Hollings tobacco researcher honored by American Society of Preventive Oncology

When Matthew Carpenter, Ph.D., arrived at MUSC Hollings Cancer Center as a psychology intern in 2002, there were no faculty members who were primarily interested in tobacco research.

“There were other people here and there who had secondary interests in tobacco research, but nobody who called this their gig. Nobody. So that was both a challenge for me, as an early-stage investigator coming to this University, but also a great opportunity,” said Carpenter, now a professor and the Flora McLeod Edwards Distinguished Endowed Chair in Cancer Research.

Over the years, the program grew. Hollings recruited more researchers; Carpenter mentored young scientists who have developed into independent investigators; and the tobacco researchers created new programs to help people to stop smoking and to spread evidence-based knowledge about tobacco cessation to health care workers. In 2018, Carpenter stepped into the role of co-leader of the Cancer Control Research Program at Hollings.

“We, as a group, have built what I think is probably one of the premier tobacco research centers in the country,” Carpenter said. “I don't say that lightly, because there are a lot of others, but I think we stand with any of them. I'm proud of the role I played in that – and we're not done. We'll continue to grow as a group. There's still important work to be done.”

In acknowledgement of the work he has accomplished so far in the field, the American Society of Preventive Oncology awarded Carpenter its Joseph W. Cullen Memorial Award this month.

The award is named for Joseph Cullen, Ph.D., who developed the Smoking Tobacco and Cancer Program at the National Cancer Institute in 1982, and honors "distinguished achievement in national tobacco control efforts” as well as leadership that fosters collaboration among basic and behavioral scientists, those in health care fields and public health advocates.

 

Carpenter’s colleagues, including previous Cullen awardee Michael Cummings, Ph.D., nominated him, citing his extensive research record that spans public health policy, clinical trials and lab studies.

“He is a visionary thinker, key opinion leader in the field of nicotine and tobacco research and outstanding role model for his mentees,” wrote Cummings, Benjamin Toll, Ph.D., and Ashish Deshmukh, Ph.D., Carpenter’s co-leader in the Cancer Control program.

“Like Dr. Cullen, Dr. Carpenter’s career has exemplified a commitment to fostering collaboration among a wide network of basic and behavioral scientists, health care professionals and public health advocates working toward the shared goal of reducing the health burden of tobacco-related diseases,” they said.

Carpenter first became interested in tobacco research while earning his doctorate in clinical psychology. His mentor, John Hughes, M.D., was one of the founders of the Society for Research on Nicotine and Tobacco, the renowned professional organization for tobacco researchers.

“He was an internationally known tobacco researcher, although he's now retired, and his passion became my passion,” Carpenter explained.

As a researcher, Carpenter found himself drawn to the precise process of puzzling out an answer from a complex situation.

“The outcomes matter. We are trying to do public health good by getting people off the leading preventable cause of cancer,” he said. “But I'm equally intrigued by the process of asking a question, designing a study that answers that question, thinking through all the ways that I might be wrong and my study might be flawed and ultimately convincing a funding agency like the NIH that this study is worthwhile, and that we can do it.”

As an example, he has a study underway now with Hollings colleague Tracy Smith, Ph.D., that takes a dynamic approach to smoking cessation. Rather than assigning Group A to one method and Group B to another, to then follow both groups for a long period to see which is more successful, this study will reassess each participant’s success at four weeks and, for those who are struggling with their assigned smoking cessation method, reassign them to a new group.

“We're not waiting six months to see how people did, which is really how most clinical trials are designed. We're looking at early response and adapting treatment as necessary, so we're really testing whether changing or staying the course is the wise approach,” he explained.

Tobacco research studies don’t always make headlines, but a study Carpenter published in August 2023 made waves among vaping proponents and opponents alike. Its findings continue to fuel online debate to this day.

The study, “Effect of unguided e-cigarette provision on uptake, use, and smoking cessation among adults who smoke in the USA: a naturalistic, randomised, controlled clinical trial,” found that e-cigarette usage among adults who already smoked tended to lead toward smoking cessation.

Further, the study suggested that people who have had trouble quitting using existing pharmacotherapy might be advised to try e-cigarettes.

The role of e-cigarettes is hotly debated, largely due to tobacco researchers' and public health advocates’ skepticism. Given the tobacco industry’s record of concealing the harms of cigarettes, there is understandable suspicion of its products.

Are e-cigarettes more or less harmful than traditional cigarettes? More or less addictive? A potential path to quitting nicotine altogether or simply another vehicle to addict a new generation?

The question of e-cigarettes has divided the field in a way he hasn’t seen before, Carpenter said.

 

The study that created such a buzz was designed to mimic real-world conditions as much as possible. Rather than give e-cigarettes to participants and tell them they must use them instead of the cigarettes they would usually smoke, the researchers simply provided e-cigarettes and told participants they were free to use them, or not, as they wished.

They found that those who were given the e-cigarettes were more likely to report complete abstinence from traditional cigarettes, fewer cigarettes smoked per day and a greater number of quit attempts than people in the control group.

“Vaping is a very controversial issue and, unfortunately, is very polarized,” Carpenter said. “This study is another study in the literature, and I think it's an important one. But no study in and of itself should be over-construed. There are multiple interpretations from ours: The people who are for e-cigarettes will find the interpretation that benefits them, and the people who are anti- will find the interpretation that benefits them.

“I do believe it ultimately was mostly positive in terms of benefiting smokers,” he explained.

Carpenter, who doesn’t have a profile on X and has remained out of the social media arguments over his work, is instead focused on what’s next.

He is developing new proposals to continue to study e-cigarettes and to quantify how people use them, while working on ongoing clinical studies.

Tobacco research, he said, was never something that he dreamed of doing when he was a child. But this path has become his life’s work.

“I love what I do,” he said. “I enjoy coming to work every day. I feel like I’m part of something bigger.”

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