National Cancer Institute Grant Funds New Phase of Anti-Smoking Research
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National
Cancer Institute Grant Funds New Phase of Anti-Smoking Research
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by Anne-Marie Kent
Lois
Biener of UMass Boston's Center for Survey Research (CSR) recently was
named one of 12 recipients of new National Cancer Institute (NCI) grants
promoting local research and tobacco control interventions nationwide.
The over $4 million grant will fund a new four-year study evaluating
the effectiveness of three major types of interventions used in Massachusetts:
local clean indoor air policies; local policies to restrict youth access
to tobacco products; and televised anti-tobacco media campaigns.
The award signals the success of Biener's ongoing research and the Commonwealth's aggressive anti-smoking campaign, the Massachusetts Tobacco Control Program (MTCP), which began back in October of 1993, funded by a surcharge on cigarettes. At that time, the Massachusetts Department of Public Health contracted with CSR to conduct the Massachusetts Tobacco Survey (MTS) to examine smoking prevalence among adults and teens, attitudes toward tobacco control policies, and smokers' motivations to quit.
In 1995, Massachusetts funded the Massachusetts Adult Tobacco Survey, through CSR, which tracked changes that might be attributed to the MTCP. In 1996 and 1997, additional funding from the Robert Wood Johnson Foundation allowed CSR to do follow-up surveys looking at, among other things, responses to anti-tobacco advertisements. “The ads that were rated most highly by both adults and teens,” says Biener, “were those that depicted the serious physical consequences of smoking.” One such television ad featured Pam Laffin, who had a lung removed due to emphysema at the age of 24.
According to Biener and colleague Michael Siegel, exposure to the television anti-tobacco advertisements reduced the rate of smoking initiation in young teenagers by about half. Biener notes, “Although there is no control group, and the program was not a randomized trial, using statistical controls to remove the effect of other factors that affect smoking initiation we found that youth who reported high levels of exposure to the ads in 1993 were only half as likely to become established smokers four years later compared to youth who reported low levels of exposure to the ads.”
The NCI grant will allow Biener to do a new baseline and longitudinal survey of adults and teens in Massachusetts, this time testing very specific hypotheses. These include: the stricter the ordinances are in limiting smoking in public places, the more likely adult smokers will be to quit smoking and the less likely teenagers will be to start smoking; and the more stringent the ordinances are that restrict access to purchase of tobacco, the less likely teens will be to start smoking. Biener is also returning to the topic of advertising. “We're attempting to get a more definitive conclusion about the role of advertising characteristics and people's responses,” says Biener.
The survey will monitor cigarette advertising to young adults in bars and clubs, and employ new technology for questioning youth. Because teens are believed to overreport smoking behaviors when surveyed at school, and underreport when questioned at home, one-third of the teens surveyed will be questioned and provide answers via computer, a process that is hoped to encourage more candid responses.
Throughout the 1990s, says Biener, smoking in Massachusetts has shown a significantly greater decline compared to smoking in states without comparable tobacco control programs. Other states are taking notice. “When we first started, there was only one other state that had a tobacco control program funded by a tax on cigarettes, and that was California,” Biener explains. “In recent years many other states have launched tobacco control programs modeled on the Massachusetts program.” The American Legacy Foundation, which was funded through the 1998 tobacco settlement, is conducting a national anti-tobacco television campaign. Biener serves as advisor to the national campaign and to several of the states.