Betty Jean Marconi calls it her "nightmare child": a character called Carmen von Boxide (representing, naturally, carbon monoxide) who stars in performances staged by the University of Pittsburgh Medical Center, McKeesport, Pa. "I think I ate a pickle before I went to bed that night," says Marconi, the facility's director of tobacco-free programs and community outreach.
She describes Carmen as "this grody creature, this really vile, icky person who pops out of a cigarette" and introduces fourth-graders to her "friends and family," substances such as ammonia, tar and insect repellent. "This really gets the audience's attention. You see the kids go, `Hhhhhhhuuuuuhhh!' "
The match that lit Marconi's creative impulses is not hard to imagine. "We certainly have seen the effects of smoking on our adult population," she says. "We found out there was this common thread, that they started smoking when they were young. So how do you stop all of these problems we have been seeing? We decided we needed to try to stop kids from even trying and experimenting." For this combination of creativity and caring, 185-bed UPMC McKeesport has won the Spirit of Excellence community award.
As part of Carmen's performances, students are asked to try breathing through a coffee-stir straw to simulate emphysema. "We tell them that when you have emphysema, there's no straw to take out of your mouth," Marconi says. "You breathe this way 24 hours a day, seven days a week." In addition, a narrated PowerPoint presentation delves into the substance behind the drama, explaining how cigarettes make smokers sick, "how they cause destruction from the cellular level on up," she says.
Some 5,000 students have seen the production. The McKeesport center plans to survey students who have seen the performance once they reach the sixth, eighth, 10th and 12th grades as part of a study of the program's effects. Early results are promising: Of those who participated during the program's first school year of 2001-02, 91% had never tried a cigarette and the rest did not smoke regularly. In a control group, 14% had smoked and half did regularly.
Marconi says there are other, similarly anecdotal but more immediate indications of success. "When you're in the middle of a live performance, it's the feedback," she says. "You know you're making an impact. You see it." Judge John Tolmie agrees. "I thought it was a tremendous value to the community and, in particular, the children," he says. "It seemed like there would be an ability to replicate that in other communities."