The Problem: Research to elucidate the complex causes of tobacco use, dependence and relapse—and the attributes of effective interventions—requires a transdisciplinary approach and the involvement of practitioners. Furthermore, once research has been conducted, the findings need to be translated and communicated to policy-makers, practitioners and the public.
Approach: The National Cancer Institute, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism have funded eight university-based Transdisciplinary Tobacco Use Research Centers (TTURCs) around the country to facilitate a transdisciplinary approach to the full spectrum of basic and applied research on tobacco use to reduce its burden of illness.
The Robert Wood Johnson Foundation (RWJF) has provided support for this national initiative through the Partners With Tobacco Use Research Centers program, a collaborative effort to help communicate and translate the results and implications of the work of the TTURCs. RWJF's interest in transdisciplinary work grew out of a 1997 Sundance, Utah, conference, which led to the Tobacco Etiology Research Network (TERN), the first "transdisciplinary" tobacco use research network that RWJF funded and that became a model for the TTURCs.
The Yale perspective: The Yale University TTURC was funded to improve the treatment of tobacco dependence particularly for those who find quitting difficult. Biomedical, behavioral and social scientists address issues such as:
- The economic value of quitting in terms of productivity gains and losses.
- How problems related to alcohol and/or depression make quitting harder.
- How these problems affect women differentially.
Grantee background: Participating in the Yale TTURC had a profound impact on Jody Sindelar's career. She had studied the economic impacts of alcohol and drug abuse, but not tobacco. Now, a major proportion of her research is on tobacco use, treatment and cessation and, through her influence on other members of the division she heads and the trainees she mentors, this impact has been multiplied many times over.
The TTURC also provided opportunities to collaborate with scientists with whom she had not worked before. This included a range of biomedical scientists such as clinicians, brain imagers and molecular biologists. As a result, Sindelar has a much deeper appreciation for the perspectives and methods that others bring to the study of complex bio-behavioral issues such as tobacco use.
Results: Perhaps the greatest impact of the TTURC experience on Sindelar resulted from RWJF's emphasis on policy research in its funding to Yale. Previously, she had done “policy-relevant” research, but not research that directly addressed policy issues. The group she leads took this on as the central focus of the TTURC at Yale, studying the following issues:
- How low-income families' expenditures on smoking “crowd out” other expenditures that would be important to the family, such as housing and food in the United States and education fees and saving in rural China.
- Whether state legislators respond to public opinion in setting tobacco policies.
- Factors that impede people's efforts to quit smoking—for example, whether their spouse smokes, stress of job loss and little direct experience with the negative health consequences of smoking.
- Willingness of individuals to pay for treatments that would help them quit smoking and prevent weight gain.
RWJF's expectation that research results would be communicated to audiences beyond other researchers stimulated Sindelar to learn about and apply new communication strategies to her work.
The RWJF grant made it possible to hire and support a communications professional to provide the impetus, expertise and assistance in communicating complex scientific findings to lay audiences. As a result, Sindelar now sees communications as an integral part of her research projects and her responsibility to society.
With the TTURC's emphasis on communications and policy impact, Sindelar has:
- Become involved in Connecticut tobacco policy.
- Applied techniques learned through her work on tobacco to new work on how early choices, such as substance use and occupation, affect health later on.
- Written op-ed articles for the Hartford Courant on the impact of tobacco taxes and on the effectiveness of smoking bans.
Says Sindelar, “The biggest impacts of my involvement in the Yale TTURC have been a heightened awareness of the opportunity to have a significant impact on a major health or social problem through policy research and communication. Also I have greater respect for the benefits of transdisciplinary research. The TTURC had these as major goals and provided the resources to make it happen. Otherwise, there are few incentives in academia to go beyond the publication of scientific results.”
RWJF perspective: The 1997 Sundance Conference set two related priorities for research that might produce breakthroughs in understanding and changing trajectories of tobacco use and addiction, according to Tracy Orleans, Ph.D., RWJF senior scientist. First, the need for more integrative approaches to the science of tobacco use and nicotine addiction, and second, the need for need for much more intentional efforts to translate research results into policy and practice.
“The resulting TTURCs and Partners With Tobacco Use Research Centers program addressed both needs—accelerating scientific discovery and its application or impact,” says Orleans.
“New modes of collaboration and communication were the hallmark of these efforts. The TTURCs were ground-breaking in their support of truly “trans-” versus “cross-” disciplinary research collaborations. They gave researchers from multiple disciplines (including genetics and neuroscience, child development and behavioral medicine, anthropology and economics) a unique opportunity to break out of their usual academic silos to learn to speak and think across disciplinary boundaries.”
In addition, says Orleans, “Through the partners program, many conducted their first-ever policy research studies, and learned for the first time how to ‘give their research a voice' by actively translating their results for key audiences—not just other researchers but policy-makers, practitioners and the public. Many TTURC scientists will tell you that these experiences transformed their careers.”