A coalition of U.S. and international health agencies is announcing a more than $20 million dollar program to support tobacco research and smoking prevention programs in the developing world.

A September 25 press release from the Fogarty International Center of the National Institutes of Health (NIH) says 14 grants supporting multi-national research partnership programs will help combat the rise of tobacco-caused disease and death. The World Health Organization says that tobacco use is the primary cause of preventable death and disability around the world, leading to 4 million deaths per year. "This new NIH program supports critically needed research and training to identify ways to prevent or reduce smoking rates worldwide, especially in the developing world," said U.S. Health and Human Services Secretary Tommy G. Thompson. Some examples of the programs funded include: -- A collaboration between the Mount Sinai School of Medicine in the United States and the Medical Research Council of South Africa to study tobacco use in South African adolescents; -- A partnership between the University of Maryland School of Medicine and the Egyptian Ministry of Health and Population to create a smoking prevention research institute in Egypt; -- A joint project between the University of California, San Francisco and the University of Jujuy in Argentina to advance understanding of smoking behavior in adolescents. The Fogarty International Center (FIC) is a component of NIH, promoting international scientific discovery and the reduction of disparities in global health. Following is the text of the Fogarty Center/NIH press release: (begin text) NATIONAL INSTITUTES OF HEALTH Fogarty International Center For Advanced Study in the Health Sciences Wednesday, September 25, Fogarty International Center Announces First Awards for International Tobacco and Health Research and Capacity Building Program Bethesda, Maryland — The Fogarty International Center (FIC) of the National Institutes of Health (NIH) and eight partners announce 14 new research and training grants to combat the growing incidence of tobacco-caused illnesses and death in the developing world. FIC led the development of the International Tobacco and Health Research and Capacity Building Program in close collaboration with five NIH institutes, the Centers for Disease Control and Prevention (CDC), the Canadian Institutes of Health Research (CIHR), and the World Health Organization’s Tobacco Free Initiative (WHO-TFI). In addition to FIC, the five NIH partners are the National Cancer Institute (NCI); the National Heart, Lung, and Blood Institute (NHLBI); the National Institute of Child Health and Human Development (NICHD); the National Institute on Drug Abuse (NIDA); and the National Institute of Nursing Research (NINR). The combined financial commitment from FIC, its NIH partners, and the CDC is approximately $3.8 million for the first year of these five-year awards. Total support will be approximately $20.5 million over the next five years. "Smoking represents one of the greatest challenges to health, both in the United States and worldwide," said Health and Human Services Secretary Tommy G. Thompson. "This new NIH program supports critically needed research and training to identify ways to prevent or reduce smoking rates worldwide, especially in the developing world." According to WHO, tobacco use is the leading cause of preventable death and disability in adults globally. More than 1 billion people — about one-third of the world’s adult population — smoke, making tobacco use one of the greatest global health threats. Each year approximately 4 million people worldwide die from diseases caused by tobacco use. If current smoking patterns persist, the number of deaths caused by tobacco use is expected to reach 10 million annually by the year 2025, surpassing the death toll from AIDS, tuberculosis, automobile accidents, homicide, suicide, and childbirth combined. Seventy percent of this increase will occur in the developing world, where health care systems are insufficient to address current needs and will be strained to the brink by tobacco-caused illnesses. "We are launching this program to provide support for the development of scientific data necessary for decision-making about tobacco issues," said FIC Director Gerald T. Keusch, M.D. on behalf of the partners. "As developing countries grapple with the enormous toll that tobacco will take on families and communities, and as they establish tobacco-control programs, it is essential that they have access to the best data. Our consultation with scientists from the developing world was crucial in helping us understand where the needs are most critical." "We are delighted to see the range of approaches and the depth of expertise in these applications," said NCI Director Andrew C. von Eschenbach, M.D. "We expect that this new global tobacco research effort will yield results that will help us address prevention and intervention at home as well as globally." The goals of the International Tobacco and Health Research and Capacity Building Program are to reduce the burden of tobacco consumption in low- and middle-income nations by conducting observational, interventional, and policy research of local relevance and to build capacity in epidemiological and behavioral research, prevention, treatment, communications, health services, and policy research. The knowledge and interventions developed abroad through this innovative research and training program will benefit the United States by building greater understanding of the many socio-cultural issues related to tobacco, such as why young people begin smoking. In making these awards, FIC and its partners will establish a global network of researchers who will develop research data; train the next generation of tobacco-control scientists; and share state-of-the-art findings with each other about best practices, opportunities, and obstacles in tobacco-control research. The successful applicants for the first International Tobacco and Health Research and Capacity Building Program awards: Dr. David Brook of Mount Sinai School of Medicine will work with collaborators from the Medical Research Council of South Africa to study disease-related determinants of changes in tobacco use in South African adolescents. The study is unique in its longitudinal design, with in-depth interpersonal, cultural, and behavioral data available about South African youth. It intends to strengthen research in this area in both the United States and Africa. Dr. Linda Ferry, Loma Linda University School of Public Health, will work with collaborators from the National Center for Health Promotion, Cambodia; Centre of Information and Education for Health, Lao PDR; and the Adventist Development Relief Agency in Cambodia and Lao PDR. The team will conduct a transdisciplinary, competency-based Global Tobacco Control Methods