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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): The broad objective of the proposed project is to evaluate and understand the psychosocial and behavioral effects of several national-level tobacco control policies that are scheduled or likely to be implemented in at least one of the four largest English-speaking countries--United States, Canada, United Kingdom, and Australia--over the next three years. In a prospective cohort design, the participants are 2,000+ adult smokers in each country (total N=9,013) who respond to a 45-minute telephone survey every 8 months for 5 years. The ITC survey had its successful launch in Fall 2002 and second wave in Summer 2003, and funds are being requested to continue support for Years 3-5. The survey includes measures of smoking behavior, psychosocial predictors of smoking and quitting, and policy-relevant variables in five major policy domains: (1) enhancement of warning labels, (2) elimination or restriction of the terms "light" or "mild" as cigarette brand descriptors, (3) elimination or restrictions on advertising and promotion of tobacco products, (4) changes in price and taxation, and (5) alternative nicotine products (e.g., products that heat, rather than burn, tobacco). The quasi-experimental design includes both between-country controls and within-country controls and will thus allow rigorous tests of national-level policies that heretofore have not been systematically evaluated. There are 7 specific aims: (1) to examine whether a policy introduced in one country will affect self-reported smoking behavior, in comparison to other countries where that policy is not changing, (2) to examine whether a policy introduced in one country will enhance policy-relevant psychosocial variables, that is, those that are closely related to the policy, in comparison to other countries where that policy is not changing, (3) to examine whether a policy introduced in one country will lead to enhance levels of psychosocial variables known to be related to smoking and quitting behavior, in comparison to other countries where that policy is not changing, (4) to examine whether the effects of tobacco control policies may be offset by compensatory behaviors (e.g., price increases leading to shifts toward discount brands rather than to quitting), (5) to examine whether the effects of tobacco control policies are moderated by situational and individual-difference factors, (6) to identify the psychosocial mechanisms that may explain how tobacco control policies achieve (or fail to achieve) their goals, and (7) to identify similarities and differences across the four countries in the factors that relate to smoking and cessation. This project has considerable time urgency because of the recently adopted Framework Convention on Tobacco Control-the first-ever international treaty on health-which will obligate over 190 countries (over 90% of the world's population) to tobacco control policies that will be evaluated by this project, and has the potential to inform future tobacco control policies throughout the world.