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From tobacco research to
tobacco control policies: the
role of advocacy
Xisca Sureda, BPharm, PhD.
Assistant Professor, De...
Why do we research in tobacco control?
To be rich?
To accumulate grants and publications?
To increase your impact factor?
...
Before…
Now…
Australia Cigarettes Plain
Packaging
Tobacco marketing in
the 50s’
Why do we research in tobacco control?
WHA...
Why do we research in tobacco control?
Lancet. 2011;377(9760):139-46.
cites: 663
Br Med J. 1950; 2(4682): 739–748.
cites: ...
Why we do research in tobacco control?
We do research to…
• Establishing the link between smoking and lung cancer, CVD, et...
Why we do research in tobacco control?
But, we do tobacco research above all…
TO IMPROVE THE HEALTH OF THE POPULATION AND ...
What advocacy is?
Advocacy is about making changes to policy and practice that will
improve the lives of the population yo...
So, who is involved in advocacy?
Can my research influence tobacco
control policies?
YES!!!
HOW???
Can I, as a tobacco res...
Why we need research to do advocacy?
THE ROLE OF
TOBACCO
RESEARCHER
BUILT RELATIONSHIPS
GENEREATE
EVIDENCE
DISSEMINATE
THE...
Why we need research to do advocacy?
• Media needs data to communicate results, to sell the new
• Citizen need data to bel...
Why we need research to do advocacy?
• Practitioners need data to intervene appropriately
• NGO, public health and other p...
Why we do research in tobacco control?
0
200
400
600
800
1000
1200
1400
1600
0
10
20
30
40
50
60
70
80
1968 1973 1978 1983...
Generate evidence
First drawbacks we have in our research system: investment
10 % in
Epidemiology,
Occupational and
Public...
Generate evidence
Second drawbacks we have in our research system: What does
the academic structure value us as scientists...
Generate evidence
Second drawbacks we have in our research system: What does
the academic structure value us as scientists...
We need to be clear and concrete in what we need to invest the
money/resources (personal, time) in science  which are the...
Generate evidence in tobacco control
According to an interview with peer-nominated “highly
influential” Australian public ...
The smoke-free legislation in Spain (2011): Law 42/2010
El País, August 2015
El diario.es. February 2015
Generate evidence...
The smoke-free legislation in Spain (2011): Law 42/2010
Aim: To describe smoking visibility and second-hand smoke
(SHS) ex...
The smoke-free legislation in Spain (2011): Law 42/2010
We also measured PM2.5 and airborne nicotine in 92 terraces and sh...
• How can we increase the use of our research in tobacco
control policies?
Generate evidence in tobacco control
Originalit...
Generate evidence in tobacco control
It is an approach that involves researchers and participant working
together to under...
Why we need research to do advocacy?
THE ROLE OF
TOBACCO
RESEARCHER
BUILT RELATIONSHIPS
GENEREATE
EVIDENCE
DISSEMINATE
THE...
Disseminate the evidence
Identification of target audiences:
• Scientific community
BUT ALSO…
• Civil Society, community g...
It is necessary to publish our research in scientific journals because…
• Peer review process
• Quality of our research
• ...
Disseminate the evidence
The use of social media (Twitter)
Disseminate the evidence
The use of social media (Twitter)
This was retweet by:
• Spanish Society of Public Health
and Hea...
Disseminate the evidence
Direct conversation with policymakers
This was retweet by:
General Directorate for Public Health
...
Disseminate the evidence
• press release
• social media (especially Twitter)
• journalist specialized in your field or tha...
Disseminate the evidence
Sometimes it's the journalists who are looking for you…
BE PREPARED
Know who is conducting
the in...
Disseminate the evidence
Sometimes it's the journalists who are looking for you…
CONTROL THE INTERVIEW
We can anticipate a...
Disseminate the evidence
The importance of media advocacy
Disseminate the evidence
The result of that email….
El País, May 2018
Disseminate the evidence
The result of that email….
National radio: Cadena Ser/Onda cero/COPE
International radio: 99.9 Ra...
Disseminate the evidence
Disseminate the evidence
National press
El País. 1.862.000
ABC 601.000
Radio
Cadena Ser. Hoy por Hoy 2.657.000
Onda cero. ...
Disseminate the evidence
The importance of media advocacy: get to the community
and policy makers
Disseminate the evidence
The importance of media advocacy: get to the community
and policy makers
Why we need research to do advocacy?
THE ROLE OF
TOBACCO
RESEARCHER
BUILT RELATIONSHIPS
GENEREATE
EVIDENCE
DISSEMINATE
THE...
Built relationships
• Build political will/alliances –meeting with decision-makers, develop a
multi-sectoral advocacy team...
Built relationships
• Built relationships with journalist
• Be well connected and collaborate with different scientific or...
Not always is easy….
Not always is easy….
When you are an advocate for controversial policies you will have arguments
and opinions against you ...
Some tips / reminder to finish…
• Get the necessary and useful data  Think about
policy-relevant research
• Be ready: for...
