Research priorities

The Tobacco-Related Disease Research Program (TRDRP) funds research that spans social, behavioral and biomedical sciences and has the common objective of achieving health equity for all Californians. Despite having one of the lowest smoking rates in the country, smoking prevalence remains high among California populations that are also plagued by the negative effects of structural and social determinants of health. Reducing the negative impact of tobacco use within these “tobacco priority populations1” is a primary goal of TRDRP. To address this goal, culturally-tailored research is needed on the health and behavioral effects of tobacco products and effective cessation strategies, particularly for tobacco priority populations1. It is also imperative that research outcomes can be used to inform the policymakers and the general public about the ills of tobacco product use and tobacco industry marketing practices that target specific populations. This also includes research on the implementation and evaluation of state and local tobacco control policies. This is directly aligned with TRDRP’s Five Year Strategic Plan, the Tobacco Education and Research Oversite Committee (TEROC) Achieving Health Equity: California's New Plan for Tobacco and the CA Endgame Initiative, which seeks to end the sale and use of all commercial tobacco products in the state by the year 2035.

The Tobacco Industry continues to launch new products, for example synthetic nicotine products introduced as recently as 2020. While individual products may experience fluctuations in use over time, overall, new and emerging tobacco products remain remarkably popular, especially among adolescents and some populations that are disproportionately affected by tobacco product use. Yet, the effects of nicotine itself, flavorings, and other additives used in these products are not well understood. TRDRP will continue to fund research analyzing the toxicological, health, and social behavioral effects of these products and their constituents. Studies using cell or animal models, human subjects, and/or Big Data strategies to integrate multiple types of data are all needed to fully understand the effects of these products. To create the base of scientific evidence to effectively end the sale and use of all tobacco products, TRDRP also remains committed to supporting research on prevention and cessation of the use of flavored nicotine products, including menthol, and on effective state and local policies governing the sale of flavored tobacco products.

The use of inhaled (combusted or aerosolized) cannabis and its influence on tobacco use behavior, including nicotine addiction, still requires additional research, especially among tobacco priority populations. Further, the health impacts of the combined use of inhaled cannabis and nicotine products are not well known. Research on the biological and population level impact of the use of inhaled cannabis is needed to inform effective public health policies. For this reason, TRDRP funds research that includes cannabis as it relates to tobacco use, tobacco policy, or tobacco-related disease.

Research into the mechanisms, diagnosis, prevention and treatment of tobacco-related diseases, especially with a focus on disproportionately affected groups, remains critical to help alleviate the suffering caused by tobacco use. Despite the overall decline in cancer death rates, including lung cancer, in the last two decades (see “Trends in Lung Cancer and Cigarette Smoking: California Compared to the Rest of the United States”), disparities in cancer incidence and death rates persist among different demographic groups. Similarly, disparities in diagnosis and mortality exist for other tobacco-related diseases, such as heart disease, stroke, and chronic obstructive pulmonary disease (COPD). TRDRP encourages biomedical research involving tobacco priority populations.

Some of the differences in health outcomes among different demographic groups may be explained by different tobacco use rates, but social and structural determinants of health contribute to disparate health outcomes as well. These disparities underscore the need for impactful research on the effective dissemination of disease prevention strategies and the implementation of evidence-based interventions that can reduce disease burden in specific cultures and communities that are disproportionately affected by tobacco-related disease. For instance, personal health care decisions, such as whether or how often to see a physician or whether to participate in clinical trials, are often influenced by policies governing health care insurance coverage and practice recommendations provided by health care providers. Studies have shown that changes in some current policy and practice recommendations may result in improved disease surveillance and/or survival in underserved communities. Therefore, TRDRP also supports research that aims to overcome the barriers to implementing system change and design strategies to bring innovative healthcare solutions for tobacco-related diseases and nicotine addiction to all Californians.

All applications must address one or more of TRDRP’s nine research priorities, as detailed below.

NOTE: While submission of projects focused on co-use of tobacco with other substances of abuse are welcome, studies that only address non-tobacco substances (e.g. cannabinoids) are not eligible under this Call.