The Tobacco Research Network on Disparities (TReND).

T here are two important goals for the USA in Healthy People 2010. The first is to increase quality and years of healthy life. The second is to eliminate health disparities. These disparities include differences in tobacco related outcomes as well as patterns of tobacco use by gender, race/ethnicity, socioeconomic status and socioeconomic position (that is, education, income, occupational status, wealth), geographical location, sexual orientation, and various forms of disability. The 2000 surgeon general’s report Reducing Tobacco Use identified eliminating health disparities related to tobacco use as a major public health challenge. In 2002 representatives from a number of disciplines and organisations met at a National Conference on Tobacco and Health Disparities. In addition to reviewing the existing science and highlighting gaps in the knowledge base, one outcome of this conference was development and articulation of a research agenda for eliminating tobacco related health disparities. Another important outcome of this conference was explicit recognition that tobacco related health disparities are very complex and exist at many levels, thus requiring a transdisciplinary perspective. This led the National Cancer Institute, in collaboration with the American Legacy Foundation to establish the Tobacco Research Network on Disparities (TReND). After a period of strategic planning, 21 scientists representing a variety of academic disciplines were invited to become core members of this transdisciplinary research network. These scientists work at 11 major research universities, two NIH Institutes, two philanthropic foundations, and one HBCU (historically black college and university) (the details of the core members of the network are listed at the end of the article). The mission of TReND is to eliminate tobacco related disparities through transdisciplinary research that advances the science, translates that scientific knowledge into practice, and informs public policy. While there has been some progress made in reporting tobacco related disparities, many questions remain about the epidemiology and aetiology of these disparities, and the amount of heterogeneity that exists between and within various population groups. Moreover, little is known about the ways in which differences in tobacco use patterns and norms, and their effects, lead to disparities in health and other outcomes. The operating principles of TReND are: transdisciplinarity, stimulation and integration of disparities research, promotion of disparities research, translation of knowledge about tobacco related disparities into practice, and a commitment to diversity. The goals of TReND are to: (1) generate new ideas and research projects focusing on tobacco and health disparities; (2) encourage collaborations among researchers representing multiple research disciplines; (3) establish mechanisms to effectively translate the science, communicate the results, and interact with other networks and community advocacy groups; and (4) promote the development of junior investigators and the participation of senior researchers in health disparities research. The entire network has met a total of eight times to this point in time (June 2006). In most of these meetings there has been a focus on tobacco related disparities in particular population groups. For example, in the February 2005 meeting in Pasadena there were presentations and discussions about tobacco among Asian/Pacific Islanders and the LGBT communities. In May/ June of 2005 TReND met in Anchorage, Alaska with a number of representatives from the Alaska Native Tribal Health Consortium concerning culturally specific tobacco use patterns and consequences among Alaska Natives. This meeting was followed in August of 2005 by a small meeting in Portland, Oregon focused on research opportunities and challenges in Alaska. In December of 2005, TReND met in Austin, Texas with representatives from the National Latino Cancer Research Network with a special focus on the so called Hispanic paradox. In June of 2006 the network met with representatives of the University of Oklahoma Community Network Project involving two American Indian groups (the Choctaw and the Cherokee Nations) and representatives from the Conference of Black Mayors representing leaders from Oklahoma towns whose populations are predominantly African American. In addition to the focus on specific population groups, there has been a substantial amount of discussion and thought devoted to the conceptualisation and measurement of socioeconomic status (SES) and position. On a number of occasions the question has arisen about whether there is a need for a 21st century conceptualisation and measurement of SES; the most widely used measures and parameters of SES have not changed much in the past half century. In line with these observations, the network sponsored a small, one day conference to begin exploring how to approach such an iconic construct in comprehensive and constructive ways. The network is involved in a number of activities directed at expanding the scientific knowledge base about tobacco related health disparities. One of the most important of these activities was the September 2005 conference on tobacco policies and low SES women and girls, the stimulus for the outstanding papers appearing in this issue. Another of these activities will occur in July of 2006. Under the auspices of NCI, the network is hosting a one day health disparities research methods training symposium in Washington immediately before the world conference on tobacco OR health. The papers to be presented at this meeting review state of the science methodological, design, and statistical approaches to understanding health disparities. A complementary purpose of the meeting is networking among health disparities researchers who applied for the limited number of participant slots at the meeting. Another activity of TReND currently in the planning stages is a meeting that will occur in the autumn of 2006. That meeting will focus on methodological (particularly sampling) and substantive issues associated with generating estimates of tobacco use and its consequences among population groups that are relatively small in size and largely invisible. The specific focus of this EDITORIAL ii3