One of the top news stories in 1964 was that cigarette smoking caused lung and laryngeal cancer in men and chronic bronchitis. Following the release of the 1964 Surgeon General’s Report on Smoking and Health, subsequent reports affirmed a causal relationship between cigarette smoking and other cancers, respiratory illnesses, cardiovascular, and other chronic diseases in men and women. Theses landmark conclusions from multiple reports helped to spur successful public health action to reduce tobacco use and exposure. But, as the old cliché goes, “much progress remains”.
For many communities and population groups, the news story is the same- tobacco use continues to be a major public health hazard, but is also a profitable source of revenue and wealth for the tobacco industry. Thus, tackling this issue is more complex than it should be because public health and industry forces are in an ongoing battle to reduce and replace consumers for a legally lethal product. So, where do we go from here and how can research help?
First, we must recognize that the work that researchers do contribute to the solution, but research alone cannot ameliorate the problem as the malignancy of the problem goes beyond the microcosm of research. We need practitioners, policy-makers, advocates, and community at large to make the difference. However, the role that researchers play is indisputable. Such efforts have resulted in reports that declared tobacco use and exposure as causal factors for chronic diseases and helped to establish an evidence-based for the prevention and treatment of tobacco use and dependence. Researchers can take on the challenge of collectively working across diverse disciplines and sectors to develop and implement effective strategies to reduce tobacco, and particularly among vulnerable groups who have been unfortunately left behind. We have said this before, but we are challenged to do a better job of bridging our intellectual and social resources as resources are strained. The good news is that we have effective strategies that have yet to reach, be implemented or sustained in many communities such as implementing complete bans on smoking any tobacco product in the home.
Second, my hope is that we collectively build on the prior knowledge to identify new solutions to reduce the initiation and continued use of flavored tobacco products, including menthol; help poor and disadvantaged populations quit using tobacco; and engage in scholarly work to investigate and evaluate the evidence related to the extent to which some emerging products help and/or harm specific populations. These are ongoing issues, some even divisive within the research community, but they must be resolved with revolutionary thinking, that is thinking that engages us in dramatic and profound change. We should never stop expecting change that results in definitive progress for all groups no matter what the context is or will be.
Third, we have to recognize that our progress demands that the next generation of researchers be adequately trained and informed of the history of tobacco prevention and control so that history does not repeat itself. We do not need to rediscover what is already known. With the landmark passing of the Family Smoking Prevention and Tobacco Control Act in 2009, a new generation of tobacco regulatory scientists have emerged. This science is an integral part of tobacco prevention and control, but the “basic” skills and competencies of tobacco prevention and control must still be embraced. There must a commitment to bridge intergenerational wisdom so that our future generations are adequately equipped to address the leading cause of preventable deaths.
Finally, I am, and I hope you are committed to advancing research discoveries expeditiously. Let us make sure that no communities are left vulnerable to tobacco products—these products are not founded in our communities. The uptake of tobacco products is shaped by forces that transcend our community boundaries. I hope that the top news story in the upcoming years will be that our research has resulted in progress that shows that tobacco use is no longer the leading cause of preventable deaths in any community or population.
Pebbles Fagan, MPH, PhD
Professor and Director, Center for the Study of Tobacco