While his grandfather and uncle both died from smoking-related illnesses, Michael Cummings’ passion for helping smokers quit — and making tobacco companies pay — grew out of years of witnessing strangers struggle with nicotine addiction and associated disease and death.
In October 2011, the 59-year-old came to the Medical University of South Carolina Hollings Cancer Center after nearly three decades of hands-on research work at Roswell Park Cancer Institute in Buffalo, N.Y. Here, he is tasked with helping lower South Carolina’s cancer rates.
MUSC President Ray Greenberg says Cummings brings “considerable strength (to Hollings and MUSC) as we work to reduce the burden of cancer in our state.”
“First and foremost, he is a top-notch scientist, and he has made major contributions to research on tobacco control,” Greenberg says. “At the same time, Dr. Cummings has a passion to put this knowledge into practical application.
“We sometimes talk about the rare combination of a person being a ‘scholar and a gentleman,’ but in the case of Dr. Cummings, I would say that he is truly the complete package: a scholar, a gentleman and an activist.”
Lab to courtroom
Unrelated directly to his work at MUSC, Cummings continues serving as an expert on the tobacco industry in lawsuits across the country, especially in Florida.
His route to the courtroom came in the mid-1990s, when lawyers Ron Motley and Dick Scruggs and Mississippi Attorney General Mike Moore pursued suing Big Tobacco, namely Brown & Williamson, on behalf of taxpayers.
“They were looking for people who knew anything about tobacco,” Cummings says. “I was invited down to Pascagoula, Miss., in 1996. It was an interesting meeting. I was there the Friday before (whistleblower) Jeff Wigand arrived on Saturday for his deposition.”
After a former staffer from Brown & Williamson and Phillip Morris talked, Cummings says, “I quickly realized sitting in the room that I knew zip. ... The amount of information I learned in two days sitting in a meeting on the inside talking to these lawyers was eye-opening to say the least.”
His early work with the lawyers was pro bono, and he had no obligations to be involved in litigation. But Cummings proved to be a valuable expert witness on nicotine, and his name got out. To this day, he’s still actively involved in cases. Last year, he was involved in 13 trials.
It was that combination of his tobacco-cessation work with the Brown & Williamson case and the subsequent releasing of documents detailing efforts to combat threats to smoking that gave Cummings empathy for smokers.
The courtroom continues to feed Cummings’ drive.
“I’m angry, and I get angrier every time I go into the courtroom,” Cummings says.
“Yes, I think smokers have a responsibility today. They ought to know (the consequences of smoking) and try to quit, but I think the cigarette companies have a responsibility, too. They lied to the American public, and they are lying today when they say that all you’ve got to do is (to) make up your mind and quit, because they have engineered a product designed to be addictive.”
At Hollings, where Cummings will serve as co-lead professor in tobacco research, he will work to develop a system for every hospital in the state to have a standardized way to identify smokers, offer cessation treatments and do follow-ups.
Cummings says hospitals, to date, have not been good at that, but with the expansion of electronic medical records, they can do better. With the system needing to reduce costs, the effort is needed even more, and he hopes to have a program in place starting at Hollings this summer.
“One-third of the patients in the hospital are there because of smoking,” Cummings says. “If you had a vaccine that could prevent a third of all cancers, wouldn’t that be a good thing? People just shouldn’t use cigarettes, essentially.”
Besides causing disease in the first place, Cummings says, evidence is accumulating that patient recovery is hindered by smoking, from affecting the metabolism of chemotherapy, the toxicity of radiation therapy and even simple processes, such as wound healing.
“It (smoking) is not just a minor little thing,” Cummings says.
“We should be following patients. We’re losing an opportunity to offer them therapy. These are the sickest people. You can prevent readmissions. There are a lot of initiatives waking up the fact that they have to lower health care costs, and smoking cessation is the way to do it.”
Statistically, Cummings points to the numbers. MUSC discharged about 27,000 patients last year — about 5,000 could be offered cessation, he says. From his experience at Roswell Park, more than 90 percent are receptive to being approached about an offer of help.
