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TReND: Research to Reduce Tobacco-Related Inequalities: Worldwide Implications for and Exemplars of Tobacco Control
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Rationale: The World Health Organization (WHO) indicates that the single most important risk factor for untimely death is smoking.  Tobacco use is not equally distributed within societies, but substantively patterned by social factors including gender, socio-economic class, race, ethnicity and caste. The differences in the patterns and treatment of tobacco use; the risk, incidence, morbidity, and mortality of tobacco-related illness; and the related differences in community capacity and infrastructure, access to resources, and secondhand smoke exposure that exist among specific population groups are defined in the United States as tobacco-related health disparities. [2-4] In other countries, these differences are referred to as inequalities. [5, 6] Tobacco use inequalities occur along the entire tobacco use continuum including initiation, current use, amount consumed each day, cessation, relapse, level of dependence, and psychosocial and societal resources. While research sheds light on some of these inequalities, there are many challenges in attempting to unravel the effects of social stratification on tobacco-related outcomes. Appropriate measures and interventions often are unknown, elusive, or not disseminated widely. This symposium at the 14th World Conference on Tobacco or Health will provide a forum to share knowledge and discuss innovative paths forward in reducing tobacco-related inequalities through measurement, communication, intervention, and policy.
Purpose: To examine tobacco-related inequalities that are created and maintained globally by factors of social stratification such as gender, socio-economic class, race, ethnicity, and caste. Specific goals include:
- Define social stratification and articulate its manifestations in different countries and regions of the world. Discuss, generally, why social stratification is important to consider when addressing tobacco-related inequalities.
- Provide specific examples of how gender, class, race, ethnicity, caste, and region are associated with tobacco-related inequalities and diseases in different countries.
- Increase understanding of different measures of social stratification by comparing and contrasting how factors such as class, race, ethnicity, caste, and region are measured in different countries and the implications for tobacco control.
- Showcase exemplar interventions to reduce tobacco-related inequalities that have been conducted and evaluated at the individual and population-based levels.
Impact: By conducting this workshop, TReND investigators seek to initiate global dialogue and establish transnational collaboration to reduce tobacco-related health disparities/inequalities through effective measurement, intervention, and policy approaches.
- World Health Organization (2002). World Health Report 2002: Reducing Risks, Promoting Healthy Life . Geneva, Switzerland.
- U.S. Department of Health and Human Services (1998). Tobacco Use among U.S. Racial/Ethnic Minority Groups: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease and Health Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA.
- U.S. Department of Health and Human Services (2000). Reducing Tobacco Use: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease and Health Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA.
- U.S. Department of Health and Human Services (2004). The Health Consequences of Smoking: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease and Health Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA.
- Acheson D (1998). Inequalities in Health: Report of an Independent Inquiry . London: HM Stationery Office.
- Jha P, Peto R, Zatonski W, Boreham J, Jarvis MJ, Lopez AD (2006). Social inequalities in male mortality, and in male mortality from smoking: indirect estimation from national death rates in England and Wales, Poland and North America. Lancet, 368: 367-370.
Deborah McLellan, MHS (Pre-conference Workshop Chair)
Lourdes Baezconde-Garbanati, PhD, MPH
University of Southern California
Francisco O. Buchting, PhD
Josephine Crisostomo, MPH
Dana-Farber Cancer Institute
Pebbles Fagan, PhD, MPH
National Cancer Institute
Deirdre Lawrence, PhD, MPH
National Cancer Institute
Xingzhu Liu, MD, PhD
International Tobacco and Health Research and Capacity Building Program
Fogarty International Center at NIH
Mangesh Pednekar, PhD
Healis-Sekhsaria Institute for Public Health
Allison Rose, MHS
K. Vish Viswanath, PhD
Harvard School of Public Health
Dana-Farber Cancer Institute
Pre-conference Workshop Chair
Deborah McLellan, MHS
Meeting summary and agenda for the 14th World Conference on Tobacco or Health, Pre-conference workshop, Research to Reduce Tobacco-Related Inequalities: Worldwide Implications for and Exemplars of Tobacco Control (March 8, 2009, Mumbai, India)
TReND’s Tobacco Inequalities Toolkit for addressing tobacco-related inequalities. This toolkit contains a number of resources to provide some assistance to start, or continue, work on tobacco-related health inequalities including:
- Data set overviews and website links
- Media materials
- International tobacco control funding organizations – Bloomberg, Gates, Fogarty, Swedish, Canadian agencies
- Links to some international tobacco control organizations
- Exemplar papers on tobacco-related inequalities research
- Pre-conference Workshop Participant list
- U.S. National Institute of Health Fogarty International Center’s International Tobacco and Health Research and Capacity Building program abstracts and contact information
American Lung Foundation and American Cancer Society (2009). Tobacco Atlas, 3rd Edition .
Institute of Medicine (2007). Cancer Control Opportunities for Low- and Middle-Income Countries
The National Cancer Institute (NCI) and American Legacy Foundation are proud to fund the Tobacco Research Network on Disparities (TReND). Previous support has also been provided by the Department of Health and Human Services (DHHS) Office on Women’s Health, NCI Office of Women’s Health, and the NCI Center to Reduce Cancer Health Disparities.