State Health Chief Seems to Thrive on Heat : Kenneth Kizer: The 38-year-old doctor has overcome long odds and piled up extraordinary achievements.

Dr. Kenneth Kizer, the man spearheading California’s hard-hitting and controversial anti-smoking campaign, wonders what he will do next year when he leaves office with other members of the Deukmejian Administration.

After all, where does a 38-year-old physician go after spending five years jumping, like some kind of fire walker, from one political hot spot to another as director of an agency with a $10.5-billion budget and 6,000 employees?

The multimillion-dollar anti-smoking campaign--which has generated international interest and howls from the tobacco industry--is just the latest in a long series of hot issues tossed into the lap of the state’s top health official.

As director of the Department of Health Services, he has been responsible for the Deukmejian Administration’s toxic waste cleanup effort and its AIDS program. Recently, he has also been thrust into the the Medfly battle because of health concerns raised over the spraying of the insecticide malathion.

Some may remember Kizer as the man who banned the sale of watermelons on the Fourth of July in 1985 because of pesticide contamination. And just weeks before that, shortly after his appointment by Gov. George Deukmejian--Kizer ordered the recall of Jalisco cheese products. Some critics said then he had moved too slowly against Jalisco. Forty people died from bacteria contamination linked to the cheeses. Beyond the crises, Kizer also must keep state Medi-Cal, nursing, family planning and hospital programs afloat in the face of Deukmejian’s notoriously stingy budget policies.

Each of these issues has put Kizer in the middle of some of the most powerful economic and political forces in the state: agriculture and industry on one side, environmental and health groups on the other. Somehow, he has managed to duck enough bullets to set a longevity record in the health director’s job.

“A sequel to this job is going to be hard to match,” he said in a typical understatement.

Whatever the state’s health chief decides to do after Deukmejian leaves office next January, Kizer is not likely to be out of work long, for he is someone who has worked exhaustively to overcome long odds and pile up some extraordinary achievements.

When he was 6, he watched his father die of a heart attack in a supermarket. Then, when he was 12, his mother committed suicide. After her death, authorities broke up what remained of his family, sending Kizer and his four brothers and sisters to foster homes.

He remembers being bumped from foster home to foster home, state to state, exposed to alcoholism and domestic violence. Kizer nevertheless managed to become president of his high school class and work his way through Stanford and then UCLA Medical School.

During a recent interview, Kizer said that being exposed to so much adversity in his youth gave him “a jump start on life. I had a flavor for reality and what real life was all about earlier than most people.”

A workaholic, Kizer is a man who tunes up for his state job by moonlighting a weekend or two a month in the emergency room of Marin (County) General Hospital.

“In an emergency room, you are balancing a pretty mundane problem over here, like a kid with an earache, with someone who is going to die if you don’t do something in a few minutes. And then you have everything in between,” he said. “That is not all that different than what I do with the Department of Health Services.”

So Kizer--himself a nonsmoker--was ready when it came time to kick off the anti-smoking campaign.

Part of a $28.6-million campaign financed by Proposition 99 tobacco tax revenues, one of the television ads that began running last week portrays cigarette industry executives as sinister predators. Others go straight at the viewers with images designed to push emotional buttons and appeal to specifically targeted ethnic groups.

They show pregnant women and children being victimized by smokers--a man inhales and his wife coughs out the smoke. Ads published in newspapers carry boxes that say “Warning: The Tobacco Industry is not your friend.”

That is tough stuff for state government, particularly one headed by a Republican governor friendly to business. The governor’s staff was quick last week to note that Deukmejian had no part in the anti-smoking campaign. Deukmejian--who has been at odds with his health director before and who opposed Proposition 99--denied he was trying to distance himself from the ads. But he wouldn’t talk about them, either.

“Neither the governor nor any of his staff saw the ads,” Kizer said. He said that Deukmejian from the beginning gave him a free hand in deciding how to proceed with the ad campaign, which was done by a Los Angeles advertising agency in consultation with a committee appointed by the health services director.

Steering an independent course is not new for Kizer, who once backed an AIDS report calling for consideration of government programs supplying clean needles to drug addicts and condoms to jail and prison inmates--two positions opposed by Deukmejian.

Kizer has also been more aggressive than Deukmejian in supporting legislative efforts for some kind of universal health insurance program.

The health director, though, calls himself a team player. He notes: “I can be more effective as a team player than as a kamikaze.”

A role Kizer plays, and one he seems willing to accept, is the Administration’s lightning rod on some of the most controversial issues in the state--from AIDS to toxic waste disposal, and now, the anti-smoking campaign.

In tackling one controversial issue after another, Kizer has proven skillful in deflecting criticism.

That’s not to say he does not have critics. Corey Brown, general counsel for the Planning and Conservation League, faults Kizer for failing to put together a strong toxics cleanup program. “There have not been adequate inspections. There hasn’t been adequate enforcement. We think the Administration has been too soft on the waste industry,” he said.

Kizer has also been criticized for downplaying the health dangers of malathion, the insecticide being sprayed from helicopters in Southern California to eliminate the Medfly. Kizer has said homeowners have more to fear from a helicopter crash than they do malathion, a comment that had environmentalists fuming.

Daniel Bender of Monrovia, president of an anti-spraying group called Safe Alternatives to Fruit Fly Eradication, said he thinks Kizer “is more interested in protecting the governor’s position” than he is in investigating complaints that malathion poses a serious health risk.

Mary Nichols, an attorney for the Natural Resources Defense Council who has filed suit to stop the spraying, said Kizer was too quick with his comments on malathion and now has egg on his face because an advisory committee he appointed has concluded that more studies must be done.

Those criticism, however, pale in comparison to the onslaught coming from the tobacco industry. Complaints from the tobacco industry landed Kizer on a number of national television shows, including the “Today” show on NBC and “Crossfire” on the Cable News Network.

Walker Merryman, vice president of the Tobacco Institute in Washington, characterized the ads in a telephone interview with The Times as “hateful, nasty and bordering on racism” because of their appeal to ethnic groups. “It seems to be an ad hominem attack on the tobacco industry,” Merryman said.

On “Crossfire,” conservative commentator Patrick J. Buchanan said during a live debate that one of the television spots makes tobacco company executives look like “evil people.”

Unruffled, the telegenic Kizer responded to Buchanan the way he did to countless other questioners, saying, “We are doing what the voters of California said they wanted done.” Kizer, who said that his “phone has been ringing off the hook” since the television campaign began, calls the ads “quite appropriate.”

Despite the controversies, Kizer seems to have more supporters than critics.

Assemblyman Lloyd G. Connelly (D-Sacramento), who helped draft Proposition 99, the 1988 anti-smoking initiative, said Kizer has done remarkably well given efforts to cut health and welfare spending by Deukmejian and the Department of Finance.

“Right now, I’d give him a ‘B.’ If he had a receptive Department of Finance and governor, he would get an ‘A.’ He is not getting the money, and I don’t think he is getting the support he needs,” Connelly said.

Paul Keye, who is directing the anti-smoking campaign for the Los Angeles advertising firm of keye/donna/pearlstein, gives Kizer credit for taking a gutsy position in supporting the hard-hitting ads.

“Brave clients make brave advertising,” Keye said.