Some tips / reminder to finish…
• Have the message you have in mind very clear: simple
and less ideas better than more ide...
Some tips / reminder to finish…
• Personal characteristics are also important for doing
advocacy:
• Be nice, generous, and...
From tobacco research to
tobacco control policies: the
role of advocacy
Xisca Sureda, BPharm, PhD.
Assistant Professor, De...
So, who is involved in advocacy?
• Media
• Civil Society, community groups
• Professional organization
• Practitioners
• N...
Generate evidence in tobacco control
A Participatory Action Research project to study
alcohol environment in Madrid: the u...
Generate evidence in tobacco control
Research team: epidemiologist,
sociologist, photographer
Madrid Public Health Institu...
Disseminate the evidence
Some tips to talk with the media….
1. Stay on message and keep it simple: Know what you
need to s...
Disseminate the evidence
The importance of media advocacy (and social media)
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From tobacco research to tobacco control policies: the role of advocacy

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Xisca Sureda, BPharm, PhD
Assistant Professor, Department of Surgery, Medical and Social Science, Alcalá University

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From tobacco research to tobacco control policies: the role of advocacy

  1. 1. From tobacco research to tobacco control policies: the role of advocacy Xisca Sureda, BPharm, PhD. Assistant Professor, Department of Surgery, Medical and Social Science, Alcalá University
  2. 2. Why do we research in tobacco control? To be rich? To accumulate grants and publications? To increase your impact factor? To get the attention of other researchers? To have a lot of free time?
  3. 3. Before… Now… Australia Cigarettes Plain Packaging Tobacco marketing in the 50s’ Why do we research in tobacco control? WHAT HAS HAPPENED IN BETWEEN TO MAKE THIS CHANGE?
  4. 4. Why do we research in tobacco control? Lancet. 2011;377(9760):139-46. cites: 663 Br Med J. 1950; 2(4682): 739–748. cites: 1,147 Addiction. 2008;103(4):580-90. cites: 115
  5. 5. Why we do research in tobacco control? We do research to… • Establishing the link between smoking and lung cancer, CVD, etc… • Developing behavioral and pharmacological smoking treatments • Determining the effects of second-hand smoke • Assessing the effects of marketing on cigarette smoking • Evaluating tobacco control interventions Etc.
  6. 6. Why we do research in tobacco control? But, we do tobacco research above all… TO IMPROVE THE HEALTH OF THE POPULATION AND INDIVIDUALS And for that we need the evidence derived from our research: • To influence people’s behaviours (smoking behaviours) • To influence public agenda: what’s important & what’s not in tobacco control • To counteract the actions of the tobacco industry and other interests against tobacco control and, thus against public health And, at the end… TO INFLUENCE TOBACCO CONTROL POLICIES
  7. 7. What advocacy is? Advocacy is about making changes to policy and practice that will improve the lives of the population you are advocating for. It is the act of speaking or disseminating information intended to influence individual behaviour or opinion, corporate conduct or public policy and law.
  8. 8. So, who is involved in advocacy? Can my research influence tobacco control policies? YES!!! HOW??? Can I, as a tobacco researcher, influence tobacco control policies? YES!!!
  9. 9. Why we need research to do advocacy? THE ROLE OF TOBACCO RESEARCHER BUILT RELATIONSHIPS GENEREATE EVIDENCE DISSEMINATE THE EVIDENCE  Which evidence is needed?  Which is the impact of our research?  Who is going to be benefit?  Which are the policy implications?  Where can we disseminate it?  How can we disseminate it?  How the information is going to be used?
  10. 10. Why we need research to do advocacy? • Media needs data to communicate results, to sell the new • Citizen need data to believe in the problem we want to change The Guardian, dec 2013
  11. 11. Why we need research to do advocacy? • Practitioners need data to intervene appropriately • NGO, public health and other professional organizations, and other advocates needs data to show it to policymakers • Policymakers need data  our research can inform policies
  12. 12. Why we do research in tobacco control? 0 200 400 600 800 1000 1200 1400 1600 0 10 20 30 40 50 60 70 80 1968 1973 1978 1983 1988 1993 1998 2003 2008 2013 2018 Numerofpublications Prevalence(%) Prevalence (%) of daily smoking among adult (≥15 years) men and women, tobacco policies and tobacco-related publications in Spain Numer of publications Men Women Sources: Spanish National Health Survey(1987, 1993, 1997, 2001, 2006, 2011, 2017); Web of Science; Spanish Ministry of Health Regulation of the promotion of tobacco products Increase taxes Law 28/2005: smoke-free legislation (public places) Law 42/2010: comprehensive smoke-free legislation (hospitality venues) Health Warning on tobacco packs Increase taxes Prohibition in public transport Prohibition promotion TV
  13. 13. Generate evidence First drawbacks we have in our research system: investment 10 % in Epidemiology, Occupational and Public Health “Spanish NIH”
  14. 14. Generate evidence Second drawbacks we have in our research system: What does the academic structure value us as scientists? Traditional scientist the accumulation of institutionally certified knowledge as an end in itself research questions driven by intellectual curiosity Contemporary researcher more socially engaged; believes in producing applied research research questions driven by utility in addressing expressed needs of policymakers and practitioners VS Source: Erno-Kjolhede, 2000 We need a combination of both: High quality research but which also influenced policy and practice.
