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Health Career Leads to Post Atop State's Smoking-Prevention Effort

Posted on: Wednesday, 12 October 2005, 09:01 CDT

By John Reid Blackwell, Richmond Times-Dispatch, Va.

Oct. 12--Sandra Whitley Ryals has seen both sides of the tobacco debate.

As a child, she lived on her grandfather's tobacco farm in Tarboro, N.C., before her family moved to Emporia in Southside Virginia.

Her father, who was strongly against smoking, died of abdominal cancer four days after his 40th birthday, when she was a teenager.

That loss -- and the strong influence of her mother, Catherine -- motivated Ryals to pursue a health-care career, and in her 40 years in nursing and public health, she has seen the effects of tobacco addiction and has worked to improve health care for children and adolescents in Virginia.

Now the registered nurse and grandmother of two will oversee the state's largest-ever smoking-prevention effort.

In August, Gov. Mark R. Warner appointed Ryals as executive director of the Virginia Tobacco Settlement Foundation, an organization created by the General Assembly in 1999 to battle teenage tobacco use.

The foundation receives 10 percent of Virginia's annual share of the 1998 national tobacco settlement -- about $12.7 million this year -- to spend on tobacco-prevention advertising, outreach, research and grants.

Leading the foundation "seems a perfect fit with my background," Ryals said recently at the foundation's office in downtown Richmond. "Prevention has really been the focus of my entire career."

Ryals started her career in 1964 as a staff nurse at Georgetown University Hospital, but within a few years she and her husband, Jim, moved to Roanoke, and she moved on to several positions teaching nursing and in public health.

She has worked as coordinator for children's specialty services for the Virginia Department of Health and as public-health nurse director for the Roanoke City Health District. Ryals was involved in starting several public-health programs -- such as the Child Health Investment Partnership -- geared toward improving health services for children, adolescents and families. As her career advanced, she became more involved in health-policy issues.

"As I got further involved in policy issues, I also got further involved in politics," she said, first as an independent, then backing candidates, including Warner.

The foundation's executive director is a political appointee of the governor. Ryals -- who previously worked as chief deputy director at the Department of Professional and Occupational Regulation -- is the third person to serve as the foundation's executive director since it was created. She succeeds Marty Kilgore, who was appointed by Gov. Jim Gilmore in 2001. Kilgore, the wife of Republican gubernatorial nominee Jerry W. Kilgore, resigned in August to help with her husband's campaign.

Ryals -- whose future with the foundation may also depend on the outcome of November's election -- oversees a staff of 13 at the foundation and reports to a 23-member board of trustees. She is taking the helm at a time when the group's major initiatives are already well-established.

Despite the loss of $15 million from the foundation's budget during the state's fiscal downturn a few years ago, the group has financed a statewide advertising and outreach campaign targeting adolescents.

The "Y Do U Think" campaign includes a Web site and numerous outreach events, but perhaps its most visible element has been a series of clever and humorous -- and sometimes gross -- television ads that emphasize some of the more embarrassing social consequences of smoking. One recent ad, for example, features a phlegm-spitting contest between adolescent boys in which one boy is hit in face with a glob of goo just as he's trying to impress a girl. The message: "Teens that smoke produce twice as much phlegm as teens who don't."

The ads may seem repugnant to some adults, "but they do reach the kids," Ryals said.

The foundation also has poured millions of dollars into local civic groups and schools across the state for smoking-prevention programs, and it has provided grants to Virginia universities for research on nicotine addiction and smoking prevention.

"I think the foundation has done some amazing work in a short time," Ryals said. "I see good things ahead."

A survey in 2004 showed a decline in smoking rates among middle and high school students in Virginia, and other surveys have indicated a more than 70 percent level of awareness about the campaign among teenagers in Virginia. Another survey is being conducted this fall that will provide a more updated assessment of the campaign's success.

With the backing of the foundation's board, Ryals has made clear her intention to work for the restoration of $15 million in tobacco-settlement money that was removed from the foundation's budget in 2002 to help fill the state's budget gap. "I dream of what the foundation could do with that money now," said Ryals, adding that she'd like to see an increase in its research grants.

The foundation's chairman, Stuart businessman Ricky E. Fulcher, said Ryals brings a combined background in public health and public policy to the organization.

"From the public-health aspect, she does bring a medical background to the board in the director's position, which is something we haven't had in the past," Fulcher said. "That is going to help in driving the research aspect of our work, and help to solidify that.

"We are, of course, looking to try to get some of our funding back, and she seems to be leading the battle on that with the governor's office and our legislators."

Ryals said she recognizes that the anti-smoking campaign will be a difficult sell when so many other needs are on the table during the General Assembly session.

"It is harder sometimes to sell prevention," she said. "Yet the old saying -- an ounce of prevention is worth a pound of cure -- is so true. We have all seen the health effects of smoking. It is much more cost-effective to prevent something from happening now, than it is to pay .$.$. in the future."

And like her predecessors, she is careful to say that the campaign is not out to sink the tobacco industry, which employs thousands in Virginia.

"This is not about tobacco farmers," she said. "I grew up on a tobacco farm. I know what it is like depending on that for a livelihood. I also know what it is like to be in an environment where there is second-hand smoke," such as in the diner her parents owned.

Ryals spent her early years on her grandfather's North Carolina tobacco farm, but when she was 5, her family moved to Emporia, where her parents opened a restaurant, The Emporia Diner, where she worked. "It was open seven days a week, 24 hours a day, and was never closed except on Christmas Day," she said.

Despite the family's connection to tobacco farming, Ryals said her father, Vernon, "was an early advocate of not smoking. He was one who would say, 'If you smoke, you're not going to smoke in my house.'$" When her father died during her senior year in high school, "I became committed to pursuing a career helping people."

Ryals started school at Mary Washington College, took summer classes at the University of Richmond and transferred to the University of Virginia, where she earned a nursing degree. Later, after her son Jim went to college, Ryals went back to school and finished a master's degree in education from Virginia Tech. With degrees from both U.Va. and Virginia Tech, she calls herself "one of those Hokie-Hoos."

Ryals said she has maintained her nursing license over the years, even after she moved into other professional roles. A former president of the Virginia Nurses Association, she said nursing is one the best careers to prepare for other professional and civic roles. "Nursing prepares one well for so many things in life. Nurses know firsthand about their communities."

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Source: Richmond Times-Dispatch

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