RESEARCH IN STATE AND COMMUNITY TOBACCO CONTROL INTERVENTIONS Release Date: October 19, 2000 RFA: CA-01-017 National Cancer Institute Letter of Intent Receipt Date: January 9, 2001 Application Receipt Date: February 13, 2001 This RFA is a reissue of RFA-CA-99-001, which was published in NIH Guide, February 11, 1999. THIS RFA USES THE "MODULAR GRANT" AND "JUST-IN-TIME" CONCEPTS. IT INCLUDES DETAILED MODIFICATIONS TO STANDARD APPLICATION INSTRUCTIONS THAT MUST BE USED WHEN PREPARING APPLICATIONS IN RESPONSE TO THIS RFA. PURPOSE The purpose of this Request for Applications (RFA) is to stimulate research on new or existing tobacco control interventions relevant to State and community tobacco control programs. This will be achieved by supporting research on innovative tobacco prevention and control interventions at the community, State, or multi-State level. The results of this research will guide tobacco control programs across the Nation in order to increase program effectiveness and produce real reductions in the prevalence of tobacco use. This is a reissuance of RFA-CA-99-001. RESEARCH OBJECTIVES Background Tobacco use, responsible for nearly one in five deaths, is the leading preventable killer in the United States. Cigarettes cause over 420,000 deaths in the U.S. each year (ref 1). This includes 120,000 deaths from lung cancer and more than 31,000 deaths from other cancers (ref 2). Tobacco use costs the nation $50 billion annually in direct health care costs (ref 3), and billions more in lost productivity. At least 3000 lung cancer deaths occur annually in nonsmokers because of exposure to the carcinogens contained in environmental tobacco smoke (ref 4). Despite the known hazards of tobacco use, 48 million adult Americans currently smoke cigarettes (ref 5). Seventy percent of those who smoke want to quit (ref 6). Approximately 3000 youth under age 18 become regular smokers every day (ref 7). Smoking rates among youth increased 73% between 1988 and 1996 (ref 8). The science and practice of tobacco control is undergoing fundamental changes. Tobacco use has received unprecedented attention as a result of tobacco taxes, State lawsuits against tobacco companies, and sweeping legislative proposals to reduce smoking, especially among youth. Litigation has resulted in the release of millions of secret documents from tobacco companies, including unpublished research on nicotine addiction and tobacco marketing. It has also produced changes in the way tobacco is advertised and sold nationwide. Several States now invest millions of dollars annually in tobacco control intervention programs, funded by either dedicated tobacco excise taxes, State settlements with the tobacco companies as part of the Master Settlement Agreement, or from the Centers for Disease Control and Prevention (CDC). Some statewide tobacco control programs have combined multiple approaches in order to have the greatest impact on smoking rates, and the NCI and CDC have for years recommended a comprehensive approach to statewide tobacco control programs (ref 9). Many more States are now planning or beginning to implement their own tobacco control programs, and are looking for evidence- based guidance on what tobacco control efforts do and do not work in order to achieve for greatest impact for the funding available. However, research has provided limited information to guide decision-makers in selecting the most effective community and State tobacco control programs. Because of this paucity of research, fundamental questions remain concerning how States and communities should invest their tobacco control funds. Part of the challenge is that the scientific community and those who plan and implement tobacco control programs in communities and States have not consistently worked together to develop and test tobacco control programs in a rigorous and scientifically sound way. This process of applied research requires expanded collaboration between scientists and community programs, and it holds promise for improving the effectiveness of community and State tobacco control programs to effect major reductions in tobacco use prevalence. Research on community and State tobacco control interventions is a top priority for the NCI, as identified by the Tobacco Research Implementation Group (TRIG) in its recent report (ref 10). (Available at http://dccps.nci.nih.gov/tcrb/TRIP) Research programs of community-based policy and media interventions were specifically recommended for implementation by the TRIG. This RFA will support community and State-based research designed to address research questions that will provide useful information to program managers and policy-makers. Research is needed to evaluate the efficacy and effectiveness of prevention, treatment, training, media and policy interventions at the community and State level, including the translation of clinical research (e.g., the recent Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence) to communities and States. Research designs and interventions must be sensitive to the unique characteristics of different populations (ref 11). Research is needed to address a wide range of multi-cultural populations and to identify interventions that are most likely to reduce the social disparities in morbidity and mortality that are attributable to tobacco use. Specific examples of research questions that may be addressed under this RFA include, but are not limited to: 1. What public policies, or combinations of policies, are most strongly predictive of reductions in tobacco use? 2. In the context of comprehensive tobacco control programs, what are the relative contributions of individual parts of that program on reductions in tobacco use rates? 