Research infrastructure assures the availability of necessary human, financial, and technological resources, systems for collaboration, and mechanisms for information dissemination and feedback to provide a strong foundation upon which effective research may be designed and conducted.
Infrastructure provides the foundation for research, much as a foundation supports a house. Adequate staff, laboratories, other core support, and training are all needed to assure the long-term stability and success of the research enterprise. Yet, as Bennet Bertenthal of the National Science Foundation observed in 1998, "most researchers rely on various forms of infrastructure that they take for granted." Noting that "science is getting bigger, faster and more expensive," Bertenthal argued that the social sciences are at an important juncture in how they prepare for the future. Consequently, investments in infrastructure are extremely important for the social sciences as well as for genetics, epidemiology, and the other sciences associated with the study of nicotine addiction. Achieving the tobacco research goals detailed in this report will require a major investment in such infrastructure.
The organization of research can have a major impact on its productivity and outcomes. Across a range of scientific disciplines, the ideal research model is based on transdisciplinary teams of scientists working in settings that facilitate collaboration and promote productivity. The complexity and interdisciplinary nature of the tobacco control research recommended in this report require such a critical mass of scientists working both independently and in collaboration with each other to accomplish these research objectives. A mix of scientists from different research areas, such as basic science, clinical science, and population science, should work in close geographic proximity, or at least in intellectual proximity, to each other. The development of transdisciplinary research centers is the most effective way to facilitate such productive interactions between different types of scientists and more rapid exchange of research findings among basic, clinical, and population studies.
RECOMMENDATIONS
Transdisciplinary Tobacco Research Centers should be created to study the initiation of tobacco use, prevention of tobacco use, addiction to tobacco, and/or treatment of tobacco addiction and tobacco-related cancers.
The highest priority for the NCI's investment should be the creation of Transdisciplinary Tobacco Control Research Centers to investigate important questions about nicotine addiction and the prevention and treatment of tobacco use. These transdisciplinary centers should include strong basic research closely linked with epidemiology, biobehavioral, prevention, treatment, dissemination, and/or policy research. Such centers would embrace a range of disciplines and investigations and would provide the critical mass of expertise needed to advance tobacco control efforts through the pursuit of promising new research opportunities. The level of specialization in different aspects of tobacco research would vary across centers. However, the centers should focus thematically on areas, such as adolescent smoking and use of other tobacco products, where there are significant gaps in knowledge. The collective effort at a center could result in major advances in and the application of knowledge. For example, nicotine addiction centers could explore and reveal the neuropharmacologic and genetic bases of nicotine addiction, which would lead to improved, tailored prevention and treatment strategies for vulnerable population subgroups. Specialized tobacco prevention centers could explore precursors of initiation and assess whether and how prevention strategies work for different populations in different contexts, such as health care organizations, work sites, and communities. Other specialized centers could investigate psychosocial factors and identify why and how strategies based on such factors work in outreach efforts that are successful with unmotivated users. Such centers also could join with health departments and other organizations to explore research issues involved in successfully transferring proven interventions from research settings to communities. To ensure further cross-fertilization and maximize the impact of the innovative research that will be conducted at tobacco control centers, mechanisms would be developed to encourage intercenter communication and collaboration.
Centers will also be able to make important contributions to methodology. For example, they could serve as repositories for biospecimens needed for tobacco research. Centers would have the opportunity to develop new methodologies that would advance the ability to conduct tobacco research in specific areas, such as community dissemination and implementation. They also could take existing methodologies and measures from related fields and adapt them for use in tobacco control research. Finally, centers might develop ways to translate tobacco industry marketing strategies into effective antitobacco campaigns or to apply new information technologies to tailor antitobacco messages to individual motivational factors.
One of the most important functions of the tobacco research centers would be to contribute to the development of the next generation of tobacco control researchers. The centers' critical mass of scientists conducting research across the spectrum of tobacco control would make it possible to train future tobacco research scientists who are knowledgeable about the need for and conduct of transdisciplinary research. Only in such a fertile environment of collaboration will tomorrow's scientists gain a true vision of transdisciplinary research.
