Purpose and Origins

Promoting health by reducing the harm caused by substance abuse is a primary goal of The Robert Wood Johnson Foundation. The Foundation gives special emphasis to tobacco use for a number of reasons. First, the scientific evidence is clear. Nicotine is an addictive drug and tobacco use is the single largest preventable cause of illness and death in the United States. The sheer toll of tobacco on the health and health care costs in the United States is motivation enough for a special emphasis on tobacco. In addition, tobacco use begins almost exclusively among young people, an alarming proportion of whom become dependent on tobacco before they reach adulthood.

Existing efforts to prevent or treat tobacco use and dependence among youth have had very limited success, for several reasons. First is our limited knowledge about the basic causes, processes, and mechanisms by which experimentation with tobacco leads to dependence for some and not for others. Prevention of the transitions leading to increased tobacco use requires that we learn a great deal more. Second, initiation of tobacco use and dependence on nicotine do not occur in a vacuum, but within the dynamic contexts of childhood and adolescence. The developmental context is itself incompletely understood. Third, our knowledge base often is built upon a single disciplinary perspective. Factors influencing the transition from initial to regular use to dependence on tobacco must be more thoroughly understood from a transdisciplinary perspective. This is essential base for the development of new paradigms in the field, and for more effective prevention, treatment, and intervention.

The magnitude of the consequences of tobacco use and dependence in our society, the evident gaps in our understanding of the basic causes, processes, and mechanisms, and the obvious complexity of the research questions that need to be addressed led the Foundation to consider a variety of options. After a lengthy discussion and planning process, the decision was to establish a collaborative research network with expertise from a diverse range of relevant disciplines. Named the Tobacco Etiology Research Network (TERN), it has been funded for eight years at a total cost of approximately $8 million.