3. What impact do restrictions on smoking in worksites, restaurants and bars, or other public places have on tobacco use behavior among various populations? 4. What is the most effective role for community-based coalitions and partnerships in the development of comprehensive tobacco control programs? 5. How do State laws that preempt local tobacco control ordinances influence the public’s knowledge, attitudes and behavior related to tobacco? 6. How do statewide cessation programs (e.g. quitlines) interact with community cessation interventions to produce changes in tobacco use behavior? 7. In the context of a State-based program, what is the impact of a State or community tobacco control media campaign on: a) tobacco use behaviors, b) readiness to quit, c) attitudes toward tobacco advertising and tobacco use, and d) other predictors of initiation and cessation? 8. What themes, techniques, and messages of mass media campaigns are most effective in achieving the goals of the campaign? 9. How should community and State interventions be designed to influence high-risk groups, such as heavy smokers, multi-cultural groups, and youth? Are targeted interventions more effective? 10. How can new communications tools and strategies, such as the Internet or other newer technology, be used to reduce tobacco use at the community and State levels? 11. How can State and community tobacco control programs facilitate the development, implementation and dissemination of public policies or clinical interventions in their communities? 12. What training models are most effective in helping prevent smoking among all audiences and which models are most effective in helping smokers stop smoking? Research teams can choose to test interventions directed at one or more population groups, at the State or local level, or across States. Applicants are strongly encouraged to collaborate with State and local coalitions, voluntary health organizations, health departments, cancer centers, and other organizations. Collaborative relationships are strongly encouraged, as are in-kind contributions of staff and other resources from these organizations. Applicants must demonstrate a detailed understanding of existing and planned tobacco control activities, and their ability to remain informed of changes in these activities. An important purpose of the RFA is to foster collaboration between tobacco control researchers and State or community-based comprehensive tobacco control programs. By building collaborative efforts between researchers who are studying the effectiveness of specific interventions and the program managers in State health departments, the programmatic efforts to reduce tobacco use across the U.S. will benefit most directly from the state-of-the-art science of tobacco control. All States have tobacco control programs supported by the State health department. A contact person for each State health department tobacco control program is available on the Internet at http://dccps.nci.nih.gov/tcrb/scrfa.html. The research team will have experience and expertise in tobacco control research at the community or State level, including behavioral science, policy, health communications and advertising research. Another important objective of this research is to foster the development of cancer control researchers with experience in community and State level research. The results of this research will guide tobacco control programs across the Nation, in order to increase program effectiveness and produce real reductions in the prevalence of tobacco use. Investigators must describe in detail their research design and methods. Applicants must describe in detail how the impact of the interventions will be distinguished from the impact of other tobacco control activities. Comparisons of different measurement tools are encouraged. Investigators may choose to evaluate so-called "natural experiments" by examining the impact of interventions, policies, or regulations that are occurring or changing independently. Large-scale trials, if proposed, should meet the criteria for such trials, as developed by the NCI Cancer Control Review Group (ref 12). (Available at http://deainfo.nci.nih.gov/advisory/bsa/bsa_program/bsacacntrlmin.htm). SPECIAL REQUIREMENTS After awards are made, it is anticipated that collaborative research will be fostered among the recipients of grants under this RFA. Awardees that are testing the impact of similar interventions, or focusing on similar populations, will be encouraged to undertake collaborative research activities. These may include