October 06, 2009

Prof. Kristie Foley

by Kelly Beggs

This summer, Davidson faculty-student collaboration crossed an ocean and a language barrier into a country with a serious smoking problem. Kristie Foley, associate professor and associate director of Davidson's Medical Humanities Program, recruited Hungarian native Felix Fabiny '11 to establish a new protocol to complement her $1.4 million grant on "Building Capacity for Tobacco Research in Hungary."

The Fogarty International Center and National Cancer Institute awarded Foley the five-year grant in 2007. Foley serves as the Principal Investigator for the project, working with an international, interdisciplinary team of social ecologists, physicians, sociologists, psychologists, lawyers, and economists. Foley supervises eleven Hungarian scientists who are doing tobacco research projects. She said, "We're building partnerships to encourage them to continue their scientific work after we pull out in two years. We need to create independent scientists, so they're not relying on this external team for support, but becoming independent agents."

Tobacco presents a severe threat to national health in Hungary. The country has the highest lung cancer mortality rate in the world for both men and women. Between 30-36 percent of the population smokes, and a third of the country's population under 18 uses tobacco regularly.

Felix Fabiny '11

"We want to make the society more aware of the harms associated with tobacco," Foley said. "A lot of people really don't know the harms, especially the short-term harms. The health ministry is looking to our project to recommend actions that will decrease tobacco use and the morbidity and mortality rates associated with it."

Increasing taxation, passing a clean indoor air law, and decreasing children's exposure to second hand smoke are among Foley's anticipated recommendations, but successful implementation depends upon the government's willingness to act in harsh economic and political times. In addition, powerful tobacco companies exert political pressure for the government to choose economic gain over national health.

Foley said, "How do you encourage a government to pay for cessation therapies when it's having challenges meeting basic infrastructure needs? They have to believe in it and commit the financial resources."

By engaging advocates in Hungary, Foley aims to make tobacco cessation a national priority. "This is the piece of science that is often missing-how to get it out to people who make a difference, how to get the advocacy component," she said. "We're trying to get advocates on board with scientists so that they have the tools and the evidence to pass along to their constituents."

Foley met Fabiny and his family when she was in Hungary as a Fulbright Scholar from 2006-07. Two years later, Fabiny was in his second year of Davidson, and the perfect fit for a new role in Foley's grant. She said, "It was really important to me to have someone outside the team to ask questions, an entirely objective person not driven by personal interests. Felix speaks the language and was able to talk to the directors of organizations to get some strong qualitative data."

Fabiny, a double history and political science major, grew up just outside of Budapest. He applied to Davidson after hearing about the school from a Davidson alumnus and colleague of his father, as well as from Professor Foley and her husband, Mark Foley, associate professor of economics at Davidson.

He said, "After hearing so much about the good academics, people, and opportunities for discovery in this small North Carolina town, I decided to apply. It certainly has been an exciting Davidson journey so far!"

Davidson opened up several international opportunities for Fabiny. In addition to his research with Professor Foley last summer, he worked on an Abernethy grant to study "The Transnational Narratives of the New York Life Buildings in Paris, Berlin and Budapest." He said, "This summer was certainly a very liberal arts experience, as I got to work on both a history and public health project." He is currently on Davidson's study abroad program in Peru.

For Foley's public health project, Fabiny translated and administered a survey, collecting data about the geographical scope, structure, funding, and tobacco-prevention activities of numerous civil societies, NGOs and advocacy organizations. His interviews uncovered organizations' involvement in tobacco cessation and will connect Foley's team to a network of like-minded advocacy organizations, optimizing the anti-tobacco movement's impact.

Though Fabiny is hopeful for his country's future, working on Foley's project gave him insight into the complexity of public health policy. "Many of the organizations I talked to were passionate about creating a healthier, more vibrant country," he said. "Nevertheless, it is hard to find a solution. The varying interests of the Ministry of Health, smokers, health care professionals, NGOs, the national government, and the perpetual lack of funding all call for difficult compromises."

Fabiny himself has always been an exception to Hungary's tobacco addiction. He said, "Thankfully, I grew up in a family that does not smoke, and I've never smoked."

However, second-hand smoke was still an issue. "I was allergic," Fabiny explained, "and I remember that my family would always have to move tables if we went out to eat, as there was almost always somebody who smoked next to us."

Throughout his childhood, Fabiny saw evidence of the country's unhealthy habit everywhere. "As a kid, I was used to seeing a pack of smokes lying around, whether it was at the hairdresser-who always rushed out to smoke after cutting my hair-or the local market. I would pass middle school kids smoking in front of their schools, and what annoyed me most was that they were getting cigarettes illegally."

He said many shopkeepers ignore the government's ban on selling to those under 18, so minors have easy access to cigarettes. Though Fabiny stayed smoke-free, many of his friends did not.

He said, "In middle and high school, several of my friends began to smoke. Smoking isn't seen as much as a rebellion as just the normal thing you do when you hang out in a group. Some of my friends just smoked at parties, while others would light a cigarette as soon as they got out of school."

As for why so many young Hungarians take up smoking, Fabiny credits cultural norms that need shifting. He said, "A lot of children grow up and see smoking as acceptable, even cool, and Hungary's economic problems just make the smoking problem worse. I believe this culture is changing, though," he said. "A lot of people and organizations are saying that there is hope for a better future."

Early spring will be a telling time for tobacco's future in Hungary, as the government will reconsider a clean-indoor-air policy that failed to pass last spring. Foley said, "We're watching that very closely."

Fabiny remains optimistic. He said, "There are plenty of challenges to achieving a successful public health policy in Hungary, but it's pretty sweet to know that Davidson-affiliated research can contribute to a solution."

Davidson is a highly selective independent liberal arts college for 1,800 students located 20 minutes north of Charlotte in Davidson, N.C. Since its establishment in 1837 by Presbyterians, the college has graduated 23 Rhodes Scholars and is consistently regarded as one of the top liberal arts colleges in the country. Through The Davidson Trust, the college became the first liberal arts institution in the nation to replace loans with grants in all financial aid packages, giving all students the opportunity to graduate debt-free. Davidson competes in NCAA athletics at the Division I level, and a longstanding Honor Code is central to student life at the college.
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