The Research to Policy Pipeline: Establishing California’s Tobacco Policy Research Center (TPRC)

In line with a major Tobacco-Related Disease Research Program (TRDRP) goal to support research that informs public policy for the benefit of California’s diverse populations, we are pleased to announce the establishment of three TRDRP-funded tobacco policy research centers (TPRCs) across the state: the Nicotine and Cannabis Policy Center at UC Merced, the Policy Research Center for Tobacco and the Environment at San Diego State University (SDSU), and the Tobacco Cessation Policy Research Center at UC Davis.

All three multi-disciplinary, collaborative policy research centers work in partnership with advocates, community members, policymakers, and other key stakeholders. The centers were established so researchers can more nimbly respond to critical policy research questions that can inform pending legislation and to evaluate the impact of existing legislation around commercial tobacco product use and marketing. 

“In general, it takes one to two years to receive funding from TRDRP for a tobacco-related disease research project,” explains Dr. Tracy Richmond McKnight, TRDRP Director. “That's too long to generate research for policy that's in discussion ‘right now.’ Policy research needs to be more rapid.”

Modeling the centers on the successful California HIV/ AIDS Research Program, TRDRP sought to establish centers with unique focal areas, to be led by principal investigators (PIs) with tobacco control research expertise and who had existing connections to their communities . Centers are also required to have a policy strategist on the research team.

“Our idea was to have two or three centers so that when policy questions come up, they can be addressed in a timely fashion by these centers,” adds Dr. McKnight, “The TPRCs also generate policy questions that are important to their local community.” All centers include four cores to maximize their efficiency and effectiveness.

• Rapid Response Project Support and Implementation: to quickly inform time-sensitive policy issues, each center must be able to support rapid response research conducted in collaboration with community partners.
• Training, Capacity Building, and TPRC Pilots: Providing training for emerging tobacco researchers is essential for establishing and sustaining the pipeline for a diverse, well-trained scientific workforce. Centers are encouraged to train, mentor, and provide funds and research opportunities to emerging researchers, postdoctoral fellows, undergraduate, and graduate students.
• Community Input and Dissemination: Each center must actively engage one or more community partners, including advocacy organizations representing Californians who have been disproportionately impacted by tobacco. When research is completed, centers must disseminate the findings back to the community.
• Administration: Each center provides infrastructure support for research and training activities.

“What's exciting is that now we have three centers, and they are all very specialized in what they do,” says TRDRP’s Senior Program Officer for State and Local Health Policy Dr. Maggie Kulik who oversees the TPRCs. “All three of them have connections with TRDRP Smoke and Vape-Free Scholars Initiatives (SVSFI) [which train the next generation of tobacco researchers from priority populations], so we are building synergies that way as well.”

Policy Research Center for Tobacco and the Environment

With a vision to “conduct community-driven tobacco policy research that leads to cleaner and healthier indoor and outdoor environments by eliminating the toxic legacy of commercial tobacco products,” the Policy Research Center for Tobacco and the Environment (CTE) at was established at SDSU in 2022 and received TRDRP funding to become one of three Tobacco Policy Research Centers in 2023. The Policy Research Center is part of the SDSU’s Center for Tobacco and the Environment, established in 2022.

Partnering with SAY (Social Advocates for Youth) San Diego, a nonprofit focused on achieving opportunity, equity, and well-being for all San Diegans, CTE’s work will support California’s Tobacco Endgame policy, which seeks to end commercial tobacco sales and use in the state.

“Our Center is particularly excited about our close collaborations with SAY San Diego,” says Dr. Georg Matt, SDSU professor of psychology, “[as well as] more than 30 local and regional organizations that represent youth, underrepresented racial/ ethnic/ sexual groups, businesses, local government, education, health, environmental organizations, Tribal communities, tobacco control, and housing.” Matt serves as the Policy Research Center CTE’s co-PI with and co-directs the Center with SAY San Diego’s Mary Baum, former Senior Director for their Alcohol, Tobacco, and Other Drugs Prevention Program and current Associate Vice President of Philanthropy.

With community input and guidance, the Policy Research Center CTE identified three major policy emphases: the environmental impact of tobacco product waste in outdoor environments, the health and environmental impact of secondhand and thirdhand smoke in indoor environments, and youth tobacco product use.

Tobacco use generates enormous amounts of non-biodegradable tobacco waste—including cigarette butts, vaping pods, and more—that harms ecosystems and, potentially, human health.[i] This litter accumulates in the environment, and research out of the Center also showed that this waste has high economic costs.[ii]  The Policy Research Center CTE will continue researching solutions for eliminating tobacco product waste and additionally, will also address policy issues related to thirdhand smoke, the toxic residue remaining on furniture, walls, and other surfaces that can remain for years after smoking has stopped. Finally, the Policy Research Center CTE will study strategies to reduce tobacco use among youth, such as the use of restorative practice approaches in local school communities for students who face disciplinary action related to tobacco and vaping, effectively keeping more kids in school while educating them on the harms of tobacco and nicotine product use.

In addition to researching local and state-wide tobacco policy issues, “our new center will offer training for community organizations, mentoring to students and emerging researchers, and tobacco education to the general public,” says Matt. The Center is unique in having affiliated SDSU professors from diverse disciplines including chemistry, biology, public health, economics, and communications. SDSU is one of the partners for TRDRP’s SVFSI program, with funding to train up to 15 undergraduate scholars from under-represented communities.