examining measurement issues, assessing complex interventions through different designs, assessing the impact of contamination, or monitoring the responses of the tobacco industry to new interventions. Investigators will be convened at the time of award and regularly throughout the project to consider these issues and how they might be addressed through enhanced collaboration. At a minimum, investigators will be asked to consider the collection of common data elements in multiple projects. Applicants are asked to discuss their plans for innovative dissemination of their findings in their applications. For this research initiative to be fully successful, findings must be translated and disseminated to a wide array of audiences, including State, local and national legislators and policy makers, program managers at all levels, public health advocates, researchers, parents and teachers, youth and youth-serving organizations, and the general public. Investigators will be convened twice annually throughout the project to consider these issues and how they might be addressed through collaboration. Support for travel by the Principal Investigator and one co-investigator should be included in the proposed budget. For purposes of estimating budgets, plan on two 2-day meetings each year, with one meeting on the East Coast of the United States and one on the West Coast. MECHANISM OF SUPPORT This RFA will use the National Institutes of Health (NIH) research project grant (R01). Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for an application submitted in response to this RFA may not exceed four years. The anticipated award date is December 2001. Because the nature and scope of the research proposed in response to this RFA may vary, it is anticipated that the size of an award will vary also. This RFA is one-time solicitation. Future unsolicited competing continuation applications will compete with all investigator-initiated applications and be reviewed according to the customary peer review procedures. Specific application instructions have been modified to reflect "MODULAR GRANT" and "JUST-IN-TIME" streamlining efforts being examined by the NIH. Complete and detailed instructions and information on Modular Grant applications can be found at http://grants.nih.gov/grants/funding/modular/modular.htm. FUNDS AVAILABLE The NCI intends to commit approximately $8 million in FY 2002 to fund 8 to 10 new grants in response to this RFA. An applicant may request a project period of up to four years and a budget for direct costs of up to $1,000,000 per year, excluding Facility and Administrative costs on consortium arrangements. Because the nature and scope of the research proposed may vary, NCI staff anticipate that the size of each award will also vary. Although the financial plans of the NCI provide support for this program, awards pursuant to this RFA are contingent upon the availability of funds and the receipt of a sufficient number of meritorious applications. At this time, it is not known if competing renewal applications will be accepted and/or if this RFA will be reissued. ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic and foreign, for-profit and non-profit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of State or local governments, and eligible agencies of the Federal government. Racial/ethnic minority individuals, women, and persons with disabilities are encouraged to apply as Principal Investigators. All current policies and requirements that govern the research grant programs of the National Institutes of Health (NIH) will apply to grants awarded under this RFA. Awards under this RFA to foreign institutions will be made only in accordance with PHS policy governing such awards. INQUIRIES Inquiries concerning this RFA are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues to: Bob Vollinger, M.S.P.H. Tobacco Control Research Branch Division of Cancer Control and Population Sciences National Cancer Institute 6130 Executive Blvd., EPN 4030 Bethesda, MD 20892 Telephone: (301) 496-0273 FAX: 301-496-8675 Email: Bob.Vollinger@nih.gov Direct inquiries regarding review issues to: Ms. Toby Friedberg Referral Officer Division of Extramural Activities National Cancer Institute 6116 Executive Blvd., Room 8109, MSC-8329 Rockville, MD 20852 (express courier) Bethesda MD 20892-8329 Telephone (301) 496-3428 Fax: (301) 402-0275 Email: tf12w@nih.gov Direct inquiries regarding fiscal matters to: Dena Solomon Grants Administration Branch National Cancer Institute Executive Plaza South, Room 243 Bethesda, MD 20892 Telephone: (301) 496-7208 FAX: (301) 496-8601 Email: solomond@gab.nci.nih.gov LETTER OF INTENT Prospective applicants are asked to submit, by January 9, 2001, a letter of intent that includes a descriptive title of the proposed research, the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number and title of the RFA in response to which the application may be submitted. Although a letter of intent is not required, is not binding, and does not enter into the review of subsequent applications, the information that it contains allows NIH staff to estimate the potential review