Film Shows Medical Students How To Understand Cultural Influences of Tobacco Use

October 5, 2007

Film Shows Medical Students How To Understand Cultural Influences of Tobacco Use

WINSTON-SALEM, N.C. – Gail Marion, P.A., Ph.D., can now add screenwriter and film producer to her resume. The final touches to the educational film “Tobacco Ties,” have been done and it’s been unveiled to medical students.
The 9-minute film depicts a typical scenario: a single, working mother of two consults her doctor because of asthma-related problems. She’s a smoker who comes from a family of smokers who have farmed tobacco for several generations. Sunday dinners at home always end with her and her sisters sitting around the table gabbing, drinking coffee and smoking. She knows smoking isn’t healthy and is aggravating her asthma, but it helps her de-stress and concentrate at work. Most importantly, it defines her role within her family which is steeped in a history of tobacco.
“In this scenario, the patient comes to her doctor with a culture of tobacco – it’s how they made their living, paid for schooling, bought their houses,” said Marion.
The goal, said Marion, is to use the film as a teaching tool to facilitate understanding and communication between doctors and their patients in a “culturally competent” way because physicians play a critical role in addressing tobacco use. Marion said she and her colleagues saw a need for such a teaching tool because students are always asking for good examples to illustrate concepts they are studying.
The film was funded as part of a $1.6 million five-year federal grant from the National Cancer Institute (NCI) awarded to John Spangler, M.D., and colleagues at Wake Forest University School of Medicine. The grant is in its fifth and final year. The film is part of a comprehensive program to train medical students in ways to improve their tobacco intervention counseling skills.
In a previous article published in JAMA, Spangler and colleagues wrote that while physicians play a critical role in addressing tobacco use, studies show that they fail to counsel their patients to stop smoking because they are ill prepared to treat patients addicted to nicotine. For WFU medical school students, tobacco curriculum is embedded throughout their schooling, Marion said.
Marion collaborated on the film with Daniel and Laura Hart McKinney, faculty members at the N.C. School of the Arts film school. The film was shot on-site at Piedmont Plaza I in the clinic with local actors, Kathy Shields as the working mother, and John Ruston as the doctor. The medical center’s own Rose West played a nurse.
The short film has also been submitted to the American Association of Medical Colleges’ Med-Ed A Portal, an on-line outlet for more than 8,000 multimedia teaching materials so health care providers across the globe can access and utilize it. Now, Marion is working on another teaching film that deals with weight. This one will feature a woman who needs to lose weight; she’s heavy because “in her culture full figured women are more attractive than thinner women,” said Marion.


Media Relations Contacts: Bonnie Davis,; (336)716-4977; Shannon Koontz,, (336) 716-2415, or Karen Richardson,, at (336) 716-4453.

Wake Forest University Baptist Medical Center is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university’s School of Medicine. U.S. News & World Report ranks Wake Forest University School of Medicine 18th in primary care and 44th in research among the nation's medical schools. It ranks 35th in research funding by the National Institutes of Health. Almost 150 members of the medical school faculty are listed in Best Doctors in America.

Media Relations