Wearing a lab coat and speaking from an exam room, La Donna Porter looks every bit the wise physician, even as she does the bidding of the tobacco industry, which contributes to the deaths of 443,000 Americans every year.
Porter is the star of tobacco-funded radio and television commercials intended to snuff out Proposition 29, the initiative on the June 5 ballot that would raise taxes by $1 per pack on cigarettes.
The consultants who created the ad call it, simply, "Doctor." There is nothing fancy about it. Porter opens by saying that she opposes smoking, but that she read the proposal, found flaws. Then she slices it apart, in 30- and 60-second versions.
From a purely professional point of view, the ad is "quite effective," observed David Townsend, a strategist who knows the tobacco industry's power well. Townsend managed the yes-on-Proposition 86 campaign in 2006, the last time Californians tried to raise tobacco taxes. Cigarette companies spent $66 million and killed it.
"We know from all the polling that doctors are very effective spokespersons," Townsend said.
The ad is a throwback to when tobacco companies could openly advertise, and often employed doctors as pitchmen.
"This is not a deviation for the tobacco industry," Townsend said.
It's also a throwback to 2006, when Porter, then named La Donna White, appeared on a tobacco-funded television ad attacking Proposition 86, and made virtually the same pitch.
"She is selling us out," said Valerie Yerger, assistant professor of health policy at UC San Francisco medical school, who has written extensively about the tobacco industry manipulation of African American consumers.
Porter, 46, who is African American, is a family practitioner who has worked in Sacramento- and Stockton-area hospitals, while carving out her unusual subspecialty by serving as a tobacco industry spokeswoman.
Within her profession, she stands virtually alone. Major organizations representing doctors and health care advocates back Proposition 29.
Porter said she didn't have time to talk with me, and asked that I send her written questions. She didn't answer those, either, except to say that she isn't being paid to oppose Proposition 29.
Porter went on to urge a "genuine examination of Prop. 29 that focuses on the issues and not on any one individual."
Fair enough. Here's an issue: Smoking among African American men remains highest among all adults, 18.4 percent, compared to white men at 13.3 percent. A similar pattern holds for African American women.
Here's another issue. African Americans suffer from smoking-related disease at greater rates than the general population. The National Cancer Institute reports 99.9 cases of lung and bronchus cancer for every 100,000 African American men, compared to 76.4 per 100,000 for all men.
For decades, tobacco companies marketed certain products to African Americans. In one of her papers, Yerger described how "inner cities populated predominantly by poor African American residents were targeted with highly concentrated menthol cigarette marketing from the entire industry."
To this day, 70 percent of African American smokers consume menthol cigarettes, compared with 30 percent of white smokers, Yerger has written. Menthol cigarettes are probably more addictive and lethal than regular smokes; they contain higher amounts of tar and nicotine.
Here's a third issue: consumption. If voters approve the $1 tax, the price of cigarettes would rise by 19.7 percent to $6.10 per pack.
The California Department of Public Health estimates that for every 10 percent increase in price, smoking declines by 4 percent, suggesting that tobacco use would fall by 8 percent if voters approve Proposition 29.
No wonder that the tobacco industry is spending upward of $30 million to defeat Proposition 29. It's basic math – profit and loss. Of course, the rest of us have a stake in the outcome, too. If smoking declines by 8 percent, California would save $5.7 billion in long-term health care costs, public health experts calculate.
Porter's involvement in political matters dates back at least a decade when she met Eric Newman, a lobbyist for KP Public Affairs, one of the top billing lobby firms in town. Newman's firm represents aerospace firms that are concerned about regulation and cleanup of perchlorate, a rocket fuel additive that has fouled groundwater and is linked to learning disabilities.
In 2002, when the U.S. Environmental Protection Agency came to Sacramento to hold a hearing on perchlorate, Newman suggested that Porter might want to testify.
Porter did so, raising questions about a perchlorate standard contemplated by the EPA, warning in written comments that compliance would be costly, and would divert money from "more immediate, real and dangerous health-related programs."
Among those more immediate risks, she noted, African Americans are "30 percent more likely to die from heart disease than white Americans and 30 percent more likely to die from cancer than are whites."
Smoking, of course, leads to heart disease and cancer.
On Aug. 4, 2005, the Schwarzenegger administration named Porter to the Development and Reproductive Toxicant board, which determines whether the Office of Environmental Health Hazard Assessment should place chemicals on a state list of toxins especially dangerous to pregnant women and fetuses.
For industry, the timing of her appointment was propitious. On Aug. 11, the board rejected a petition to list perchlorate as a reproductive toxicant.
Later in 2005, Porter enlisted with the pharmaceutical industry in a fight over an initiative that would have hit drug company profits, signing an opinion article that appeared in The Bee.
"We made a big effort to recruit MDs, and we had some success," said Jose Hermocillo, who heads the APCO office in Sacramento and worked for the drug companies' campaign. "Doctors are credible."
The following year, 2006, APCO was one of the firms that worked to defeat Proposition 86, the earlier tobacco tax initiative. Porter joined in, warning that the initiative would allow hospitals to "fix prices, reduce access to health care services and deny patients some of the critical care they need."
Hermocillo and others say Porter receives no pay for her efforts but rather believes what she says.
Whatever her motivation for dancing with industry, Porter had a troubled few years. In October 2007, she and her then-husband signed a lease on a building on Auburn Boulevard, intending to start the Abundant Word of Faith church.
They never paid rent. Landlord Dan Alexander sued and won a judgment for $117,991. Porter extricated herself from her short-lived marriage in 2008, and filed for bankruptcy. That left Alexander with no hope of ever being paid, though he does not blame Porter so much.
Recalling that Porter's then-husband drove a red Corvette and wore what looked to be a gold Rolex, Alexander said: "I got the definite impression that he was playing her. I felt she was duped by the guy."
Whether or not she was conned by her ex-husband, Porter's eyes are wide open now. She knows she's doing the tobacco industry's bidding. What must she think when she sees emphysema and cancer patients gasping for air? What must her patients think when they see her on television?