NCI Initiates Two High-Priority Tobacco Research Programs

BETHESDA, Md—The National Cancer Institute (NCI) and National Institute on Drug Abuse (NIDA) will jointly fund a 5-year, $72 million project to create a series of Transdisciplinary Tobacco Research Centers to study tobacco use initiation, addiction, and cessation, and tobacco-related cancers. The NCI, in a separate initiative, will spend $72 million over 4 years for research to improve state and community tobacco-control efforts.

The two programs will solicit research proposals from investigators nationwide, and the NCI says they will complement its existing tobacco research. NCI also said it will seek the advice of state and community tobacco-control experts in developing and implementing the programs.

The two new efforts are among nine high-priority areas that the NCI-established Tobacco Research Implementation Group (TRIG) identified as “unique, overarching research opportunities” that the Institute should pursue over the next 5 to 7 years. “NCI is moving quickly to follow these recommendations,” NCI director Richard D. Klausner, MD, said.

The NCI-NIDA program stems from a TRIG recommendation that NCI collaborate with public and private organizations—including several other NIH units, the Centers for Disease Control and Prevention, and the Robert Wood Johnson Foundation—in pursuing the priority objectives. The joint effort will start late in fiscal year 1999, which ends September 30.

NCI will provide $50 million, at $10 million a year, and NIDA will contribute $20 million in equal yearly payments of $4 million.

A major thrust of the Transdisciplinary Tobacco Research Centers is to focus the efforts of scientists with diverse expertise—including molecular biology, genetics, neuroscience, epidemiology, imaging, behavioral science, economics, and marketing—in collaborative efforts to address key causation, addiction, and treatment issues.

“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,” Dr. Klausner said.

Over 4 years, beginning early in fiscal year 2000, NCI will also provide $18 million annually to study the effectiveness of state and local tobacco control efforts, with a strong focus on their use of mass media presentations and on policies aimed at preventing people from starting tobacco use and helping users quit.

Among the interventions to be studied are increased tobacco excise taxes, advertising restrictions, clean indoor-air policies, and restrictions on tobacco sales to minors. Researchers will also examine such issues as the impact of large media campaigns and how they influence the smoking behavior of specific groups such as heavy smokers and teenagers.

‘An Extraordinary Opportunity’

Many states and localities are expected to increase their tobacco-control efforts in the next few years, often using money from the recent settlements with tobacco companies. NCI said its new initiative is meant to help boost the effectiveness of these 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,” Dr. Klausner said.

Other recommendations included in the TRIG report, titled “Priorities for Tobacco Research Beyond the Year 2000,” urge the NCI to conduct:

Basic biobehavioral research to understand 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.

Research to find the best ways to tailor tobacco cessation interventions to specific sociocultural, psychological, physiological, and genetic subgroups.

Research to improve community and state tobacco control programs, to increase their effectiveness for populations at disproportionate risk, and to identify mechanisms for the optimal dissemination of these interventions.

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.

Basic biologic research to identify and validate biomarkers of tobacco exposure and tobacco-induced cellular events as they relate to the different stages of carcinogenesis.

Research to understand genetic and environmental interactions in the susceptibility to tobacco-related cancers in order to identify subgroups at risk.

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.