certificate program to develop tobacco-control leadership skills in health professionals. Research will monitor tobacco-use prevalence and attitudes toward prevention counseling, estimate prevalence of tobacco use, and assist health professionals in designing a 5-year national research plan. Dr. The-wei Hu of the University of California, Berkeley, together with collaborators from The World Bank, the Chinese Ministry of Health, Sichuan University, and Fudan University, will build research capacity in China in the economics of tobacco control. Studies will examine the impact of an additional tobacco tax, economic costs of smoking, and cost-effectiveness of tobacco-control interventions. These results will inform policymakers in China’s provincial and central governments. Dr. Ebenezer Israel, University of Maryland School of Medicine, and colleagues in Cairo and Baltimore will work with collaborators from the Egyptian Ministry of Health and Population and Georgetown University to create a new smoking prevention research institute in Egypt to establish research and capacity building projects to reduce tobacco use. Dr. Prabhat Jha, University of Toronto, will collaborate with colleagues from three institutes in India — Epidemiological Research Center, National Institute of Mental Health and Neuro Sciences, and Institute of Health Sciences. The project will expand India’s Sample Registration System, the primary system for collection of Indian mortality data, to obtain reliable estimates of mortality from tobacco smoking and chewing by age, gender, and socioeconomic group. The project will also build capacity within India’s surveillance system to monitor the growing tobacco epidemic, evaluate the effectiveness of control policies, and provide reliable data to policymakers. Dr. Gary King and colleagues at Pennsylvania State University will collaborate with three universities in Africa — Cape Town University in South Africa, Universite Cheikh Anta Diop in Senegal, and University of Dar Es Salaam in Tanzania — to investigate tobacco control among youths. Two Centers of Excellence will be established in Africa, regional networks of researchers will be formed, fellowships will be established, and exchanges between Centers of Excellence will be fostered for research on tobacco use among youths. Dr. Harry Lando and colleagues at the University of Minnesota will lead a collaborative effort with the University of Arizona, the University of Missouri, Acutha Menon Centre for Health Sciences in India, and the Gadjah Mada University in Indonesia to build tobacco research capacity and promote smoking cessation in India and Indonesia. Dr. Deborah Ossip-Klein, University of Rochester, will work with collaborators from the Dominican Republic to increase tobacco awareness and cessation activities in the Dominican Republic through the existing Little Intelligent Communities (LINCOS) units that offer wireless Internet access to state-of-the-art health education, agricultural science, and global economic information. Dr. Eliseo Perez-Stable of the University of California, San Francisco, will work with collaborators from the University of Jujuy in Argentina to further knowledge of smoking behavior of adolescents. The study will include a longitudinal school-based survey among high school youth of two ethnic groups (Kolla and European descent) in the province of Jujuy to assess the prevalence of smoking behavior, as well as the predisposing, reinforcing, and facilitating factors associated with smoking acquisition within this population. Dr. Cheryl Perry and colleagues at the University of Minnesota will work with collaborators in India to conduct a randomized, multi-component, community intervention trial in four cities and 56 schools in India focused on preventing the onset and reducing the prevalence of tobacco use among adolescents in grades 6 to 9. They will use an intervention system called Project HRIDAY that involves classroom-based behavioral curricula, parental education, media advocacy, peer leadership, and community linkage programs. Dr. Richard Peto of the Clinical Trial Service Unit in Oxford, United Kingdom, will collaborate with colleagues at the Russian Academy of Medical Sciences in Russia. The project will study death rates among approximately two million people in six large study populations in Russia. The goal is to determine to what extent tobacco is causing deaths from particular diseases and to ensure that data from these studies is available to inform future public health strategies and other research strategies. Dr. Ken Resnicow and colleagues at Emory University, the Medical Research Council of South Africa, the University of Natal, and the University of Cape Town will conduct a randomized trial comparing the effectiveness of two approaches to tobacco-use prevention in a multiethnic sample of South African youth in grades 5 to 7. One of the interventions will be based on a social skills/peer resistance model, the other on a Harm Minimization model. The team will also conduct a comprehensive capacity-building initiative to enhance knowledge of tobacco control among South African educators, clinicians, researchers, and policymakers. Dr. Jonathon Samet and colleagues at The Johns Hopkins University will collaborate with partners conducting tobacco-control research and training programs at the Chinese Academy of Medicine, the National Cancer Institute of Brazil, and the National Institute for Public Health in Mexico. These programs will focus on an intervention in China to reduce women and children’s environmental tobacco smoke exposure at home; a survey on determinants of youth smoking in Brazil; and a study of smoking-attributable deaths and diseases and the associated costs of smoking-related diseases in Mexico. Dr. Kenneth Ward and colleagues at the University of Memphis will work with Virginia Commonwealth University and Aleppo School of Medicine in Syria to establish a center for the study, treatment, and prevention of tobacco use in the Eastern Mediterranean region. The Syrian Center for Tobacco Studies will serve as a resource for tobacco-control efforts, including epidemiological study, clinical research, and prevention and cessation intervention development, and as a focal point for dissemination of information about tobacco-control efforts in the Eastern Mediterranean region. FIC is the international component of the NIH. It promotes and supports scientific discovery internationally and mobilizes resources to reduce disparities in global health. FIC will commemorate its thirty-fifth anniversary in 2003 with a year-long lecture series on global health issues and a scientific symposium on May 20-21, 2003. NIH is an agency of the U.S. Department of Health and Human Services. Press releases, fact sheets, and other FIC-related materials are available at www.nih.gov/fic.

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