A review of tobacco regulatory science research on vulnerable populations

Prev Med. 2019 Nov:128:105709. doi: 10.1016/j.ypmed.2019.04.024. Epub 2019 May 2.


In 2013 the U.S. Food and Drug Administration and National Institutes of Health established fourteen Tobacco Centers of Regulatory Science (TCORS) to advance scientific knowledge relevant to conducting evidence-based tobacco regulation. This report reviews TCORS-funded research with adult vulnerable populations. The literature search included a list of all TCORS-funded publications compiled by the TCORS coordinating center; all TCORS were requested to share publications not in the coordinating-center's list. Only TCORS-funded reports describing an empirical study with an adult vulnerable population published in a peer-reviewed journal between September 2013 and June 2018 were included. 71 reports met inclusion criteria; 39% (28/71) examined tobacco use among those with mental health and medical comorbidities, 34% (24/71) socioeconomic disadvantage, 31% (22/71) women of reproductive age, 30% (21/71) racial/ethnic minorities, 18% (13/71) rural residents, and 3% (2/71) each among active military/veterans and sexual/gender minorities. Regarding scientific domains, 63% (45/71) investigated behavior, 37% (26/71) addiction, 24% (17/71) health effects, 20% (14/71) impact analyses, 18% (13/71) toxicity, 8% (6/71) marketing influences, and 7% (5/71) communications. Totals exceed 100% because some reports addressed multiple populations/domains. TCORS funding has generated a substantial, multidisciplinary body of new scientific knowledge on tobacco use in adult vulnerable populations. However, considerable variability was noted in the amount of research conducted across the various vulnerable populations and scientific domains. Most notably, relatively few studies focused on active military/veterans or sexual/gender minorities, and the scientific domains of marketing influences and communications were conspicuously underrepresented. These are important knowledge gaps to address going forward.

Keywords: Adults; Cigarettes; Nicotine; Tobacco; Tobacco regulatory science; Vulnerable populations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Community-Based Participatory Research*
  • Ethnicity / education*
  • Ethnicity / statistics & numerical data
  • Female
  • Health Promotion
  • Humans
  • Male
  • Middle Aged
  • Minority Groups / education*
  • Minority Groups / psychology
  • Minority Groups / statistics & numerical data
  • Research Report*
  • Socioeconomic Factors
  • Tobacco Products / adverse effects*
  • Tobacco Use Disorder / epidemiology
  • Tobacco Use Disorder / prevention & control*
  • Tobacco Use Disorder / psychology*
  • United States / epidemiology
  • Vulnerable Populations / psychology
  • Vulnerable Populations / statistics & numerical data
  • Young Adult