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Institute for the Study of Smoking Behavior and Policy Harvard University John F. Kennedy School of Government 79 John E Kennedy Street Cambridge, Massachusetts 02138 Ti0098-.0376

Cigarette smoking is dae leading preventable cause of death and disability in the Unitcd St-arcs. While remarkable progress has been made in the past twentT years in reducing smoking, over 50 nail]ion Amcricans continuc to s~lloke, exacting an enormous toll in human and economic costs. Millions more smoke in other countries where progress in rcducing smoking has not bccn so rapid or where smoking is still on the rise. Enough is known about the health conscqttenccs of smok- ing; much more needs to be learned about how to prevent people from starting to smoke and how to help them to quit successfully. These needs can best be met by applying more effectively what is already known and by targeting re- search at those questions whose answers have the greatest poten- tial to prevent or reduce smoking. q~ help mcct the nccd for a more strategically oricntcd view of" the smoking problem, the John E Kennedy School of Government at Harvard Uni- versity established the Institute K)r the Study of Smoking Behavior and Policy, a research center dedicated to examining the linkages between smoking behavior research and policy at all levels. The lnstitutc's primary goal is to develop new knowledge aud translatc it into programs and policies which will reduce the use of cigarettes. In addition to drawing on the resources of the Harvard community, the Insti- tute reaches out to iudividuals and institutions in the United States and abroad which art" addrcssing the same problems. TI,0098-0377

~ ROLE OFTHE INSTITUTE The Institute was founded in 1984 with the support of the Carnegie Corporation of New York, tbllmving a planning, period fostered by Harvard's Division of FIealth Policy Rcscarch and Education. The lnstitutc's location in the John F. Kennedy School of Govermnent enables it to draw on the broad interest an.d expertise in public policy, economics and health issues of the School's faculty and its Center for Health PoLicy and Management. The Institu&s mission is to: • Serve as a focal point and in- formation resource for research in smoking behavior and policy • Stimulate research which will support and enhance policy dcvclopment • Conduct rescarch projects with potential for program or policy applications • Monitor events and changes in policies to identify research opportunities • Search for opportnnities to translate research findings into programs and strategies for smoking prevention and control The diversified program of research needed to carry out this nfission is supported primarily by grants from the Carnegie Corporation of New York and the W. K. Kdlogg Fouudation with additional support from the Cabot Family Charitable Trust, The Conrad Hilton and Alfred R Sloan Foundations and the National Cancer Institute. The seven elements or projects which comprise our research program are as follows: The natural history project exam- ines smoking bd~avior on the levd of the individual. The em- phasis is on naturally occurring transitions in smoking, front i,t- itiation through to cessation, and on their potential as points for intervention. The three main objectives arc to: • Investigate the transitions in smoking that occur among adolescents and young adults, with particular emphasis on the quit attempts made by this age group • Explore transitions in smok- ing associated with health events • Study in detail relapse among smokers who have made an initial attempt to stop smoking This work combines interview aud survey research, analyses of existing data, and literature reviews. In order to develop aud evaluate approaches to reducing or pre- venting smoking, policymakers need to know more about who smokes, who is starting, and who is trying to stop. This project collects and evaluates the available data on changes in smoking behavior in various demographic and socioeconom- ic groups in order to: • Use population-based data on smoking behavior to identify target populations that offer good opportunities for smok- ing intervcntkm programs • Develop methods for analyz- ing smoking as a dynamic behavior • Study differences in snloking behavior by country DEMOGRAPHY AND SOCIAL EPIDEMIOLOGY TI0098-0378

