A: TReND began in 2004 as the Tobacco Health Disparities Research Network, following a 2002 meeting entitled the National Conference on Tobacco-Related Health Disparities. Over 100 recommendations came out of that meeting, and developing a network was a means to address some of the recommendations, facilitate transdisciplinary science, and collectively conduct tobacco-related health disparities research.  NCI and the American Legacy Foundation partnered to fund a 5-year network that would help do those things, and with the development of our logo, the name changed to the Tobacco Research Network on Disparities, or TReND.  In 2003, a small group of us convened to develop the concept for the network, and regular meetings began in September 2004.  Before TReND, there were significant gaps in tobacco-related health disparities research, and to eliminate disparities, we need high risk, cutting edge, innovative research. It was important to provide a venue for doing so, because many of the grant mechanisms do not provide for that. TReND research will hopefully prime the grant pool.

Q: What was the motivation to begin researching this particular cohort?

A: In 1980, the first Surgeon General’s Report (SGR) on Women, Tobacco, and Cancer was released, finally linking smoking to cancer among women. This was 16 years after the release of the 1964 SGR linking smoking to lung cancer. The second SGR detailed significant gaps, which include the lack of research on tobacco use and exposure among low socioeconomic status women and girls. Not much is known about smoking among low socioeconomic status women, except pregnant women. We know that smoking rates in general are lower among women compared to men, but low socioeconomic status women have higher rates of smoking and lower rates of quitting compared to women of higher socioeconomic status women. Women and girls of low socioeconomic status are at increased risk for lung cancer and other tobacco-related diseases because of this, and the chronicity of things such poverty put women and girls’ health and social wellbeing at risk. This is a high priority given that women and girls are the primary caregivers for their families and their health and well-being impacts future generations’ health and wellbeing.

Q: What steps need to be taken to ensure that low SES women and girls are able to take advantage of the benefits of recent tobacco policy changes?

A: It is important to continue to assess how polices impact low SES women and girls. These policies are at a population-level, so continued monitoring of policies and their impact is needed.

Q: How are policymakers and other researchers translating the science coming out of TReND?

A: We’re not sure. We hope that we have informed policy and translation research. In addition, community-based organizations are in a good position to use our research to inform practice; researchers who work closely with community-based organizations have the linkages to make this happen.

Q: What was your motivation for joining TReND? How did you learn about it?

A:  I have worked for twenty years in the tobacco control movement and many of those years I have focused on women and tobacco issues. Through that work I learned that issues of gender, race/ethnicity, and class were not adequately addressed by mainstream tobacco control researchers and policymakers. My interest was piqued by the opportunity to participate in a research network that would think outside the box on issues that were dear to me.  I learned about TReND through my friend and colleague, Pebbles Fagan.

Q: As someone who has background in policymaking and government, specifically in women’s health, do you feel that the recommendations in the report “Women, Tobacco and Cancer: An Agenda for the 21st Century” (2004) have been implemented to the fullest extent?

A:  We have only begun to scratch the surface.

Q: What other steps should be taken to reduce tobacco disparities among women and girls in the U.S.?

A: In response, I draw upon the work of two mentors, Lorraine Greaves and Hilary Graham, who have contributed to my thinking. First, we need to move beyond a parochial focus on tobacco use and improve the social and living conditions in which many women and girls live. Although researchers, clinicians, and policymakers may define people as “smokers” and “nonsmokers,” smoking is usually part of a constellation of behaviors and social conditions that women may experience.  I’m persuaded by Graham’s research which speaks both to “biographies of disadvantage” that influence women’s smoking across the lifecourse, and the need to target interventions for smokers and the social conditions in which they live. Second, to assist us in better understanding the influence of social conditions and the role of the lifecourse, longitudinal surveys should be funded and conducted to incorporate questions about health behaviors and measures of wealth. In addition to quantitative surveys, qualitative research is necessary to understand nuanced experiences of gender, diversity, and social condition. And finally, gender and diversity based analyses should be conducted before policies are passed.

Q: Do you feel that more collaboration is needed with women’s groups and other stakeholders? What kinds of cooperative efforts would be the most effective to reach this population?

A: Yes, more collaboration is necessary. If we broaden our agenda to address improvements in  education, working conditions, and financial security, women’s groups and other stakeholders will be more interested in working with us. The tobacco control movement, as a whole, has always been too focused on its own agenda, and unwilling to work on collaborators’ issues. This is critical to true collaboration.