issues proved to be the right mix for the position.

“We would have been in big trouble without David,” Pinney said. “He demonstrated . . . a capacity for work that is really quite extraordinary.”

Solidified Position

The 1979 report solidified Burns’ reputation as a savvy medical doctor who understood the complex blend of government bureaucracy, tobacco company influence and public opinion that has shaped the nation’s tobacco-use policy.

But, although Burns has “maintained his high national visibility, unlike many, he’s not invisible at the local level,” according to John Elder, an associate professor in San Diego State University’s School of Public Health, who worked with Roe and Burns in an attempt to win passage of the Del Mar initiative.

Burns “is the expert in San Diego County” according to Carole Fish-Botkin, director of public education for the San Diego chapter of the American Cancer Society. “He’s always very helpful whenever we call him for advice.”

Burns has developed a reputation as “the person you start with anytime you’re interested in working on some aspect of public policy or a bit of research related to smoking and tobacco control,” Elder said.

“He’s been very cooperative, and has done what has to be done,” said Ira Goldstein, treasurer of the San Diego Medical Society and chairman of the Tobacco Free 2000 Committee, which was formed a year ago to rid the county of tobacco by the year 2000. “It’s what he likes to do and what he feels will benefit people the most.”

Heavyweight Among Experts

To Ed Fletcher, director of health services for the San Diego Unified School District, Burns is a heavyweight medical expert who “knows how to cut right through” the bureaucracy and “get to the right people and get things done. He’s not opposed to going right to the top. And, when it’s someone who is as prominent as a David Burns,” those at the top are going to listen to him, Fletcher said.

Burns, who never began smoking, tackles the subject with the fervor usually associated with a dedicated former smoker.

Although he has repeated the statistics hundreds of times, he still grows visibly upset as he describes tobacco’s effect: Smoking will kill more than 40% of the people with the habit. Tobacco this year will be responsible for the deaths of 390,000 people, “which is more than the sum total of all deaths (this year) due to alcohol, drugs, AIDS, murder, suicide and auto accidents,” Burns said.

Despite that litany of pain and suffering, “this nation is reluctant to remove the exposure because it might inconvenience people,” he said. “We think about tobacco and give it a special exception.

Contrast to Asbestos

“We don’t ask tobacco companies to accept responsibility for their products. And we allow them to say things that are absolutely outrageous. . . . We make it convenient and easy for people to injure themselves.”

That public policy contrasts with the national policy on asbestos, the leading occupational killer, “which will cause 10,000 deaths during 1989,” Burns said. Just imagine if an asbestos company declared the material to be safe, he said. “Everybody in the world would bury them.”

Burns’ dedication to the anti-smoking campaign--he spends half his working day on smoking-related issues--has “hurt some aspects of his career,” according to Pinney.

“A lot of what I do is in conflict with my best interests academically,” Burns acknowledged. “It would be much better,” he said of his career, “if I sat around in the laboratory” conducting experiments.

‘Committed and Fascinated’

Pinney, who has long been involved in shaping the nation’s public policy on smoking, believes that Burns remains involved because he “is both committed to and fascinated by public policy and public health. It blends the elements of medicine, politics, bureaucracy . . . which is a perfect combination of his interests. There is a genuine commitment there.”

“Of anyone I’ve known on the East and West coasts, David has the broadest knowledge of research and policy development,” said Elder.

Burns’ active role in the surgeon general’s reports has caused supporters to consider him a logical candidate for surgeon general.

“I suppose if one were to design the (model) surgeon general, a person like David, after another 10 years of public health experience, might well qualify,” Pinney said.