Reducing Tobacco Use Initiation

Research Gaps

What are Research Gaps?

Prior to and during the literature review and data analysis, the review team and the Community Preventive Services Task Force attempt to address the key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as "research gaps." Research gaps can be pulled together in the form of a basic set of questions to inform a research agenda for those in the field.

Identified Research Gaps

Effectiveness

The effectiveness of increasing the unit price for tobacco products and mass media campaigns in reducing tobacco use by adolescents is established. Important questions remain regarding the composition and content of effective campaigns and the effectiveness in different settings and populations. Some issues raised by others overlap with questions generated as a result of this review.

• What interventions are most effective in combination with mass media campaigns? What interventions are least effective?
• What are the relative effects of these interventions on adolescent initiation, consumption, access to tobacco products, and cessation?
• What is the required intensity (frequency of spots and the broadcast exposure) of media messages for an effective campaign?
• What are the independent contributions of particular intervention features (e.g., components, content, intensity, and duration) to overall intervention effectiveness?
• What are the most effective ways to maintain reductions in youth tobacco use into young adulthood?
• Does tobacco use in adults respond to mass media campaigns that are youth-focused?

Applicability

The effectiveness of these interventions should be applicable in most settings and populations. However, there could be differences in the effectiveness of these interventions for specific subgroups of the population. The following questions remain about the applicability of these interventions in various settings and populations:

• Are there differences in the responses of adolescents to tobacco product price increases by age, race, and ethnicity?
• Are the effects of mass media campaigns on adolescents by gender, race, and ethnicity similar to or different from those observed in Florida?

Other Positive or Negative Effects

The studies in these reviews did not provide information on other positive or negative effects. Research questions pertinent to interventions to increase the price of tobacco products are presented in the Research Gaps for: Strategies to Increase Tobacco Use Cessation. Some issues generated by the review of mass media campaigns are the following:

• Do mass media campaigns that target children and adolescents result in increases in tobacco initiation among young adults by delaying the age of initiation?
• What are the most effective ways to maintain reductions in youth tobacco use into young adulthood?

Economic Evaluations

Available economic information was limited to a single study of mass media campaigns. Therefore, considerable research is warranted regarding the following questions:

• Are the costs and cost-effectiveness, net cost, or net benefit of mass media campaigns similar to or substantially different from those that have been previously reported?
• How do the costs per tobacco user averted compare with other tobacco prevention strategies?
• How do specific characteristics of mass media campaigns contribute to economic efficiency?
• What combinations of components in multicomponent interventions are most cost-effective?

Barriers

The strategies evaluated in this section require political action and support. Research questions generated in this review include the following:

• What characteristics are effective in successful legislative and referendum campaigns?
• How can adequate funding levels be maintained for mass media campaigns?

Methods of Intervention Research

Evaluations of mass media campaigns should provide information on the costs, scale, duration, and content of the campaign. Researchers should identify concurrent tobacco control efforts, especially excise taxes or changes in the price of tobacco products, and should attempt to control for these changes in their analyses.