Nicotine & Tobacco Research (1999) 1, S15-$23
Transdisciplinary paradigms for tobacco prevention research David B. Abrams
Introduction Especially within the latter half of the 20th century, incredible progress has been made in understanding how nicotine sustains compulsive use of tobacco products despite clear evidence of enormous harm. But it is unclear how to delineate the best ways to combine these different streams of knowledge--from diverse and often insular disciplines--to advance the field. A new conceptual model must emerge from a true transdisciplinary synthesis of biopsychosocial perspectives, rather than the multidisciplinary approach. A multidisciplinary approach adds one or two methods or measures from another discipline to an existing research program but falls short of full transdisciplinary integration (Stokols, 1998; Kahn & Prager, 1994). The characteristics of transdisciplinarity are collaboration, openness, trust, self-confidence with one's own discipline, and comfort that facilitates mutual respect and two-way communication. Transdisciplinarity is about the constructive breaking down of disciplinary boundaries and the institutional barriers that impede true collaborative work. Kahn and Prager (1994) identify certain milestones or phases that mark a transition from uni- and multi- to transdisciplinarity. The early phases include listening across the divide, use of analogy and metaphor, and finding common ground. Late phases include the emergence of shared language, new measures, and methods. As stated by Sir Isaac Newton in a letter to Robert Hooke, "If I have seen further, it is by standing on the shoulders of giants" (Turnbull, 1959). The Sundance conference, sponsored by the Robert Paper prepared for New Partnerships and Paradigms for Tobacco Prevention Research, a conference sponsored by the Robert Wood Johnson Foundation, Sundance, Utah, 6--7May I997. 1Portions of this paper are adapted from: Abrams DB. (in press). Nicotine addiction: paradigms for research in the 21st century. Proceedings of 'Addicted to Nicotine: A National Research Forum.' Nicotine & Tobacco Research.
David B. Abrams,PhD, BrownUniversityCenterfor Behavioraland Preventive Medicine, Brown University School of Medicine and The Miriam Hospital, Providence,Rhode Island, USA. Correspondence to: David B. Abrams, PhD, Director, Brown UniversityCenterfor Behavioraland PreventiveMedicine, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906, Tel.: (40I) 793--4315; FAX: (401) 331-2453. Email:
[email protected]
Wood Johnson Foundation, may well go down in history as a marker of a major paradigm shift toward transdisciplinary thinking about tobacco prevention research. Historians of science may want to note the transition. Program evaluators may want to measure the specific markers of the paradigm shift toward transdisciplinarity and track over time whether the field moves in that direction over the next few decades. New paradigms are needed for tobacco prevention research that (a) characterize patterns of initiation, use, and cessation over time; and (b) bridge the boundaries between disciplines, both within and across different levels or 'systems' of structure from molecular (cellular) to molar (societal); and from fundamental science to policy applications (see Figure 1). Characterization of the patterns of tobacco initiation, use, and cessation must include both aggregate (group, population) and individual units of analysis. At the population level, it will be important to study the forces that determine the rise and fall of tobacco use within and across the generations over the years and decades of the 21st century. At the individual level, we need to know more about the forces that determine risk of tobacco initiation, progress to dependence, and relapse across at least two or three generations of the human lifespan. The goal is simply stated: complete elimination of the extra-cellular human exposure of our children to tobacco products in all forms. Nicotine can be a useful medication, when used appropriately. Tobacco products are the vector of one of the most health-damaging, human-created epidemics of all time. It is caused solely by the invention of cigarettes and other tobacco products and by the aggressive marketing and reckless greed of the tobacco industry. Apparently, societies are as 'addicted' to the economic benefits of the tobacco industry as individuals are to tobacco products. In the developed nations from 1950 to 1999, tobacco has already killed more than 10 million women and 60 million men, and it will kill many more people worldwide in the next century (Murray & Lopez, 1996). The World Health Organization (WHO) reports that tobacco will kill more people by the year 2020 than the
1462-2203199/S10015-09 © 1999 Societyfor Research on Nicotine and Tobacco
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