Nicotine and Cannabis Policy Center 

Part of UC Merced’s Health Sciences Research Institute (HSRI), the Nicotine and Cannabis Policy Center (NCPC) was initially funded by TRDRP in 2018, with a mission to “gather, understand, and promote the thoughts and feelings of rural California residents on current tobacco and cannabis policy.”

Having just competed for and been awarded funding for a second four-year period, NCPC will continue to serve Central California’s San Joaquin Valley, which has higher-than-average tobacco use rates for California. The NCPC is partnering with public health departments of the 11 counties in the valley, the state Department of Public Health, California Health Collaborative, and Healthy House, a nonprofit organization addressing healthcare access and equity in underrepresented cultural groups in Merced County, particularly Hmong and Hispanic populations.

“Our Center is the only one of its kind located in rural California’s Central Valley, [which] has specific histories, demographics, and economic characteristics,” explains NCPC’s PI Dr. Irene H. Yen, a professor of public health at UC Merced. Due to population density, language diversity, and immigration, organizations and scientists in the Central Valley region face challenges in collecting data, and some may not have infrastructure to combine with other data. “Combining data and training people to analyze and interpret the data across the region is a key focus of our renewal activities.”

Already, NCPC has established essential infrastructure to support tobacco control activities in the region, including biannual community-academic workshops, a citizen scientist training program, and a robust undergraduate internship program, providing critical personnel support for six counties, which have made remarkable improvements in tobacco control indices.

“Whereas California Endgame goals seemed impossible in 2018, advocates in the region now view [it] as a lofty, but possible goal,” says Yen. “NCPC’s role in the evolution of tobacco control in the region has been to organize previously disparate groups into a cohesive network that shares information, resources, and supports each other in a unified mission.”

Tobacco Cessation Policy Research Center

Housed at UC Davis’s Comprehensive Cancer Center (UCDCCC), the Tobacco Cessation Policy Research Center (TCPRC) received funding from TRDRP in 2023 to investigate policy on tobacco and nicotine product cessation. TCPRC’s mission is “to enhance health care access, promote excellence in healthcare delivery, facilitate community engagement, and achieve equity in health plan coverage by building capacity for tobacco cessation.”

A multidisciplinary, collaborative effort, TCPRC is partnering with the American Cancer Society’s Cancer Action Network (ACS CAN), UCLA Health, and UC Center Sacramento (UCCS), a UC-systemwide program for public policy teaching, research, and public service. The Greater Sacramento Smoke and Tobacco-Free Coalition, supported by the Sacramento County Tobacco Education Prevention Program, is also a key partner for local policy activities.  TCPRC aims to generate evidence to inform tobacco cessation policy, collaborate with partners to optimize policy impact, and develop a pipeline of researchers to sustain the mission.

“Our center is important because we can help bridge the silos between tobacco cessation treatment and public health policy,” says TCPRC Director Dr. Elisa Tong. A UC Davis professor of internal medicine, Tong also serves as director of CA Quits, which works to advance tobacco treatment and population health with health systems and plans serving Medi-Cal, and the UCDCCC’s Stop Tobacco Program (SToP).

TCPRC has begun work on four “rapid response” policy projects related to health care access, delivery, engagement, and equity health care plan reform.

• The health care access study addresses barriers to implementing Assembly Bill (AB) 1114, which reimburses certain pharmacies for tobacco counseling services. “By state law, pharmacists can furnish nicotine medications without a prescription,” says Tong, and they can receive reimbursement for their services from the state for providing tobacco cessation treatment. But in a recent study, “we found a lot of system barriers.”[iii]
• The health care delivery study will assess barriers to implementing AB 541, which requires substance use disorder facilities to assess tobacco status of patients and conduct cessation treatments. People with Substance Use Disorder continue to have higher tobacco use rates than other Californians.
• The health care engagement study will examine ways to engage health care providers on adoption and implementation of SB 793, a state law banning the retail sale of most flavored tobacco products that went into effect January 1, 2023.
• The health care equity plan reform study is investigating strategies for getting publicly covered health plans, including ones for state employees, to include comprehensive tobacco treatment coverage as Medi-Cal currently does, since previous legislative attempts have failed.

In addition, TCPRC’s training core is providing opportunities and funding for graduate students and early investigators to gain experience in policy research and helping to build capacity in research and community advocacy.

[i] Novotny TE, Bialous SA, Hill K, et al. Tobacco Product Waste in California: A White Paper. California Tobacco Control Program, California Department of Public Health, February 28, 2022. https://merg.sdsu.edu/wp-content/uploads/2022/05/Tobacco-Product-Waste-in-California_-A-White-Paper.pdf [accessed 5 May 2024].

[ii] Lam J, Schneider J, Shadbegian R, et al. Modelling the global economic costs of tobacco product waste. Bull World Health Organ. 2022 Oct 1;100(10):620-627. doi: 10.2471/BLT.22.288344. https://cte.sdsu.edu/tobacco-product-waste-economic-model/

[iii] Ellis Hilts K, Elkhadragy N, Corelli RL, et al. Closing the Tobacco Treatment Gap: A Qualitative Study of Tobacco Cessation Service Implementation in Community Pharmacies. Pharmacy (Basel). 2024 Mar 28;12(2):59. doi: 10.3390/pharmacy12020059. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11055024/

Tobacco Policy Research Centers (One Pager)

MEDIA CONTACT
Wendee Nicole Holtcamp, trdrp@ucop.edu