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This supplement is an important milestone on the path leading from recognition of the health consequences of tobacco use to identification and implementation of those “appropriate remedial actions”* that will finally bring the tobacco epidemic to an end. But it is just a milestone, albeit an important one, and without further energy and direction, it will take its place with other well intentioned, but ineffectual, efforts to set priorities and focus attention on tobacco control policies.
In the almost 30 years since the journey began in earnest, there has been progress on almost every front. Now, there is a strong consensus within the tobacco control field that research that informs and supports policy makers and advocates can greatly enhance our efforts at preventing smoking and promoting cessation. What, then, can be done to ensure that this consensus breeds action, that this supplement is converted to new ideas and new approaches to tobacco control?
The first essential ingredient is leadership. At almost every critical point in the history of tobacco control efforts, someone, or some organisation, has risen to the occasion and provided leadership: the voluntary health agencies, the Surgeon General, people like Califano, Koop, and Cullen. This present Tobacco Policy Research Project is in great part the result of Joe Cullen’s vision, Jesse Steinfeld’s leadership, and the American Cancer Society’s nurturing.
The second ingredient is resources, both financial and human. Funding to support research, researchers who are keenly interested in tobacco issues and bring insights and fresh thinking, financial and intellectual support to help guide the effort, are all critical to the pursuit of the many important questions presented in this supplement. The human resources are available and many thoughtful people have contributed their time to bring us to this point. The financial resources remain to be identified and dedicated to transforming the supplement into research.
This field is at a critical juncture as we struggle to assemble the ingredients that will move us beyond a list of research priorities toward an energetic and relevant programme that supports policy change. Smokers continue to respond to economic changes and the tobacco industry’s techniques as much as or more than to tobacco control policies. Despite declining prevalence overall, teenage smoking rates remain essentially unchanged and there are still 50 million smokers in the United States.
The ingredients for action and success must come from a broader base of individuals and institutions: collective leadership and resources can move this ambitious research agenda ahead, and no single person or agency is likely to assume the responsibility alone; nor should they. The original concept that spawned this supplement envisioned collective action with a number of groups contributing according to their unique capabilities to form a cohesive programme. That concept is still workable, and it is the only way that the research questions posed in this document can be considered.
↵* The Surgeon General’s Advisory Committee on Smoking and Health, which produced the landmark 1964 Surgeon General’s report on smoking, concluded that “Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action.”