By Beth Azar
Monitor staff

Under the tobacco settlement now before Congress, behavioral researchers stand to gain a huge amount of money to fund smoking prevention and treatment research.

But there?s a catch: They won?t get a penny of that money if they aren?t able to convince policy-makers that more studies are needed to uncover what spurs people to smoke. If behavioral scientists can?t sell their research, the funding will likely go instead to those studying cures for smoking-related diseases.

Curing diseases is sexier than preventing them, says Timothy Condon, PhD, director of science policy and communications at the National Institute on Drug Abuse (NIDA). But if more money were spent on understanding why people smoke, including studies of addiction to nicotine, advertising?s influence on the decision to smoke, peer pressure and the critical ingredients of prevention programs, we might be able to eliminate the diseases by stopping the behavior that causes them.

?I truly believe that if we can solve the problem of addiction, a lot of this other stuff?lung disease, cancers?will go away,? says Condon, NIDA?s representative to the U.S. Department of Health and Human Services for discussions of the tobacco settlement.

The settlement was hammered out between state district attorneys and the tobacco industry last June and may serve as a model from which Congress could draft tobacco reform legislation. Senate hearings and a review by the Clinton administration have highlighted several short-comings of the settlement, including limits placed on the Food and Drug Administration?s authority to regulate nicotine. However, several basic provisions are piqueing the interest of the research community. One provision would assign $25 billion into a Public Health Trust Fund, which will pay for public education campaigns and other public health initiatives. A portion of that?estimated at $100 million a year?would go toward tobacco-related research. It?s unclear who will distribute that research money and what type of research it will fund, but Condon is working to ensure that behavioral research is included in all discussions.

Sending the right message
In discussions of the tobacco settlement, psychologists are calling for more money for basic behavioral research and asking Congress to implement the research they?ve already completed (see table).

?We know a tremendous amount about what prevents young people from smoking,? says tobacco researcher Leonard Jason, PhD, of DePaul University, who notes there are four actions that have been scientifically proven to reduce teen smoking by 50 percent:

? Make cigarettes unavailable to people under age 18, including strict enforcement programs to curb underage sales of cigarettes.

? Increase the excise tax on cigarettes. Studies clearly show that such an increase has a big effect on smoking by young people.

? Outlaw all cigarette advertising, not just advertising targeted at children.

? Implement antismoking programs that involve peer leaders to spread the message that smoking isn?t good.

?With that said, there?s more research to be done on all four of these issues,? says Jason. For example, researchers need to better understand the effectiveness of antismoking advertising on the decision to start smoking or quit smoking, says psychologist Robert Cialdini, PhD, of Arizona State University.

The focus of the recent tobacco legislation has been on teen smoking, primarily because most people who smoke in the United States begin in adolescence. But that could change if antismoking campaigns only target access to cigarettes. The Japanese successfully enforce restrictions on teen smoking and, there, most people who smoke begin after age 21.

Along with eliminating the availability of cigarettes to teens, prevention programs need to pay more attention to the structure of the messages they send, says Cialdini.

?Rather than just turning off the spigot?eliminating the availability of cigarettes?we need to send teens a message that will reduce their desire for the product,? says Cialdini. ?The message [to children] can?t be that ?smoking is an adult thing, so it?s not for you.? The message has got to be that ?smoking is a dangerous thing and it?s not for anybody.??

APA advocacy
In November, Cialdini and Jason took their messages to federal legislators as part of an APA science advocacy workshop devoted to tobacco issues. The workshops bring scientists to Washington, D.C., to give them media and advocacy training and send the researchers onto Capitol Hill to talk to legislators about research funding issues and policy issues related to their research. Along with Cialdini and Jason, researchers participating in the November workshop study risk management, decision-making, behavioral economic forces associated with smoking, psychopharmacology of nicotine addiction and other aspects of tobacco-related research.

As a result of his time on the Hill, Jason was asked by a member of the House Commerce Committee, Subcommittee on Health and Environment, to testify about behavioral aspects of teen-age tobacco use (see page 11).

APA has also joined a coalition of organizations called Effect National Action to Control Tobacco (ENACT), which advocates for tobacco-control legislation on behalf of public health. Other members of ENACT include the American Heart Association, the American Cancer Association and the Society of Behavioral Medicine.

To date, input from the public health community has been dominated by organizations that focus on the consequences of smoking, such as heart disease, lung disease and cancer, says Geoff Mumford, PhD, APA public policy officer.

But the recent addition of APA and several other behavioral science organizations will expand ENACT?s involvement across a broader range of research issues, says Mumford.