Tobacco prevention and cessation efforts at the Center

Published: November 16, 2023

Tobacco causes many types of cancer: 90% of lung cancer cases are caused by smoking cigarettes, and 29% of all cancer deaths are due to cigarette smoking. Other cancers throughout the body — mouth and throat, cervical, and liver, among others — have also been linked to smoking (cigarettes, cigars, e-cigarettes) and smokeless (dip, chew) forms of tobacco1.

Smoking remains the single largest preventable cause of death and illness in the world, causing an estimated 480,000 deaths every year, or about 1 in every 5 deaths, in the United States. That’s more than the combined number of deaths attributable to murder, suicide, illegal drug use, alcohol abuse, car accidents, and AIDS-related illnesses2.

But the possibility of ingesting a harmful substance is often ineffective rhetoric for persuading people to end tobacco use. Quitting is challenging due to the highly addictive drug (nicotine) found in tobacco and often requires a myriad of evidence-based methods, such as telephone quitlines, Nicotine Anonymous meetings, and nicotine replacement therapy. Because tobacco consumption now includes e-cigarette use, modern cessation interventions also provide education and resources related to quitting vaping. Doctors, counselors, and pharmacists can offer professional medical advice on individualized approaches. 

Decades of tobacco cessation efforts have led to higher cigarette taxes, restrictions on some types of tobacco advertising, and policy changes, such as workplace smoking bans. Additionally, the American Cancer Society-hosted Great American Smokeout, an annual event since 1977, “challenges people to stop smoking and helps people learn about the many tools they can use to help them quit and stay quit” on the third Thursday of every November3.

At the Michael & Susan Dell Center for Healthy Living, Drs. Steve Kelder, Melissa Blythe Harrell, and Emily T. Hébert, among other faculty members, engage in research and projects related to both tobacco prevention and cessation. To learn about the Center’s tobacco-related work, visit our Research & Resource Station.

Steve Kelder, PhD

Dr. Kelder, a senior faculty member at the Center with tobacco expertise, served as a Senior Editor for the 2016 Surgeon General’s Report on e-cigarette use among youth and young adults, and as an expert witness in a class action suit against JUUL and Altria (2023). The case ended in a settlement for over 2 billion dollars, to be paid to over 1,500 school districts and counties nationwide by both JUUL and Altria. 

Dr. Kelder is the Principal Investigator (PI) for the Coordinated Approach To Child Health (CATCH) My Breath, an evidence-based vaping prevention program for students in grades 5-12. Developed as a rapid response to emerging vaping trends among teens, the program equips students with the tools to make healthy choices in social situations that may pressure them to use e-cigarettes. The program’s curriculum is accessible online and is zero cost for U.S. schools. 

Dr. Kelder is one of the lead investigators for ‘CATCH,’ a school-based research program promoting physical activity, healthy food choices, and oral health, and preventing tobacco and e-cigarette use. He lists his research interests as the relationship between climate change and child health outcomes; behavioral epidemiology of oral health and tobacco/e-cigarette use in children; and school-based child health programs that support healthy eating and physical activity.

Melissa Blythe Harrell, PhD

Dr. Harrell served as a Senior Editor for two Surgeon General’s Reports on tobacco and e-cigarette use among young people and as an expert witness in Minnesota v. JUUL. In both roles, she compiled extensive research to help practitioners and advocates.

“These Reports serve an important role in our field as a comprehensive, state-of-the-art synthesis of the research,” Dr. Harrell said about her role as Senior Editor.

Currently, Dr. Harrell is working on a comprehensive analysis to understand the ‘gateway effect.’

“I am working to answer the question: ‘Do youth and young adults who start using nicotine by vaping go on to smoke cigarettes?’” Dr. Harrell explained. “After summarizing results from more than 55 longitudinal studies on this topic, the answer is ‘Definitely; yes!’ About 60% of cigarette smoking among youth and young adults could be prevented in the absence of vaping.” 

Dr. Harrell is the PI for ‘TATAMS 2.0,’ a research project about tobacco use trajectories and transitions from adolescence through young adulthood. She lists her research interests as patterns of e-cigarette, cannabis, and other tobacco use among young people; youth risk factors for and health outcomes of tobacco and cannabis use; and behavioral interventions for young people in international settings (e.g., India).

Emily T. Hébert, DrPH

Dr. Hébert focuses much of her research on technology as an effective mode of intervention for tobacco cessation and prevention among adolescents/young adults who have grown up with technology and are active online, and adults who may not have time and access to treatment. 

“85% of U.S. adults own a smartphone,” Dr. Hébert said. “Using technology for tobacco cessation has the potential to widely increase access to evidence-based interventions, and our technology is getting better, so we can personalize treatment using real-time data and sensors to give people individualized support based on how they’re feeling in the moment.”

In the future, as artificial intelligence (AI) output increases, Dr. Hébert's work will continue optimizing technology for tobacco treatment.

“We’re already using AI to predict when someone is likely to lapse during a quit attempt,” Dr. Hébert noted. “I think as the field evolves, we’ll get more accurate in our predictions and be able to do so less invasively, using fitness trackers or other passive methods of data collection.”

Dr. Hébert is the PI for ‘Using Machine Learning to Develop Just-In-Time Adaptive Interventions for Smoking Cessation,’ a research project about a personalized, just-in-time adaptive intervention when machine learning predicts a risk of lapse in smoking cessation. She lists her research interests as mobile technology as a vehicle for health behavior interventions; health behavior intervention access for socioeconomically disadvantaged populations; precision (personalized) interventions for substance use disorders. 

Written by Kirsten Handler, communication specialist at the Michael & Susan Dell Center for Healthy Living.