Strengthening actions to end tobacco use

The International Tobacco Control (ITC) Project at the University of Waterloo has been awarded one of six Governor General’s Innovation Awards for 2021. Celebrating excellence in innovation that makes a positive impact on quality of life in Canada, the honour is awarded jointly to the interdisciplinary ITC team including Faculty of Arts’ Geoffrey Fong (Psychology), Faculty of Mathematics’ Mary Thompson (Statistics and Actuarial Science), and Faculty of Health’s David Hammond (School of Public Health and Health Systems).

“With the persistent leadership of Dr. Geoffrey Fong, the ITC Project, centered at the University of Waterloo, is globally renowned for its innovative research supporting and defending effective tobacco control policies such as graphic health warnings, smoke-free laws, advertising bans and tobacco taxes,” states the Governor General’s Innovation Award citation.

“This pioneering research, across 29 countries covering over half of the world’s population, has led Canada and many other countries to strengthen their tobacco control efforts, improving the health of millions of people worldwide,” the citation continued.

> Geoffrey Fong
> Professor, Social Psychology
> Faculty of Arts

Fong, a professor of social psychology, founded the ITC Project in 2002, and has been its Chief Principal Investigator heading the ITC team of more than 150 researchers across its 29 countries. Both Thompson and Hammond have been key project collaborators since then.

“From the very beginning, the ITC Project has been a truly inter-faculty research program involving three faculties at UWaterloo — Arts, Math and Health, with the three of us representing each of the three faculties,” says Fong. “This is a truly special honour in that we are receiving the Governor General’s Innovation Award with five other recipients whose accomplishments are so extraordinary and so diverse—a diversity that is reflective of Canadian society itself.”

Evaluating key policies of the WHO Framework Convention on Tobacco Control (FCTC), the ITC Project has conducted over 170 surveys collecting nearly 400,000 completed surveys, to measure the impact of tobacco control policies of the FCTC including more recent policies such as plain packaging and bans on additives and flavourings in cigarettes. Over the past 20 years, Fong and his colleagues have built the evidence base to promote stronger actions to tackle tobacco smoking — which kills 47,000 people a year in Canada and more than 8 million people a year globally.

Fong recalls the early days of the ITC Project. “Although I had very little background in tobacco research when the ITC concept was developing in my mind, thanks to extraordinary support from colleagues at Waterloo — like Roy Cameron, now a Waterloo distinguished professor emeritus — and top tobacco researchers in the US, U, and Australia, who put their faith in Mary, Dave and me in creating the ITC Project.”

Fong also reflected on why the ITC Project has been recognized for its innovation. “Before ITC, there were almost no international studies of tobacco use, and the few that existed were designed to assess whether smoking was going up or down over time. ITC was the first international tobacco program to be created by research institutions rather than governments and ITC was designed to address not just whether smoking was changing, but how and why —especially whether tobacco control policies were responsible for those changes.”

> David Hammond
> Professor, School of Public Health and Health Systems
> Faculty of Health

Originally joining the ITC Project as a graduate student, Hammond recalls how he was “sent around the world learning how to conduct surveys on the back of mopeds in Taiwan and with school kids in China. Today I lead the ITC research project that examines youth and young people, including how vaping and newer tobacco products are influencing smoking initiation.”

About the Governor General’s award, Hammond said, “It’s a testament to the importance of basic public health research and of international collaborations to understand how global risk factors for chronic disease can be addressed.”

> Mary Thompson
> Professor, Statistics and Actuarial Science
> Faculty of Mathematics

Thompson, a distinguished professor emerita, is currently the ITC Project’s director of data management. From the start of the ITC Project, she has developed or played a leading role in the sampling designs for the ITC surveys in all 29 countries and guided the analyses of the complex data sets that result. “It’s certainly a great honour to be part of this team,” she says, “and being recognized for work that seeks to make a difference in global public health.”

The ITC Project has been active in Canada since the project began, with recent research impacts including Canada’s world precedent-setting plain packaging regulations and automatic increase of tobacco tax rates every five years. One of project’s latest research publications shows the effectiveness of menthol flavour ban in Canada that has led to significant increases in quitting among smokers and lower relapse among former smokers. On April 29, the US FDA announced that the US would also ban menthol cigarettes, highlighting the ITC study and Fong’s estimates based on the Canadian findings that the US menthol cigarette ban would lead an increase of 923,000 smokers to quit.

While the measurable positive impact of ITC Project has been widely recognized with numerous international awards and honours, the work of Fong and his project colleagues continues — “Because of the addictive properties of nicotine, this is a long fight,” says Thompson.  

Given how the nicotine market is rapidly evolving with different forms of vaped nicotine and tobacco, Hammond says more research is needed to understand whether these products are helping smokers to quit, “or keeping them in the market, and possibly recruiting the next generation of young people who have largely turned their back on smoking. Understanding the impact of other factors, such as COVID-19 and cannabis legalization, are also a priority.” 

Fong is grateful to the support of the University, particularly the Office of Research, for making “it possible for our ITC Project to advance the science of population health and to use our evidence to successfully support action to strengthen and accelerate implementation of measures to combat the number one preventable cause of death in the world — tobacco smoking.”