The National Cancer Institute (NCI), following the recommendations of its Tobacco Research Implementation Group, is advancing a plan to expand and accelerate tobacco research that can prevent cancers associated with tobacco use. The plan was announced today by Vice President Gore.
The Tobacco Research Implementation Group was created to establish NCI's tobacco-related cancer research priorities for the next five to seven years. These priorities are put forth in a new report, The National Cancer Institute Tobacco Research Implementation Plan, Priorities for Tobacco Research Beyond the Year 2000.
"This implementation plan will focus the nation's commitment to forge a body of knowledge that will guide tobacco use research into the next century and help turn the tide on the epidemic of tobacco-related diseases," said Secretary of Health and Human Services Donna E. Shalala.
The implementation group identified and prioritized a core set of tobacco-related cancer research opportunities, including what it called "nine unique, overarching research opportunities" requiring "immediate implementation."
"NCI is moving quickly to follow these recommendations," NCI Director Richard Klausner, M.D., said. "As the first step in following the plan, we are launching two major research initiatives that will be funded at $142 million over five years."
In the first initiative, which creates a collaborative Transdisciplinary Tobacco Research Centers program, NCI will commit $50 million and National Institute on Drug Abuse (NIDA) will commit $20 million over five years. For the second program, NCI will separately fund $72 million over four years for state and community tobacco control intervention research. Both initiatives will solicit research proposals from investigators across the country. The new programs will complement existing NCI and NIDA tobacco research efforts.
The implementation group said that strategic partnerships would be critical for success in following through on the research agenda, and recommended that NCI collaborate with both public and private organizations, including NIDA and other NIH institutes, the Centers for Disease Control and Prevention (CDC), and the Robert Wood Johnson Foundation.
"The collaboration between NCI and NIDA emphasizes the need to focus on all aspects of the problem, the causes, prevention, and treatment of nicotine addiction and its dramatic health consequences," said NIDA Director Alan I. Leshner, Ph.D.
In the NCI and NIDA initiative, the institutes will co-fund the creation of Transdisciplinary Tobacco Research Centers that will examine a range of areas. Researchers from different scientific disciplines will seek to answer a number of pressing questions, such as: Why do children start smoking? How can people be helped to quit smoking? Are there genes that predispose people to tobacco addiction?
NCI and NIDA will fund $14 million annually for five years for the centers, with $10 million from NCI and at least $4 million from NIDA per year starting in late fiscal year 1999.
"These centers have the potential to dramatically alter the way tobacco research is conducted on a national level and to speed the pace of discovery, leading to a major public health benefit by reducing tobacco use," Klausner said.
These new initiatives will alter the way tobacco control research has been traditionally conducted. Advances in molecular biology, genetics, and behavioral science now provide unparalleled opportunities to study the tobacco problem in ways that will integrate biological and psychosocial models of tobacco and addiction. To facilitate advances, NCI and NIDA are supporting new models of research organization, synthesis, and collaboration.
Klausner added that NCI plans to meet with state and community tobacco control experts to continue their input in the development of these new programs.
Under the second initiative, NCI will award $18 million annually for four years beginning in early fiscal year 2000 to study the effectiveness of state and community tobacco control interventions. The focus will be on mass media and policy interventions that are used to motivate tobacco use prevention and cessation.
Researchers will look at policies that influence behavior, including excise taxes, advertising restrictions, clean indoor air policies, and restrictions on tobacco sales to minors. They will also examine, for example, the impact of large media campaigns and how they influence subpopulations such as heavy smokers and youth.
In the next few years, many states will initiate new or expanded projects to reduce tobacco use. This new research initiative is intended to be in place by 2000 to boost the effectiveness of state efforts.
"This is an extraordinary opportunity and will contribute information that will improve the major tobacco control programs in states and communities across the country," Klausner said.
The nine high-priority areas recommended by the Tobacco Research Implementation Group are:
- Create Transdisciplinary Tobacco Research Centers to study the initiation of tobacco use, prevention of tobacco use, addiction to tobacco, and treatment of addiction and tobacco-related cancers;
- Conduct basic biobehavioral research to understand the sociocultural, psychological, physiological, and genetic factors that influence the initiation of tobacco use, progression to nicotine addiction, and smoking cessation among children, adolescents, and adults;
- Conduct research to find the best ways to tailor tobacco cessation interventions to specific sociocultural, psychological, physiological, and genetic subgroups;
- Conduct research to improve community and state tobacco control programs and to increase the effectiveness of these programs for populations at disproportionate risk;
- Conduct research to identify mechanisms for optimal dissemination of proven prevention and treatment interventions at the community and state levels;
- Conduct research to understand the impact of tobacco policies, including taxation and pricing, clean indoor air policies, marketing restrictions, youth access restrictions, and tobacco product and nicotine replacement regulation;
- Conduct basic biological research to identify and validate biomarkers of tobacco exposure and tobacco-induced cellular events as they relate to the different stages of carcinogenesis;
- Conduct research to understand genetic and environmental interactions in susceptibility to tobacco-related cancers in order to identify subgroups at risk; and
- Conduct research on expanded surveillance systems to monitor tobacco use behaviors, the implementation and fidelity of tobacco-related interventions and other factors that influence tobacco use.