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Tobacco Control Research

We put tobacco control research into action by collaborating with the American Cancer Society Cancer Action Network (ACS CAN) to promote evidence-based tobacco control advocacy.

What We Do

The American Cancer Society (ACS) Tobacco Control Research (TCR) team studies factors in the United States that predict what leads adults and adolescents to start and stop using any one of the many conventional or novel tobacco products. As part of this effort, we track the use of conventional tobacco products, such as cigarettes, cigars, and snuff along with more novel ones, such as electronic cigarettes (e-cigarettes), hookahs, and nicotine pouches.

For example, before new tobacco control policies are implemented, we evaluate how those policies may affect the use of tobacco and may lead to health and economic consequences. In the same way, after a new tobacco control policy in the United States is implemented, we evaluate its overall value in reducing the use of tobacco products for individuals, communities, and the nation.

Our Advocacy-Research Collaboration

The ACS TCR team studies tobacco control policies, related health and economic policies, and the activities of the tobacco industry through the lens of health equity. Our work is closely knit with the tobacco control advocacy efforts led by the American Cancer Society Cancer Action Network (ACS CAN), which is the ACS nonprofit, nonpartisan advocacy affiliate founded in 2001.

ACS CAN influences evidence-based policy changes at the federal, state, and local levels with legislative (through laws) and regulatory solutions (requirements issued when a law is passed to help the law be put into action) that reduce the cancer burden.

We give an overview of our partnership in action in “An Advocacy-Research Collaboration Model to Inform Evidence-Based Tobacco Control Efforts­,” published in Tobacco Control in January 2023.

Experts with diverse backgrounds from ACS and ACS CAN align on the priorities of tobacco control while considering—or generating—evidence related to the intended, unintended, and potential implications of tobacco control efforts.

We describe our work as both:

  • Research in action because our studies relate to timely scientific investigations of emerging or ongoing tobacco control milestones.
  • Evidence-based advocacy in action because we use emerging scientific evidence from research to inform urgent tobacco-control efforts. 

Glossary for Nonscientists

Featured Term: 
Tobacco Control

Tobacco control can involve multiple actions to protect people from the effects of using tobacco products and exposure to secondhand smoke. These effects can include disease (morbidities), death (mortality), and economic consequences, such as lost wages due to sick leave and medical expenses to treat illnesses linked with using tobacco. 

Tobacco-control actions that countries, states, and local jurisdictions can make include:

  • Not allowing the sale of flavored tobacco products
  • Requiring health warnings on packaging for all types of tobacco products
  • Making it illegal to advertise or promote tobacco products and making it illegal for tobacco companies to sponsor events
  • Making it illegal to sell tobacco products to minors
  • Having rules about where people can smoke in public places to protect people from exposure to tobacco smoke
  • Increasing the excise tax (taxes on particular goods or services) on tobacco products to make them less affordable
  • Promoting tobacco cessation to help people quit smoking or stop using other forms of tobacco
  • Continuous surveillance of the tobacco-product retail landscape

These actions may be practiced by federal, state, and local government agencies, community-based organizations, hospitals and clinics, businesses, and households.

How ACS Tobacco Control Research Supports ACS CAN Tobacco-Control Advocacy

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Our ACS Tobacco Control team meets our ACS CAN advocacy partners every week to discuss advances in tobacco control efforts in the United States. We share and update the group with emerging research findings, proposed policies, interpretations of events and news, and potential regulatory implications of a wide variety of nicotine-delivery products in the market.”

Nigar Nargis, PhD

Senior Scientific Director, ACS Tobacco Control Research

American Cancer Society

Our Work

Restriction on the Sale of Menthol-Flavored Cigarettes 

Menthol-flavored cigarette smoking has been associated with:

  • Encouraging youths and young adults to start smoking
  • A greater dependence on cigarettes, making it more difficult for people who use menthol-flavor cigarettes to quit
  • A lower rate of success with smoking cessation

Plus, the disproportionate use of menthol cigarettes among youth and African Americans raises important public health concerns about disparities in the health consequences of smoking.

The prevalence of current cigarette smoking among US adults has declined 30% over the last 55 years. But the availability of menthol-flavored cigarettes is slowing down the pace of success in reducing the number of people who smoke in the US.

Our Research Focus 

The American Cancer Society (ACS) Tobacco Control Research (TCR) team analyzes the sale and use of cigarettes in states with sales bans on menthol-flavored cigarettes to help predict results of—and prepare the groundwork for—a future national menthol sales ban by the FDA.

Our studies about how sales restrictions of menthol-flavored cigarettes affect both overall cigarette sales and smoking prevalence have provided evidence in support of the proposed federal ban on menthol cigarette sales in the US.

The Cost of Tobacco Use 

Two of most obvious economic costs attributed to tobacco smoking and exposure to tobacco smoke (passive smoking) are:

  • Health care costs to treat tobacco-related illnesses
  • The cost of lost productivity at work and in commerce due to tobacco-related diseases and premature death

There are also many “hidden” costs of tobacco use that can be more challenging to quantify, such as how the tobacco industry affects the environment, and how working on tobacco farms affects short and long-term health.