workload and to plan the review. The letter of intent is to be sent to Bob Vollinger, M.S.P.H. listed under INQUIRIES by the letter of intent receipt date. SCHEDULE Letter of Intent Receipt: January 9, 2001 Application Receipt: February 13, 2001 Peer Review Date: June 2001 Review by NCAB Advisory Board: September 2001 Earliest Anticipated Start Date: December 2001 APPLICATION PROCEDURES The modular grant concept establishes specific modules in which direct costs may be requested as well as a maximum level for requested budgets. Only limited budgetary information is required under this approach. The just-in- time concept allows applicants to submit certain information only when there is a possibility for an award. It is anticipated that these changes will reduce the administrative burden for the applicants, reviewers and Institute staff. The research grant application form PHS 398 (rev. 4/98) is to be used in applying for these grants, with the modifications noted below. Applications kits are available at most institutional offices of sponsored research and may be obtained from the Division of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301/710-0267, email: grantsinfo@nih.gov. For those applicants with Internet access, the 398 kit may be found at: http://grants.nih.gov/grants/forms.htm. Applicants are strongly encouraged to call the program contacts listed in INQUIRIES above with any questions regarding the responsiveness of their proposed project to the goals of this RFA. SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS BUDGET INSTRUCTIONS Modular Grant applications will request direct costs in $25,000 modules, up to a total direct cost request of $250,000 per year. (Applications that request more than $250,000 direct costs in any year must follow the traditional PHS 398 application instructions.) The total direct costs must be requested in accordance with the program guidelines and the modifications made to the standard PHS 398 application instructions described below: o FACE PAGE: Items 7a and 7b should be completed, indicating Direct Costs (in $25,000 increments up to a maximum of $250,000) and Total Costs [Modular Total Direct plus Facilities and Administrative (F&A) costs] for the initial budget period. Items 8a and 8b should be completed indicating the Direct and Total Costs for the entire proposed period of support. o DETAILED BUDGET FOR THE INITIAL BUDGET PERIOD - Do not complete Form Page 4 of the PHS 398. It is not required and will not be accepted with the application. o BUDGET FOR THE ENTIRE PROPOSED PERIOD OF SUPPORT - Do not complete the categorical budget table on Form Page 5 of the PHS 398. It is not required and will not be accepted with the application. o NARRATIVE BUDGET JUSTIFICATION - Prepare a Modular Grant Budget Narrative page (see http://grants.nih.gov/grants/funding/modular/modular.htm for sample pages). At the top of the page, enter the total direct costs requested for each year. This is not a form page. o Under Personnel, list all project personnel, including their names, percent of effort, and roles on the project. No individual salary information should be provided. However, the applicant should use the NIH appropriation language salary cap and the NIH policy for graduate student compensation in developing the budget request. For Consortium/Contractual costs, provide an estimate of total costs (direct plus facilities and administrative) for each year, each rounded to the nearest $1,000. List the individuals/organizations with whom consortium or contractual arrangements have been made, the percent effort of key personnel, and the role on the project. Indicate whether the collaborating institution is domestic or foreign. The total cost for a consortium/contractual arrangement is included in the overall requested modular direct cost amount. Include the Letter of Intent to establish a consortium. Provide an additional narrative budget justification for any variation in the number of modules requested. o BIOGRAPHICAL SKETCH - The Biographical Sketch provides information used by reviewers in the assessment of each individual"s qualifications for a specific role in the proposed project, as well as to evaluate the overall qualifications of the research team. A biographical sketch is required for all key personnel, following the instructions below. No more than three pages may be used for each person. A sample biographical sketch may be viewed at: http://grants.nih.gov/grants/funding/modular/modular.htm. - Complete the educational block at the top of the form page, - List position(s) and any honors, - Provide information, including overall goals and responsibilities, on research projects ongoing or completed during the last three years, - List selected peer-reviewed publications, with full citations. o CHECKLIST - This page should be completed and submitted with the application. If the F&A rate agreement has been established, indicate the type of agreement and the date. All appropriate exclusions must be applied in the calculation of the F&A costs for the initial budget period and all future budget years. The applicant should provide the name and phone number of the individual to contact concerning fiscal and administrative issues if additional information is necessary following the initial review. Applications not conforming to these guidelines will be considered unresponsive to this RFA and will be returned without further review. The RFA label available in the PHS 398 (rev. 4/98) application form must be affixed to the bottom of the face page of the application. Type the RFA number on the label. