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Cancer Control Research

Abstract

DESCRIPTION (provided by applicant): The broad objective of this project is to evaluate and understand the psychosocial and behavioral effects of national-level tobacco control policies of the Framework Convention on Tobacco Control (FCTC), the first- ever international treaty on health. In an expansion of over 40 tobacco control experts across 9 countries, we will conduct parallel cohort surveys of adult smokers in two Asian countries that are prominent in the domain of tobacco use: China and South Korea. In a prospective cohort design, the participants in China will be 800 adult smokers and 200 adult non-smokers in each in each of 7 cities (Beijing, Shanghai, Guangzhou, Zhengzhou, Changsha, Yinchuan, and Changsha) who will complete a 30-40 minute face-to-face survey every year for 6 years (2006-2011). The participants in South Korea will be 2000 adult smokers who will complete a 40-minute random digit dialed phone survey every year for 6 years (2005-2011). We are requesting partial funding from NIH to continue each survey for Years 2-6. The sampling design, research protocol and survey instrument are identical or as similar as possible to those of the existing ITC survey in the US, UK, Canada, Australia, Ireland, Thailand, and Malaysia, and includes measures of smoking behavior, psychosocial predictors of smoking and quitting, and policy-relevant variables in 5 major policy domains, covering all of the demand reduction policies of the FCTC (1) enhancement of warning labels, (2) elimination of deceptive brand descriptors (e.g., light or mild) (3) elimination/ restrictions on tobacco advertising and promotion, (4) tax increases, (5) smoke-free laws. The quasi-experimental design includes both between-country controls and within-country controls and will thus allow rigorous tests of national-level policies that here-to-fore have not been systematically evaluated in Asia. We will identify similarities in FCTC policy impact and in the factors that relate to smoking and cessation across the 4 ITC Asian countries (including ongoing cohort surveys in Thailand and Malaysia), and across all ITC countries more generally. The ITC project, whose core funding comes from the Roswell Park TTURC, is the first-ever international cohort study of smoking, and the most substantial research project to evaluate the effectiveness of FCTC policies. The ITC project is now conducting parallel prospective cohort surveys of representative samples of smokers in countries inhabited by 45% of the world's smokers. The proposed project also requests funds to add to the ITC Product Repository, the first ever international repository of cigarettes from which analyses of smoke chemistries physical characteristics, and bio-markers studies are being conducted in an international context, and to conduct a parallel cohort study of bio-markers among 120 Chinese smokers in four cities, with replication 2 years later. The ultimate mission of the proposed project is to provide the evidence base for the FCTC policies as the critical ratification and implementation phases of the FCTC continue to unfold and to understand the mechanisms underlying the impact of public health policies.