INTERVENTION RESEARCH CONFERENCES The lnterveution project is cur- rcntly evaluating the effects of implcmcnth~g hospital smoking policies, and conducting research to identify general in- tervention models for smoking prevention and intervention, such as interventions which aim to reduce smoking: • During and after pregnancy • Following coronary artery bypass surgery • Among teens and young adults in transitiou Tile Institute sponsors and co- sponsors a nmnbcr of confer- ences each ycar on research and policy issues. The confcrcnces bring togethcr such diverse groups as econo- mists, policy makers, behavioral scientists and pharmacologists to examine research and public policy issues in order to identify nc~v areas of research or new options for addressing various aspects of the smoking problem. Topics include: • Cigarette Excise Tax • Tobacco Use as an Addictive Process • Pharmacologic Treatment of Tobacco Dependence • Insurance • Advertising • Quitting by Teens To monitor and assess current activities in smoking behavior and policy, the Institute has built a research database which includes information on researchers and their interests. The database facilitates conmm- nications with the research community and enables us to provide coordination in smok- ing research and policy issues. The Institute publishcs and dis- tributes a series of ten discus- sion papers a year to draw attention to new topics and to provide an avenue for discussion of work that has not as yet bccn published. Examples include papers writtcu by establishcd rcscarchcrs associated with dac Institute as well as those written by students as part ofthc Kennedy School's Policy Analy- sis Excrcisc. Comments f'rom readers provide valuable feed- back for studies iu progress. The series welcomes manuscripts ofprdiminary work, work in progress, and other unpublished reports. Through historical analysis, researchers can determine which policies have worked successful- ly in the past and can track changes that havc taken place in public attitudes. Dr. Allan Brandt, an historian in the I)cpartmcnt of Social Medicine aud Health Policy at the Har- vard Medical School is conduct- ing such a study, which will result in a book on the social and cultural history of smoking in American life. RESEARCH DATA_BASE DISCUSSION PAPER SERIES SOCIAL HISTORY TI0098-0379

INSTIT U '1 ~ STAFF ADVIS O RY BOARD Thomas C. Schelling, Direc- tor, is Ludus N. Littauer Professor of Po]itical Economy. John M. Pinney, Executive Director, is former director of the Office on Smoking and Healda in the Public Health Service. Jan L. Hitchcock, Assodate Director, is a psychologist studying the natural history of smoking. Nancy A. Rigotti, M,D., As- sociate Director, is an instruc- tor in medicine at Harvard Medical School and an intern- ist at Massachusetts General Hospital. She is examining smoking intervention in health care settings. Michael A. Stoto, Associate Director, is associate profes- sor of public policy conduc- ing demographic research on. smoking. Laura J. Flinchbaugh, Research Assistant, supports the work of the Natural His- tory and Intervention projects. Andrea M. Berman, Research Assistant, manages the research database and the In- stitute library. Helen Chayefsky, Administra- tive Assistant, is responsible for the administrative management of the Ii~stimtc. Graham T. Allison l)eau Johu F. Kennedy School of Government Harvard University John Bunker, M.D. Professor of Anesthesia Stanford Medical Center Joseph A. Califano Partner Dewey, Ballandne, Bushby, Pahner & Wood Beatrlx A. Hamburg, M.D. Professor of Psychiatry and Pediatrics Mr. Sinai School of Medicine Howard Hiatt, M.D. Professor of Medicine Harvard Medical School Newton N. Minow Partner Sidley and Austin James L. Moorefield President Health Insurance Association of America Frederick Mosteller Roger I. Lee Professor School of Public Health Harvard University Joseph P. Newhouse Head Economics Department The Rand Corporation Julius B. Richmond, M.D. Director Division of Health Policy Research and Education Harvard University Arthur C. Upton, M.D. Chairman Institute of Environmental Medicine New York University Medical Center David M. Burns, M.D. Associate Professor of Medicine University of California San Diego School of Medicine RESEARCH ADVISORY COMMITTEE T10098-0380

Ellen R. Gritz Director Division of Cancer Control Jonsson Comprehensive Cancer Center University, of California Los Angeles Jeffrey E. Harris, M.D. Associate Professor Department of Econonfics Massachusetts Institute of Technology C. Anderson Johnson Director Health Behavior Research Institute University of'Southern California Edward Lichtenstein Professor Department of Psychology University of Oregon Mark H. Moore Daniel and Florence Guggcnhcim Professor John E Kennedy School of Government Harvard University Judith K. Ockene Director, Division of Preventive and Behavioral Medicine University of Massachusetts Medical School Terry Pechacek Associate Profcssor Division of Epidcmiology University of Minnesota Michael Pertschuk Co-Director The Advocacy Institute Saul Shiffman Assistant Professor Department of Psychology University of Pittsburgh Kenneth E. Warner Chairman, l)cpartmcnt of Health Planning and Administration School of Public Health University of Michigan Institute for the Study of Smoking Behavior and Policy john E Kcnncdy School of Govcrnmcnt Harvard University 79 John E Kennedy Street Cambridgc, MA 02138 (617) 495-0806 TI0098-0381