The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US

Abstract

International and cross-cultural research is critical for understanding multilevel influences on health, health behaviors, and disease. A particularly relevant area of need for such research is tobacco control. The tobacco epidemic is one of the biggest public health threats globally, killing over 7 million people a year. Research critical to addressing this public health problem has leveraged variability in tobacco use, history, product market, and policies across different countries, settings, and populations, particularly in low- and middle-income countries (LMICs) where the tobacco burden is increasing. These efforts are needed in order to advance the science and inform practice and policy in various settings, including the US. Several funding agencies provide support for international research focused on tobacco control in LMICs because of the importance and implications of such research. This paper provides some concrete examples of how such research has advanced our knowledge-base and informed practice and policy globally, particularly in high-income countries including the US. Some prominent themes emphasized in this manuscript include: the development of knowledge regarding the diverse tobacco products on the market; better understanding of tobacco use and its impact among different populations; generating knowledge about the impacts including unintended consequences of tobacco control policy interventions; and better understanding tobacco industry strategies and informing advocacy efforts. In summary, international tobacco control research, particularly in LMICs, is critical in effectively and efficiently building the evidence base to advance tobacco control research, policy, and practice globally, including the US, with the ultimate goal of curbing the tobacco epidemic.

Tobacco control and sustainable development: shared challenges and future opportunities

“…These can help underpin responses to the multi-faceted activity of the TTCs. Existing networks should be used in particular to strengthen tobacco control in LMICs, through capacity building, deepening international collaborations, and fostering local leaders and enabling them to draw on the vast pool of experiences and case studies from around the world [74][75][76][77]. Global tobacco control networks also need to be sustainable, because adopting legislative measures is only the first step, with their implementation and enforcement being equally important.…”

“…Thus far, the bulk of tobacco control research, and in particular research on tobacco industry interference, has focused on high-income settings. While this has begun to change in recent years [27,74,75,78], we still know relatively little about the needs of local tobacco control advocates in LMICs and how they can be best supported by global networks in countering the interference of the tobacco industry. With LMICs now at the core of the TTCs' business expansion plans, understanding and addressing these needs is now more urgent than ever.…”

The scope of tobacco cessation randomized controlled trials in low- to middle-income countries: protocol for a scoping review

“…As researchers attempt to minimize the harms from tobacco in LMICs, they need to be aware of scientific evidence to develop RCTs to achieve their aim. The planned study hopes to build knowledge around inadvertent outcomes of tobacco cessation interventions and enhance understanding around tobacco control advocacy efforts [36].…”

“…Secondly, to effectively design RCTs that mitigate tobacco-related harms in LMICs, further understanding of RCTs in this environment will be helpful. Research in this area may augment knowledge about tobacco products, broaden understanding around tobacco use among diverse populations, and improve understanding of tobacco firm strategies [36]. Greater understanding around tobacco cessation research may also aid the evidence base to enhance tobacco cessation scholarship, policy, and implementation globally, mitigating the tobacco epidemic [36].…”

“…Research in this area may augment knowledge about tobacco products, broaden understanding around tobacco use among diverse populations, and improve understanding of tobacco firm strategies [36]. Greater understanding around tobacco cessation research may also aid the evidence base to enhance tobacco cessation scholarship, policy, and implementation globally, mitigating the tobacco epidemic [36]. In this scoping review, we will evaluate evidence on the scope of tobacco cessation RCTs, already conducted, in LMICs.…”