Our Research Focus

The American Cancer Society (ACS) Tobacco Control Research (TCR) team studies the massive costs of tobacco to:

  • Provide evidence to nations across the world to make the investment in tobacco control a priority
  • Inform the development of new tobacco control policies and offer feedback on existing policies about the most successful ways to reduce smoking across the world 

Surveillance of Emerging Tobacco Products

The consumer tobacco marketplace is rapidly evolving. In the last 10 years alone, the popularity of e-cigarettes has risen and multiple new products have been introduced, including non-combusted (heat-not-burn) cigarettes and tobacco-less nicotine pouch products. Little is known about how these new products affect long-term health effects for individuals and the public.

Our Research Focus

The American Cancer Society (ACS) Tobacco Control Research (TCR) team studies:

  • Sales of emerging tobacco products
  • The impact new product sales have on other concurrently available tobacco products (such as cigarettes)
  • Public awareness and perceptions of the health risks of emerging tobacco products

COVID-19 Pandemic and Tobacco Use

The spread of the SARS-CoV-2 virus (the cause of the infectious disease known as COVID-19) and its variances in the United States in early 2020 evoked major public health concerns. It also led to shifts in people’s health behaviors including tobacco use, alcohol consumption, and marijuana use.

At the same time, stay-at-home orders and fear of contracting COVID-19 led to reduced utilization of preventive services such as cancer screening and HPV vaccination during the pandemic.

Our Research Focus

The American Cancer Society (ACS) Tobacco Control Research (TCR) team monitored changes in health behaviors, including smoking and cancer screening, during the pandemic.

Cancer and Tobacco Use Disparities and Health Equity

Tobacco use remains the leading preventable cause of death in the United States, accounting for about 1 in 5 deaths each year. Smoking causes about 80% of lung cancers and is responsible for about 80% of deaths from lung cancer. Lung cancer is the leading cause of cancer death in people in the US.

While there’s been progress in the US to reduce tobacco use, people who are part of certain racial or ethnic minority groups, who have low income, and adults with less than a high school education, are more likely to use tobacco and have worse outcomes if they develop cancer. These disparities in tobacco use and cancer outcomes are due to a complex set of factors, including social determinants of health, as well as access to health care, systemic racism, and discrimination.

Additionally, the tobacco industry has historically targeted Black/African-American communities with marketing and advertising, leading to higher rates of tobacco use and related health problems.

Achieving health equity in the context of cancer and tobacco use requires a multifaceted approach, including:

  • Addressing national and state policies aimed at reducing tobacco use
  • Improving access to health care and cancer screening
  • Addressing the root causes of health disparities

Our Research Focus

The American Cancer Society (ACS) Tobacco Control Research (TCR) team is currently addressing health inequities by examining rates of tobacco use among various subpopulations and geographical locations and conducting research to better understand the intended and unintended impact of tobacco control (including related public policies) on health disparities.

Affordability and Taxation of Tobacco Products

Raising taxes to make tobacco products less affordable by significantly increasing their prices has proven to be the single most effective and cost-effective measure to reduce the number of people who buy and use tobacco and reduce the number of products they use each day.

Our Research Focus

The American Cancer Society (ACS) Tobacco Control Research (TCR) team has developed an affordability index that informs policymakers which subgroups need interventions to reduce their increased risk of tobacco use and tobacco-related deaths and disabilities because of increases in affordability where they live. Affordability increases when income grows at a faster pace than price. The affordability index is a combination of both price and income changes. 

The ACS Tobacco Control Research Team

These tobacco control researchers are part of the larger ACS Surveillance and Health Equity Science department:

Nigar Nargis, PhD, Senior Scientific Director

J. Lee Westmaas, PhD, Scientific Director

Minal Patel, PhD, MPH, Senior Principal Scientist

Tyler Nighbor, PhD, Principal Scientist

Samuel Asare, PhD, Principal Scientist

Zheng (Ashley) Xue, MSPH, Senior Associate Scientist

Shanshan Wang, MPH, Associate Scientist

Eva Orr, MPH, Associate Scientist

The ACS CAN Tobacco Control Collaborators

ACS CAN has successfully advocated for billions of dollars in cancer research funding, expanded access to quality affordable healthcare, and advanced proven tobacco control measures. Here are some ACS CAN staff members who collaborate with the ACS on tobacco control.

Lisa LaCasse, MBA, President, ACS CAN

Kirsten Sloan, Managing Director, Public Policy

Cathy Callaway, Senior Director, State & Local Campaigns

Mary Rouvelas, Managing Counsel & Legal Advocacy Director

Catherine McMahon, Principal, Policy Development

Deanna Henkle, Senior State and Local Campaigns Manager

Christy Cushing, MPP, Senior Analyst, Prevention & Health Equity