Yesterday in Am J Respir Crit Care Med was published An Official American Thoracic Society Research Statement:
Current Understanding and Future Research Needs in Tobacco Control and
Treatment.
Introduction: Since the mid-20th
century, the scientific community has substantially improved its
understanding of the worldwide tobacco epidemic. Although significant
progress has been made, the sheer enormity and scope of the global
problem put it on track to take a billion lives this century. Curbing
the epidemic will require maximizing the impact of proven tools as well
as the development of new, breakthrough methods to help interrupt the
spread of nicotine addiction and reduce the downstream morbidity.
Methods:
Members of the Tobacco Action Committee of the American Thoracic
Society queried bibliographic databases, including Medline, Embase, and
the Cochrane Collaborative, to identify primary sources and reviews
relevant to the epidemic. Exploded search terms were used to identify
evidence, including tobacco, addiction, smoking, cigarettes, nicotine,
and smoking cessation. Evidence was consolidated into three thematic
areas: (1) determinants of risk, (2) maternal-fetal exposure, and (3)
current tobacco users. Expert panel consensus regarding current gaps in
understanding and recommendations for future research priorities was
generated through iterative discussion.
Results: Although much has been accomplished, significant gaps in understanding remain. Implementation often lags well behind insight. This report identifies a number of investigative opportunities for significantly reducing the toll of tobacco use, including: (1) the need for novel, nonlinear models of population-based disease control; (2) refinement of “real-world” models of clinical intervention in trial design; and (3) understanding of mechanisms by which intrauterine smoke exposure may lead to persistent, tobacco-related chronic disease.
Discussion:
In the coming era of tobacco research, pooled talent from multiple
disciplines will be required to further illuminate the complex social,
environmental and biological codeterminants of tobacco dependence.
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