Spotlight On: John Pierce, PhD

Issue 23, Summer/Fall 2014

John Pierce, Ph.D.

Distinguished Professor
Family and Preventive Medicine
Director of Population Sciences
University of California, San Diego
Moores Cancer Center

Each year, the American Association for Cancer Research (AACR) bestows its prestigious Award for Outstanding Achievement in Cancer Prevention Research on an investigator who has "had not only a major impact on the field," but has also "stimulated new directions" in cancer prevention research.

In 2013, that researcher was Dr. John Pierce, whose pioneering epidemiological studies have provided vital insight into how the behavior of individuals, as well as societies as a whole, work for and against cancer prevention.

Pierce's impact has been key to broadening our understanding of what drives people to smoke and, more importantly, on how to reduce smoking, particularly among adolescents. His team was the first to show how effective well-designed, statewide tobacco control programs were at driving down smoking rates in his native Australia. Recruited to CDC, Pierce and his team published the first major analyses of trends in smoking behavior that highlighted successes and problems in need of improvement. Such trends have been a mainstay of Surgeon General's reports ever since.

When he moved to UC San Diego in 1990, he turned his attention to tobacco marketing and helped spotlight the seductive lure of the R.J. Reynold's "Joe Camel" character on children. This was followed with a series of studies documenting tobacco marketing's powerful influence. A key paper in the Journal of the American Medical Association preceded the restrictions on tobacco marketing that were included in the Master Settlement Agreement, the landmark 1998 agreement between major tobacco companies and U.S. states. His team also built on findings from his Australian studies and introduced and did the initial evaluation that led to Statewide Smoker's Helplines.

Pierce's work also helped propel groundbreaking anti-smoking legislation in California. Following a 1992 JAMA paper documenting levels of secondhand smoke with different workplace smoking rules, in 1994, the nation's most populous state became the first and only jurisdiction in the 1990s to ban smoking in the workplace. His team documented the success of this policy and it became a core component of the Framework Convention for Tobacco Control in 2002, which led to its widespread dissemination.

"California was the first state to aggressively respond to the evidence that cigarette smoking caused disease," Pierce noted, "Not only did it lead by increasing cigarette taxes regularly, it was also the first state to introduce an ongoing, well-funded comprehensive tobacco control program." In 2010, Pierce documented that these interventions led to declines in cigarette consumption in California that were much greater than in the rest of the nation. Critical to public health efforts, the increasingly lower consumption in California was mirrored by an increasingly lower lung cancer rate that began to appear 16 years later.

Population-wide changes in public policy can spur trends that save countless lives. Three years ago, Pierce's team reported in JAMA that the number of Americans who smoked more than a pack of cigarettes per day plummeted between 1965 and 2011. This decline was largely driven by a decline in the proportion of young people who became smokers. There was also evidence that consumption by smokers changed fairly uniformly across ages, indicating the broad impact of tobacco policies.

Pierce's work goes beyond investigations into smoking behaviors, however. Throughout the late 1990s, he led a study investigating the role of a plant-based diet in preventing relapse following breast cancer. In 2007, he led a study that found that eating a healthy diet and getting regular exercise could reduce a breast cancer survivor's risk of death by half - even if she were overweight or obese. On the other hand, the trial of the plant-based dietary pattern showed that there were limits to what diet can do: Women with early stage breast cancer saw no added survival benefit from a dramatic increase in fruit and vegetable intake over recommended healthy levels.

Work like this was recognized in 2011 when Pierce received the first Harold Dorn Award for Translation of Epidemiologic Evidence in Public Health Policy and Practice, bestowed by the joint Epidemiological Societies of North America. Speaking at the time, UCSD colleague Dr. Ruth Patterson said the lifetime achievement award was "well-deserved recognition for Dr. Pierce's profound and fearless work over the past 30 years."

Pierce received his bachelor's degree from Monash University in Melbourne, Australia, his master's from McMaster University in Hamilton, Ontario, Canada, and his doctorate from Stanford University. Besides his role at the Moores Cancer Center, he is also director of the doctoral program in public health at the joint program between UC San Diego and San Diego State University. He was the recipient of the first Doll/Wynder Award for epidemiological research from the Society for Research on Nicotine and Tobacco, and the Joseph Cullen Memorial Award from The American Society of Preventive Oncology.