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The UNC Tobacco Prevention and Evaluation Program (TPEP) conducts tobacco control research and program evaluation. Based in the UNC Department of Family Medicine, our interdisciplinary team collaborates with national and state level clients to conduct high quality research and responsive program evaluation studies. Our work is designed to inform policy and strengthen programs to advance public health.

 

Cigar Warnings Grants

In recent years, UNC’s Tobacco Prevention and Evaluation Program has received funding to develop and improve cigar warnings and communications about cigar warnings. This research is important because nearly 9 million U.S. adults use cigars (i.e., cigars, cigarillos, filtered little cigars) and cigars cause negative health effects, including multiple cancers, stroke, and heart disease. The research conducted at UNC TPEP helps inform policies and regulations regarding cigars and their warnings requirements within the United States.

Little Cigar and Cigarillo Warnings to Reduce Tobacco-Related Cancers and Disease

In 2019, the National Cancer Institute awarded UNC Tobacco Prevention and Evaluation Program and Lineberger Comprehensive Cancer Center researcher Adam Goldstein, MD, MPH, a five-year, $2.7 million grant to develop more effective health warnings for little cigars and cigarillos. Adam Goldstein, MD, MPH, is a UNC Lineberger member, professor in the UNC School of Medicine Department of Family Medicine, and Director of Tobacco Intervention Programs.

This research study will help develop more effective health warnings for little cigars and cigarillos and increase the body of knowledge of tobacco warnings and provide insights specific to little cigars and cigarillos. Per Dr. Goldstein, the study seeks to “fill critical gaps regarding of our understanding of which characteristics will make little cigar and cigarillo warnings labels most effective and provide needed evidence to policy-makers for how little cigar and cigarillo warnings impact user behavior.”

To learn more about the UNC Tobacco Intervention Programs, based in the Department of Family Medicine, visit: med.unc.edu/fammed/tobacco/. To learn more about Dr. Goldstein and his research interests, visit his bio page.

  • Publications supported through this funding:
  • Kowitt SD, Jarman KL, Cornacchione Ross J, Ranney LM, Smith CA, Kistler CE, Lazard A, Sheeran P, Thrasher JF, Goldstein AO. Designing more effective cigar warnings: an experiment among adult cigar smokers. Nicotine Tob Res. 2021 Oct 10:ntab207. doi: 10.1093/ntr/ntab207. Epub ahead of print. PMID: 34628506.
  • Kowitt SD, Cornacchione Ross J, Jarman KL, Kistler CE, Lazard AJ, Ranney LM, Sheeran P, Thrasher JF, Goldstein AO. Tobacco Quit Intentions and Behaviors among Cigar Smokers in the United States in Response to COVID-19. Int J Environ Res Public Health. 2020 Jul 25;17(15):5368. doi: 10.3390/ijerph17155368. PMID: 32722469; PMCID: PMC7432467.

Strengthening Cigar Warnings to Prevent Adolescent Use.

In 2021, the National Institutes of Health awarded UNC Tobacco Prevention and Evaluation Program researcher, Leah Ranney, PhD, and Wake Forest School of Medicine researcher, Jennifer Cornacchione-Ross, PhD, a NIH (R01) three-year award in the amount of $1.2 million for the research study Strengthening Cigar Warnings to Prevent Adolescent Use. This grant is dual funded by the National Cancer Institute (NCI) and Federal Drug Administration (FDA) and the study seeks to improve the effectiveness of warnings for little cigars and cigarillos (LCCs) among youth who currently use, have ever used, or are susceptible to using LCCs, especially Black/African American youth. Findings will provide novel and necessary evidence regarding the effectiveness of LCC warnings and inform efforts to strengthen warnings through larger warning size and added images to reduce LCC use among youth and lessen tobacco-related disparities

To learn more about the UNC Tobacco Intervention Programs, based in the Department of Family Medicine, visit: med.unc.edu/fammed/tobacco. To learn more about Dr. Ranney and her research interests, visit her bio page.

This portion has been adapted from this UNC news release.

 

Supplements to R01 Funding

Between September 2020 and August 2021, the research team received additional funding via a supplement to the R01 grant received by Adam Goldstein to further examine health messaging. These include:

Diversity Supplement 

In 2021, Chineme Enyioha, MD, MPH was awarded a diversity supplement by the National Institutes of Health (NIH) to develop messages for a communication campaign on little cigars and cigarillos. This study seeks to create messages to augment and support the new health warning labels developed in the “Little Cigar and Cigarillo Warnings to Reduce Tobacco-Related Cancers and Disease” parent grant led by Dr. Goldstein and focuses on a vulnerable population of LCC users – young adults, including African Americans.

Alcohol and Tobacco Co-Use

In 2020, the team of researchers from the UNC School of Medicine Department of Family Medicine and Lineberger Comprehensive Cancer Center received a $100,000 administrative supplement from the National Institutes of Health (NIH) to further examine how to communicate about the risks of using cigars and alcohol. To do this, the team is developed and tested messaging for co-users of alcohol and tobacco products about the risk of associated cancers. This supplement was led by Leah Ranney, PhD, with help from Adam Goldstein, MD, MPH Sarah Kowitt PhD, Melissa Cox, PhD, and program manager Kristen Jarman, MSPH.

The supplement filled a critical research gap by developing and testing health messages targeted to users of both alcohol and tobacco products.

This overview has been adapted from this UNC news release.

Publications supported through this funding:

Kowitt SD, Jarman KL, Kong AY, et al. (2022). Communicating Risks of Alcohol and Tobacco Co-Use. Addictive Behaviors. In Press.

Dual Use Communication Campaign

In 2020, M. Justin Byron, PhD, Assistant Professor in the Department of Family Medicine, was awarded a K01 grant from the NIH National Cancer Institute (NCI) and the U.S. Food and Drug Administration (FDA) to develop and test communication campaign messages to encourage dual users of e-cigarettes and cigarettes to quit. Over the course of five years, Byron will design and test communication campaign messages to educate dual users about their continued health risks and to encourage them to quit cigarettes and ultimately e-cigarettes. He will use a combination of qualitative research with dual users, eye-tracking experiments, and national surveys to optimize campaign messages and ads.