working group of the National Cancer
Institute (NCI) has released a series
of recommendations aimed at
stimulating scientific research into
tobacco-related cancers in women and
translating discoveries into evidencebased
interventions to prevent the
The report, "Women, Tobacco,
and Cancer: An Agenda for the 21st
Century," noted that the incidence
and mortality rates of smoking-related
cancers in US women soared during
the second half of the 20th century.
Lung cancer mortality in women
increased 600% between 1950 and
1997, making it the leading cause of
cancer death in females.
The NCI working group comprised
experts from the institute, other federal
agencies, nongovernment research
institutions, and advocacy
groups. Members drew in part on information
contained in several recent
reports, including the 2001 Surgeon
General's report, "Women and Smoking,"
which highlighted the importance
of gender-specific research into
tobacco use and effects.
The panel set several key goals for
future research into tobacco-related
cancers in women:
Increase our understanding of
sex differences across the broad range
of research on women, tobacco, and
Develop new and more effective
interventions to prevent and treat tobacco
use and environmental tobacco
smoke exposure among women
and girls, especially in populations at
greatest risk; expand partnerships,
networks, and innovative research
platforms to ensure the widespread
delivery of these interventions.
Improve national and global
evaluation and surveillance of the
health hazards related to tobacco use
and ETS exposure, specifically, of
women's and girls' knowledge, attitudes,
and behaviors related to tobacco
use and associated risks.
The working group emphasized
that there is a critical need to better
understand sex differences as they relate
to all phases of tobacco addiction
and tobacco-related diseases.
"This includes genetic, molecular,
cellular, neurobiological, biobehavioral,
and hormonal factors that
play a critical role in tobacco addiction
and in the etiology of cancers
and other diseases caused by tobacco,"
the working group stated.
Researchers also need to decipher
the etiologic role of gene-hormoneenvironment
interactions in the cancers,
and discover new methods for
prevention and treatment of tobacco
addiction. In addition, the NCI panel
said that development of better treatment
and prevention techniques requires
identifying the behavioral,
psychosocial, sociocultural, and environmental
factors that influence tobacco
use, exposure to second-hand
smoke, and disease risk.
Translating basic and applied research
into effective interventions will
depend on advances in four areas:
Using evidence from animal
studies, pilot projects, and small clinical
and community studies to develop
new interventions for prevention,
cessation, and treatment.
Finding ways to use or modify
existing infrastructures to rapidly evaluate
the efficacy of promising treatments
and the effectiveness and costefficiency
of proven small-scale
programs and policies.
Exploring and strengthening the
positive health effects of tobacco-control policies on women and girls.
Monitoring the harmful effects
of tobacco marketing on females.
Delivering the proven results of research
and development efforts will
depend on finding ways to increase
the appeal, access, affordability, and
use of effective interventions, the
working group said. This, in turn, will
require identifying and targeting messages
and strategies that successfully
involve individuals and organizations
in evidence-based tobacco-control
policies. Data from research-including
surveillance, policy, economic,
and cultural studies-need to be more
available to health care workers, policy
makers, and the public, the panel
The NCI report also stressed the
importance of partnerships between
government agencies, nongovernment
organizations, private foundations,
corporations, academic institutions,
and community groups in accelerating
progress in tobacco-related interventions
aimed at women and girls.
Finally, the panel cited the importance
of local, national, and worldwide
evaluation and surveillance in
determining the progress of efforts to
reduce tobacco use, ETS exposure,
and tobacco-related cancers among
women and girls, and to make changes
in programs when needed.