Health and Science Research

The Foundation seeks to reduce barriers to quitting and/or switching from combustibles and other toxic tobacco products. We seek to strengthen understanding, knowledge, and research capacity in low- and middle-income countries (LMICs), where most smokers live but often are overlooked, and for others who often are marginalized. To do so, we start with a carefully developed understanding of the research being conducted globally, the gaps in current knowledge, and where funding for tobacco control research is limited.

Our grantee partners are leading global public health organizations that are using innovation and leveraging their vast experience to advance our vital mission in impactful ways, including through the projects detailed below.

A replica project study by the Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), an interdepartmental research center based in Catania, Italy, was published by the scientific journals Nature and Regulatory Toxicology and Pharmacology. This “ring-study” replicated three major studies on next-generation harm reduction products over four years of inter-laboratory work that involved more than 100 researchers and academic laboratories in Indonesia, Oman, Serbia, the USA, and Greece. Replicating relevant studies confirmed lower toxicity of nicotine-releasing electronic devices, with the conclusion that electronic nicotine delivery systems are less toxic than traditional cigarettes.

The Rose Research Center, founded by its CEO Dr. Jed Rose who is a co-inventor of the nicotine patch, conducted research that evaluated smoking cessation and harm reduction strategies to help smokers quit or switch to reduced-risk products. The Center also studied a combination of drugs to facilitate the smoker’s transition from combustible tobacco products to tobacco harm-reduction products. The findings from this vital research were published in May 2022.

"I completely endorse all the fundamental values listed by the Foundation….I would place innovation at the top of our list of what distinguishes us because the [treatment] approaches that I’ve talked about….are ones that I don’t believe anyone else in the world is pursuing….We really need innovative approaches to help them quit or switch to less harmful products.”

Jed Rose
Rose Research Center, President

Analytisch-biologisches Forschungslabor (ABF) GmBH, a Germany-based bioanalytical research laboratory, conducted a clinical trial to identify and assess biomarkers and/or biomarker patterns of exposure in various human body fluids to discern between nicotine product-use groups systematically and objectively. The findings from this work were published by the journals Contemporary Clinical Trials Communications and Separations. Several bioanalytical methods were successfully developed and validated as part of this research project. The data represent the first systematic evaluation of new emerging nicotine delivery products.

Knowledge•Action•Change (KAC) is an organization in the UK that focuses on harm reduction as a key public health strategy. One of its initiatives is the Tobacco Harm Reduction Scholarship Programme, which provides scholarships to researchers, primarily from LMICs, who are given the opportunity to develop skills and undertake research to advance knowledge and understanding of tobacco harm reduction (THR) as a tool to ending the use of combustible tobacco. Seventy-five scholars from 33 countries completed their work and their achievements were documented in KAC’s “The First Three Years” report, which also provides details on the impact of the scholarship program and plans for the next three years.


KAC also presented the Global State of Tobacco Harm Reduction (GSTHR) 2021 report: Tobacco Harm Reduction: A Burning Issue for Asia, which examines a geographic area where 60% of the world’s smokers live and almost half the global deaths from smoking occur. Asia is also home to nine of every ten users of smokeless tobacco, which has led to high rates of oral cancer in the region. This GSTHR report was the latest in a series that examines progress in and barriers to THR around the world. The reports are featured on a dedicated website – GSTHR.org – that allows users to search, compare, and build data visualizations using regularly updated smoking and THR statistics for more than 200 countries and territories. This is the first time this type of comprehensive global THR resource has been available to researchers.

“The Foundation has core values guiding its work, in fact, they reflect the core values of our organization, including Collaboration, Transparency, Integrity, Diversity, Equity and Inclusion all of these things run right through what we are trying to do at Knowledge•Action•Change.”

Gerry Stimson
Director of Knowledge•Action•Change

Cambridge Design Partnership (CDP), an innovation partner based in the UK and the USA, explored the impediments to mass adoption of reduced-risk products (RRPs) in LMICs, specifically Russia, China, India, and Indonesia. The Impediments to tobacco harm reduction in LMICs report outlines CDP’s research findings and discusses the range of impediments to RRP adoption, particularly the public’s general lack of acknowledgment that they are at risk from combusted tobacco use, which diminishes the drive to seek RRPs. The results from this research provide a valuable dataset to help steer the direction of future efforts in the understanding of RRPs among consumers in these markets.

BOTEC Analysis

BOTEC Analysis, a group of global researchers, practitioners, and former policy makers who work to solve problems of public health and safety, conducted an interdisciplinary investigation into the drivers of smoking cessation in five countries with alternative nicotine delivery systems (ANDS) markets. The result of this study was a series of five national case studies for Australia, Canada, Great Britain, Japan, and South Korea that highlighted lessons and specific recommendations that may be practical for successful cessation efforts around the world.

BOTEC studied the relationship between tobacco control policies, ANDS use, and smoking cessation, as well as other salient aspects of the national tobacco control landscape. The work drew on an interdisciplinary framework for investigation, combining sociological, ethnographic, policy analytics, and econometric disciplinary approaches for studying the drivers of smoking cessation at the individual, micro-, meso-, and macro-population levels.

Cornell University

Leading health economists at Cornell University initiated a cross-country study that aims to develop empirical evidence, using cost-benefit analysis, to help guide public policies and end smoking in this generation. Built on the premise that consumers compare the benefits (current satisfaction) of smoking to the full cost, which includes both the monetary cost and future health costs, this study comprises five distinct projects that examine the effect of the COVID-19 pandemic on adult smoking and vaping. The researchers analyzed patterns and trends in smoking and tobacco harm reduction (THR) product use in multiple countries. They also conducted a cost-benefit analysis of tobacco regulations and experiments to provide empirical evidence on consumer choices. The research program is designed to identify THR product regulations that lead to high quit rates while limiting youth initiation of tobacco use, minimizing illicit trade, and building economic research capacity on THR products among economists globally.

“The Foundation values are all great, it’s hard to choose one. I would stress the importance of integrity as a value…if scientific research is not done with integrity it doesn’t contribute to science”

Prof. Donald Kenkel
Cornell University

The UK-based Centre for Health Research and Education Limited (CHRE) developed a smoke-free mental health protocol to support people in the care of Priory Group, the UK’s leading independent provider of behavioral health care. To implement a new sustainable smoke-free policy on Priory Group’s premises, CHRE created a two-hour interactive e-learning course that was completed by more than 3,000 staff members who then supported patients in their efforts to quit smoking and provided information on THR products to help them quit. The staff could also access a helpline seven days a week during the first COVID-19 lockdown to aid them in offering this support. A virtual smoke-free summit and an e-cigarette vending machine pilot project also launched.

“Each of these values really means something to what we do, its part of our DNA. That’s what makes our work enjoyable, satisfying and impactful but also that’s what makes us want to keep working with the Foundation because we see a clear alignment in our values across the board.”

Dr. Sudhanshu Patwardhan
Founder of Centre for Health Research and Education