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. In addition, the RFA title and number must be typed on line 2 of the face page of the application form and the YES box must be marked. The sample RFA label available at: http://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to allow for this change. Please note this is in pdf format. Submit a signed, typewritten original of the application, including the checklist, and three signed, exact, single-sided photocopies, in one package to: Center for Scientific Review National Institutes of Health 6701 Rockledge Drive, Room 1040 - MSC 7710 Bethesda, MD 20892-7710 Bethesda, MD 20817 (for express/courier service) At the time of submission, two additional copies of the application must be sent to: Ms. Toby Friedberg Division of Extramural Activities National Cancer Institute 6116 Executive Boulevard, Room 8109, MSC 8329 Bethesda, MD 20892-8329 Rockville, MD 20852 (for express/courier service) Applications must be received by February 13, 2001. If an application is received after that date, it will be returned to the applicant without review. The Center for Scientific Review (CSR) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The CSR will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of substantial revisions of applications already reviewed, but such applications must include an introduction addressing the previous critique. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by CSR and responsiveness by the NCI. Incomplete and/or non-responsive applications will be returned to the applicant without further consideration. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by the Division of Extramural Activities of the National Cancer Institute in accordance with the review criteria stated below. As part of the initial merit review, all applications will receive a written critique and undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of the applications under review, will be discussed assigned a priority score, and receive a second level review by the National Cancer Advisory Board (NCAB). Review Criteria The five criteria to be used in the evaluation of grant applications are listed below. The goals of NIH-supported research are to advance our understanding of biological systems, improve the control of disease, and enhance health. The reviewers will comment on the following aspects of the application in their written critiques in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. Each of these criteria will be addressed and considered by the reviewers in assigning the overall score weighting them as appropriate for each application. Note that the application does not need to be strong in all categories to be judged likely to have a major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward. Significance: Does this study address an important problem? If the aims of the application are achieved, how will scientific knowledge and public health be advanced? What will be the effect of these studies on the concepts or methods that drive this field? Approach: Are the conceptual framework, design, methods, and analyzes adequately developed, well-integrated, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics? Innovation: Does the project employ novel concepts, approaches or method? Are the aims original and innovative? Does the project challenge existing paradigms or develop new methodologies or technologies? Investigator: Is the investigator appropriately trained and well suited to carry out this work? Does the investigator (or team of investigators) have experience in community or State-level research or in the field of tobacco control? Is the work proposed appropriate to the experience level of the principal investigator and other researchers (if any)? Environment: Does the scientific environment in which the work will be done contribute to the probability of success? Do the proposed experiments take advantage of unique features of the scientific environment or employ useful collaborative arrangements? Is there evidence of institutional support ? The initial review group will also examine: the adequacy of plans to include both genders and minorities and their subgroups, and children as appropriate for the scientific goals of the research and plans for the recruitment and retention of subjects, the provisions for the protection of human and animal subjects, and the safety of the research environment. AWARD CRITERIA Award criteria that will be used to make award decisions include scientific merit as determined by peer review, availability of funds, and programmatic priorities. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing research involving human subjects should read the UPDATED "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research," published in the NIH Guide for Grants and Contracts on August 2, 2000 (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html), a complete copy of the updated Guidelines are available at http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm: The revisions relate to NIH defined Phase III clinical trials and require: a) all applications or proposals and/or protocols to provide a description of plans to conduct analyses, as appropriate, to address differences by sex/gender and/or racial/ethnic groups, including subgroups if applicable, and b) all investigators to report accrual, and to conduct and report analyses, as appropriate, by sex/gender and/or racial/ethnic group differences. INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS. It is the policy of NIH that children (i.e., individuals under the age of 21) must be included in all human subjects research, conducted or supported by the NIH, unless there are clear and compelling reasons not to include them. This policy applies to all initial (Type 1) applications submitted for receipt dates after October 1, 1998. All investigators proposing research involving human subjects should read the NIH Policy and Guidelines on the Inclusion of Children as Participants in Research Involving Human Subjects that was published in the NIH Guide for Grants and Contracts, March 6, 1998, and is available at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html. Investigators may also obtain copies of these policies from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. URLS IN NIH GRANT APPLICATIONS OR APPENDICES All applications and proposals for NIH funding must be self-contained within specified page limitations. Unless otherwise specified in an NIH solicitation, Internet addresses (URLs) should not be used to provide information necessary to the review because reviewers are under no obligation to view the Internet sites. Reviewers are cautioned that their anonymity may be compromised when they directly access an Internet site. HEALTHY PEOPLE 2010 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2010," a PHS-led national activity for setting priority areas. This RFA, Research in State and Community Tobacco Control Intervention, is related to priority area of tobacco and cancer. Potential applicants may obtain a copy of "Healthy People 2010" at http://www.health.gov/healthypeople/. AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance No. 93.397. Awards are made under authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and administered under NIH grants policies and Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. The PHS strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care, or early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. References: 1. American Cancer Society. Cancer Facts & Figures 1996, 24-26, 1996. 2. Bartecchi CE, MacKenzie TD and Schrier RW. "The Human Costs of Tobacco Use." New England Journal of Medicine, 330:907-912, 1994. 3. Bartlett JC, Miller LS, Rice DP et al. Medical-Care Expenditures Attributable to Cigarette Smoking--United States, 1993. Morbidity and Mortality Weekly Report, 43:469-72, 1994. 4. U.S. Department of Health and Human Services and U.S. Environmental Protection Agency. Respiratory. Health Effects of Passive Smoking: Lung Cancer and Other Disorders. The Report of the U.S. Environmental Protection Agency. National Cancer Institute, Bethesda, MD. 1993. NIH Publication No. 93-3605. 5. Centers for Disease Control and Prevention. "Cigarette Smoking Among Adults--United States, 1994." Morbidity. and Mortality. Weekly Report, 45:588-590, 1996. 6. Thomas RM, Larsen MD. Smoking Prevalence, Beliefs, and Activities by Gender and Other Demographic Indicators. The Gallup Organization, Inc., Princeton, NJ, 1993. 7. Pierce JP, Fiore MC, Novotny TE et al. "Trends in Cigarette Smoking in the United States." Journal of the American Medical Association, 261:61-6, 1989. 8. Crump C, Packer L, Gfroerer J. "Incidence of Initiation of Cigarette Smoking--United States, 1965-1996." Morbidity and Mortality Weekly Report, 47:837-41, 1998. 9. National Cancer Institute. Strategies To Control Tobacco Use in the United States: A Blueprint for Public Health Action in the 1990"s. National Institutes of Health, 1991. Publication No. 92-3316. 10. National Cancer Institute. The National Cancer Institute Tobacco Research Implementation Group. National Cancer Institute, Bethesda, MD, 1998. (Available at http://dccps.nci.nih.gov/tcrb/TRIP) 11. Thompson, Beti, et. al. (1991). Principles of Community Organization and Partnership for Smoking Cessation in the Community Intervention Trial for Smoking Cessation (COMMIT) In a Special issue of the International Quarterly of Community Health Education: A Journal of Policy and Applied Research, Volume 11, No. 3. 1990-91. 12. Report of the National Cancer Institute Cancer Control Review Group. National Cancer Institute, 1997. (Available at http://deainfo.nci.nih.gov/advisory/bsa/bsa_program/bsacacntrlmin.htm)

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