While close geographic proximity is characteristic of transdisciplinary centers, the Internet has made it possible to establish virtual research centers. These "collaboratories" permit researchers from centers across the globe to conduct collaborative research. For example, collaboratories can enable researchers to simultaneously conduct similar experiments at different locations in the United States and in other countries using the same protocols. Such studies may be especially useful for the study of nicotine addiction, since different centers with access to unique populations and study conditions would have the potential to discover significant similarities and differences in the nicotine addiction process that could be applied to the development of prevention and treatment interventions. Scientists working at the different centers should be brought together to foster synergy. Moreover, academic attention should be paid to strategies for maximizing transdisciplinary collaboration within and between centers. Novel approaches should be encouraged and supported.
The NCI should consider funding centers through the Specialized Programs of Research Excellence (SPORE) mechanism. These specialized centers support the full-range of research and development, from basic research to clinical and population research, and are ideally suited to facilitate the kind of transdisciplinary, bench-to-bedside research required to advance the science of tobacco control. The SPORE mechanism would provide the needed flexibility to change course when new discoveries are made and the opportunity for unique research interactions, both within a SPORE and across SPOREs. Three aspects of SPOREs are especially appropriate for enhancing the field of tobacco control research: the mandate for training and career development, the availability of developmental funds, and the provision of support for core resources.
OTHER INFRASTRUCTURE RECOMMENDATIONS
In addition to centers, the scope of the proposed research efforts detailed in this report also calls for transNIH initiatives, where possible, with funding from multiple institutes, including NIDA. In addition, partnerships should be developed with voluntary organizations (such as the American Cancer Society), foundations (such as the Robert Wood Johnson Foundation), and private industry (such as pharmaceutical companies).
Cohort studies should be expanded to identify determinants and health consequences of tobacco use in children and young adults. Such cohorts would permit research to track multiple behaviors and outcomes, such as smoking, alcohol use, drug use, and depression, over time. Long-term research with such cohorts could pinpoint the precise relationship of individual characteristics, such as "low self-esteem," and behaviors, such as tobacco use, and the time sequence in which they occur. Such research also should investigate other individual and family factors or genetic and biological factors that contribute to tobacco use. Funding for these efforts should derive from multiple NIH institutes.
Training the next generation of tobacco control researchers is essential. The Transdisciplinary Tobacco Control Research Centers represent an ideal model for training. However, more training opportunities are needed for the next generation of tobacco control investigators. The extramural community should be encouraged to apply for training grants and to develop programs that would use transdisciplinary groups of researchers to train scientists in tobacco research. In addition, young scientists should be encouraged to apply for Independent Scientist and Career Awards with a focus on tobacco control research. We also must consider other mechanisms to meet the urgent need to train investigators from minority and underserved populations. Training is absolutely critical if the science of tobacco control is to be advanced.
The rapid advancement of tobacco research requires the use of a variety of mechanisms. Possibilities include a mechanism like the B/START (Behavioral Science Track Awards for Rapid Transition), which was developed by NIDA. These awards are tailored for new investigators and could be used for quick-start research on new or novel research approaches and collection of pilot data in tobacco control research. Special exploratory or developmental initiatives should also be considered for pilot studies in tobacco control research, including the use of ethnographic methods.
Members of the TRIG were concerned about the upcoming changes in the NIH review process. They were emphatic that tobacco research needs fair peer review. They recommended that the NCI should be cautious about giving up review of tobacco research grants, especially those in high-priority areas. This is important if researchers in tobacco control are to have optimal opportunities to conduct research.
Much of the investment in tobacco research will be lost without adequate attention to the synthesis of research results and the dissemination of proven programs and techniques. The NCI should strengthen its capability in research synthesis and should regularly disseminate research results using both the peer-review literature and special monographs. Dissemination strategies should also utilize the Internet. Similarly, the impact of research investment is diminished if the programs developed through that research are not disseminated successfully to those who can apply them to tobacco control. The NCI should increase its commitment to research dissemination by building a strong unit that focuses on the efficient and effective transfer of proven tobacco control programs and technical assistance to assure that these programs are implemented as designed. The goal of these efforts is to disseminate evidence-based strategies for tobacco control.
THE IMPACT OF BUILDING THE TOBACCO RESEARCH INFRASTRUCTURE
Few places in the United States now have the critical mass of scientists needed to optimize tobacco control research. Therefore, these infrastructure initiatives could have a major impact on tobacco use and tobacco-related cancer. Changing the way research is conducted on a national level could accelerate the development of more effective tobacco control interventions for general and special populations, speed the transfer of these scientifically validated approaches to application in communities across the Nation, and create a core of new tobacco control researchers who can advance the science of tobacco control in the next century.
