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Institute for Global Tobacco Control

Knowledge Generation

Knowledge generation, synthesis and translation is one of the three pillars of IGTC's operating framework. Since its inception, the institute has been actively involved in the generation of scientific evidence to support to the development of strong tobacco control policies around the world. The MPOWER policy package frames the range of focus areas in which we engage, including research on tobacco product advertising and health warning label effectiveness. Examples of three such projects are provided below:

Vaping and Patterns of E-cigarette use Research (VAPER) Study

Woman Vaping

Johns Hopkins University, Virginia Commonwealth University (VCU), Ohio State University (OSU), University of South California (USC), and NORC at the University of Chicago (NORC) are conducting the Vaping and Pattern of E-Cigarette Use Research (VAPER) Study, with funding from the U.S. Food and Drug Administration (FDA) and the National Institute on Drug Abuse (NIDA) (2U54DA036105- 06), to better understand the impacts of future policy proposals on e-cigarette use and vaping behavior.

This study will determine the extent to which results from other previous studies (conducted under controlled conditions) are valid population-level predictions. In combination with the other studies, this study will provide the FDA with a set of tools that can be used to guide regulation development such that, by the time a regulation goes into effect, validated methods have been used to test it, refine it, and generate data that show that its health-promoting effects are maximized and unintended consequences are minimized.


The Battle to Increase Tobacco Health Warning Labels: Lessons from India


Tobacco use is a major public health problem in India, with estimates of deaths attributable to tobacco use ranging from 700,000 to almost 1,000,000 deaths per year. The primary goal of this study is to understand the process and determinants that led to the ultimate implementation 85 percent Health Warning Labels (HWLs), with a specific focus on the tactics and arguments used by proponents and opponents of the HWLs. A case study approach was used whereby data were gathered from key informants (N=22) and documents (N=68). Findings showed that proponents launched an effective advocacy campaign that focused on three complementary tactics - litigation, strategic use of the media, and sensitization of decision makers – in order to build awareness of the harms of tobacco use, and the effectiveness of a larger health warning label, elevate the visibility of this policy issue, and persuade the government to take action. The campaign was grounded in scientific evidence and in-depth knowledge of the political context, which also helped advocates better frame their tactics as well as arguments.

Cigarette Health Warning Labels in Indonesia: Identifying the Effectiveness of Religious vs. Non-religious Messages


Indonesia has the largest population of Muslims in the world, and religion’s influence on the country’s political, economic and cultural life is significant. Given the potential role that religion and religious teachings, and religious priorities, hold for the people of Indonesia, we wanted to test its influence in the context of Health Warning Labels (HWLs). We designed HWLs that included religious teaching messages, and surveyed 817 participants convened by University of Airlangga, our data collection partner, along criteria such as smoking status to assess the label’s credibility and/or effectiveness. We also took into account the magnitude of each participant’s religious beliefs, which was measured using the Centrality of Religiosity Scale (CRS).

Four different HWLs with religious-based text were developed to reflect Islam’s negative view of smoking as a health risk. In order to compare the effectiveness of religious messages, we paired selected images with four non-religious messages, and measured the results against religious messages. The overall effectiveness of both religious and nonreligious HWLs were similar (~7 out 10). The credibility of both religious and nonreligious SHS were higher than the other warnings. Gangrene-Religious HWL was significantly rated higher in response to “makes me feel more concerned about smoking” than Gangrene-Nonreligious.

Examining the Appeal of Cigarette Packs Among Adolescents and Young Adults in Mexico City


With the potential to reach millions, advertising is a powerful source used by tobacco companies to recruit and retain smokers. As more countries adopt restrictions on tobacco marketing and promotion, cigarette packs serve as a valuable communicative platform, acting as portable advertising with users disseminating brand imagery and messaging wherever they go. This mixed-methods study will be carried out in two phases. First, we will conduct 12 focus group discussions with adolescent smokers and non-smokers (13-17 years old) and young adult smokers (18-24 years old) in Mexico City to assess which cigarette pack features are most appealing to young people and why. These features may include color, flavor, brand, size, or shape. The features identified through these discussions will inform the next phase of the study: a self-administered survey of adolescents and young adults. Combined, findings from this research will inform advocacy efforts to improve regulations on tobacco advertising and promotion, focusing on pack features that seem to target youth.