Research for effective global tobacco control in the 21st century: report of a working group convened during the 10th World Conference on Tobacco or Health.

Introduction The 10th World Conference on Tobacco or Health was held in Beijing at a critical juncture for the world’s tobacco control movement. Facing a declining market in many Western, developed countries and formidable law suits in the United States, the major tobacco companies of the developed nations have aggressively turned to developing countries as their future markets. This global conference oVered a venue for discussion at a time of urgent need for action as marketing of cigarettes by multinational corporations is spreading rapidly throughout the developing world and in central and eastern Europe. To foster discussion on policy-relevant research, tobacco control experts from throughout the world (see appendix) met intensively during the conference. The participants were policy makers, researchers, tobacco control specialists, and activists, drawn from developing and developed countries from all over the world. Key sectors were represented including academia, public health agencies, non-governmental organizations, and private industry. Two working groups met in parallel throughout the conference: one addressing epidemiological research and intervention studies, and the other, broader policy-related research. The overall objective was to identify the research evidence and public health data with the highest potential to aVect tobacco control policy. Over the past few years, several global and national reviews of priorities for tobacco control, and for tobacco control research more specifically, have been completed. These reports have emphasized the need for cost-eVective interventions to be developed for the prevention and control of tobacco use and ultimately of tobacco-attributable disease. Particular attention has been given to the need for information on tobacco use and health impact, identification of the determinants of use and quitting, and the impact of interventions (in terms of eYcacy, eVectiveness, and occasionally, cost-eVectiveness), and to the need for investments in human and institutional capacity for addressing tobacco control research and prevention needs. Although there have been other listings of research needs, the emphasis here is on identifying those minimum countryspecific and international elements that are essential for successful tobacco control. This report summarizes the outcome of the deliberations and is intended as a contribution to other ongoing tobacco control initiatives aimed at ensuring that, globally and within every country, tobacco control is given appropriate priority and is based on sound evidence. Participants in the working groups noted key barriers to the implementation of tobacco control research: a lack of research and data-gathering infrastructure in many countries; inadequate expertise in epidemiology, biostatistics, and health systems; and a nearly complete absence of funds for research directed at the global control of tobacco use and of tobacco-attributable disease. Participants unanimously called for urgent action to remedy these problems. Lacking expertise in tobacco control and even basic data collection, many developing countries are left vulnerable to the aggressive penetration of the multinational tobacco corporations. In developing the recommendations, participants concurred strongly that tobacco control policies need to be evidence-based, drawing from data on the prevalence of smoking and the characteristics of smokers and on the adverse health eVects of smoking in the population, and using intervention methods of proven eYcacy. Research on tobacco control should reflect a planned, sustained, and comprehensive surveillance strategy put into place to track progress in controlling tobacco use and tobacco-related disease.