In the past 20 years, a solid scientific base of information has been codified showing that the majority of cancers are closely linked to lifestyle and environmental factors. To act on this knowledge, however, and modify the conditions for the public to profit from this knowledge is a major challenge. In the mid-1980s the National Cancer Institute (NCI) began a new initiative to reduce cancer mortality 50% by the end of this century. This effort is aimed at saving hundreds of thousands of lives partly through primary prevention measures, and particularly by reducing the prevalence of tobacco use.
The first conclusive evidence linking smoking to cancer is nearly 4 decades old. In 1950, Wynder and Graham published sufficient evidence that smoking causes lung cancer. A decade and a half later, the Surgeon General of the United States published his first Report on Smoking and Health. This monograph was a landmark document in the US. It became the base from which a series of additional reports on varying aspects on smoking and disease evolved. Although encouraging changes have taken place in smoking behavior in the US—as many as 37 million Americans have stopped smoking in the past several decades—approximately 54 million Americans continue to smoke, and the prevalence of smoking behavior among females remains at levels that foreshadow continued increases in lung cancer mortality in women for at least another decade. The need for new knowledge about innovative, effective, and long lasting ways to control tobacco use is paramount. Efforts to generate this knowledge must be given a high priority between now and the end of this century. canadian neighbor pharmacy com
NCI’s Response—An Intensive Intervention Research Program
In 1982 the NCI launched its new Smoking, Tobacco, and Cancer Program (STCP). A commitment was made to develop and test intervention strategies to reduce tobacco use and then to apply the best of these strategies in large target populations. The STCP now includes 55 prevention and cessation trials, affecting over 10 million people. It is being carried out in 25 states and in over 200 North American cities. Each of these trials lasts about 5 years and most are characterized as phases 3 and 4 of the cancer control phases (Fig 1). The cost for these trials is about $155 million. These trials encompass a broad program testing 4 intervention channels, schools, physicians and dentists, self-help, and the media in 6 target populations, blacks, Hispanics, women, youth, smokeless tobacco users, and heavy smokers (Fig 2).