A family of smokers
Cummings’ experience with the deadly perils of smoking dates back to his childhood.
Growing up in New Jersey, Cummings’ grandfather and uncle worked in top positions for Lorillard Tobacco, the maker of popular cigarette brands Old Gold, Kent and Newport. Both were smokers, as were more than half of the American population in the 1950s.
His grandfather died from heart disease in 1953, six months after Cummings was born, and his uncle died from lung cancer when he was 48, when Cummings was an older boy in 1967. He recalls his uncle as a robust, outdoorsy guy who was left shriveled and weakened by the cancer before dying from it.
But at the time, even after the landmark surgeon general’s report in 1964, few were making the connection between smoking and diseases.
“Back in the day, whole TV shows were sponsored by cigarette companies,” Cummings says. “It was part of Americana. ... I really didn’t put two and two together.”
Both Cummings’ father and mother smoked. As a high school student, he tried smoking and even signed a petition for an outdoor smoking lounge for students, but gravitated toward playing basketball. Many sports teams forbade smoking.
The winding road
Basketball took Cummings to Florida Southern College in Lakeland, but Cummings, who had lost his father to a nonsmoking-related cancer, started missing his girlfriend and future wife, Susie Johnson, who attended Western College in Oxford, Ohio.
Cummings transferred to nearby Miami (of Ohio) University with plans to be a physical education and health teacher.
Michael and Susie got married in August 1975, and Cummings kept going to school and getting opportunities to further his education, ending up with a doctorate in public health from the University of Michigan.
Research with benefits
While at Michigan, he became acquainted with a smoking-cessation program by a graduate student, Don Powell, that came in handy when he started working at Roswell Park and responded to requests to have year-round smoking-cessation programs.
With an intern, Cummings took a part of Powell’s program to use and started with 15 Roswell employees. And it failed. Most of them didn’t quit.
“How come most of these people didn’t quit? We gave people the information — the surgeon general’s reports. People gained weight. ... They were supposed to be breathing better, but they were crying in the corner because they were so miserable when they quit smoking.”
The question of why became the focus of his research.
Cummings started running cessation programs on his own time in the evenings. Studies at Roswell looked into withdrawal symptoms, the effect of knowing the dangers of smoking and quitting aids, to mention a few issues.
“There wasn’t a lot of research on behavioral aspects of smoking cessation and methods for quitting. My research started focusing on that,” Cummings says
Empathy for smokers
After 30 years of running smoking-cessation clinics, he knows how hard it is for people to quit. Smoking is the fastest and most addictive way of delivering nicotine to the brain: eight to 10 seconds. By comparison, delivery via gum in the mouth is five to 20 minutes and via a patch on the skin, 20 minutes.
“The empathy I have for smokers is from learning that it’s not so easy to put an addictive product down. And the only reason that cigarettes are addictive is that they have been engineered to be addictive, starting with the blending of types of tobacco to make the smoke inhalable.”
Cummings wife of 37 years, Susie Cummings, says that tackling the smoking problem became a passion for her husband.
“He never worried about money. For a while, we were a one-car family, living paycheck-to-paycheck. And sometimes he even forgot to bring the paycheck home,” Susie Cummings says. “He’d work 80-hour work weeks and loved every minute of it. And he’s still working harder than ever.”
While Cummings originally had planned to move to the Charleston area, where all three of their grown sons live, after retiring from Roswell Park in their 60s, an opportunity arose to join MUSC earlier.
Ultimately, neither expect Michael to give up his work in tobacco cessation and litigation.
“I just don’t see him not working. He has the freedom to work or not work now,” Susie Cummings says. “He’s doing this because he wants to.”
Michael Cummings, co-lead of tobacco research at MUSC, stands in an area that was a “smoking hut” until March 2012, when it was converted to a smoke-free sitting area and herb garden. The entire campus went smoke-free last year.×
Cummings helped develop this traveling exhibit, “A Century of Cigarettes,” currently at the Colbert Library. The exhibit traces the rise of cigarette use and lung cancer through the 20th century.×