  15. 15. Generate evidence Second drawbacks we have in our research system: What does the academic structure value us as scientists? Traditional scientist the accumulation of institutionally certified knowledge as an end in itself research questions driven by intellectual curiosity Requirements to get promoted within the academic or research institutions Professional awards and incentives The academic and research institutions should also value: • social impact of our research • influential research and influential activities • dissemination of results beyond scientific publication
  16. 16. We need to be clear and concrete in what we need to invest the money/resources (personal, time) in science  which are the priorities in tobacco control research? Generate evidence in tobacco control THINK ABOUT POLICY-RELEVANT RESEARCH! We need to think about the policy implication of our results when we apply for a grant or write a paper  What my project/publication is going to change? // Which are the policy implications?
  17. 17. Generate evidence in tobacco control According to an interview with peer-nominated “highly influential” Australian public health researchers: Most of them design and conduct their research targeting policy goals to some degree. The majority said they tried to identify and respond to emerging policy opportunities. Strategies included addressing gaps in the evidence-base, engaging with community groups to monitor emerging needs, and targeting “the big questions of the moment” and research areas that seemed likely to become important in the future. Many researchers planned their research program in consultation with key stakeholders
  18. 18. The smoke-free legislation in Spain (2011): Law 42/2010 El País, August 2015 El diario.es. February 2015 Generate evidence in tobacco control
  19. 19. The smoke-free legislation in Spain (2011): Law 42/2010 Aim: To describe smoking visibility and second-hand smoke (SHS) exposure in outdoor hospitality venues in Madrid, Spain. Generate evidence in tobacco control
  20. 20. The smoke-free legislation in Spain (2011): Law 42/2010 We also measured PM2.5 and airborne nicotine in 92 terraces and showed that: • Almost 80% of the outdoor terraces where we measured tobacco markers were not compliant with the law during fall/winter season (9.5% in summer). • When the terraces were completely closed, PM2.5 concentrations reach values of almost 80 µg/m3. This value can be comparable or even higher than those values obtained in other studies for indoor places. Generate evidence in tobacco control
  21. 21. • How can we increase the use of our research in tobacco control policies? Generate evidence in tobacco control Originality and innovative research design: • Use of mix methods: qualitative and quantitative data. • Involved citizen when doing research: citizen science// participatory action research • Multidisciplinary research teams: combined classical epidemiology with other fields such as economy, geography, sociology…
  22. 22. Generate evidence in tobacco control It is an approach that involves researchers and participant working together to understand a situation and change it for the better What is Participatory Action Research? • Equal relationship between researcher and participants • Research for and with people not about people The results obtained by the participants are disseminated to the rest of the community and policymakers in order to co-create future interventions.
  23. 23. Why we need research to do advocacy? THE ROLE OF TOBACCO RESEARCHER BUILT RELATIONSHIPS GENEREATE EVIDENCE DISSEMINATE THE EVIDENCE  Which evidence is needed?  Which is the impact of our research?  Who is going to be benefit?  Which are the policy implications?  Where can we disseminate it?  How can we disseminate it?  How the information is going to be used?
  24. 24. Disseminate the evidence Identification of target audiences: • Scientific community BUT ALSO… • Civil Society, community groups • Professional organization • Practitioners • NGOs • Policymakers Multiple methods of research dissemination and promotion (including tactical use of the media)
  25. 25. It is necessary to publish our research in scientific journals because… • Peer review process • Quality of our research • Disseminate results among scientific community • Our system demand us to publish to get promoted • Also increase our policy influence Disseminate the evidence HOWEVER…. We need to get the research out there…media appearances, briefings, government reports and, also direct conversation with policymakers are sometimes even better strategies that the scientific publication itself (Social Science & Medicine 72 (2011) 1047-1055) we can not be out of the real world!
  26. 26. Disseminate the evidence The use of social media (Twitter)
  27. 27. Disseminate the evidence The use of social media (Twitter) This was retweet by: • Spanish Society of Public Health and Health Administration • Influential scientists • Colleagues • Influential advocates in public health • Patients Associations
  28. 28. Disseminate the evidence Direct conversation with policymakers This was retweet by: General Directorate for Public Health Spanish Society of Internal Medicine Delegate of the National Plan on Drugs Ministry of Health Influential scientists Recovery community organizations Association of community pharmacies
  29. 29. Disseminate the evidence • press release • social media (especially Twitter) • journalist specialized in your field or that are interested in your work  also follow them and tag them in twitter • use contacts (journalist, influential researchers/collegues…) How can increase the presence of my research in the media? Sometimes it's the journalists who are looking for you… Media appearance
  30. 30. Disseminate the evidence Sometimes it's the journalists who are looking for you… BE PREPARED Know who is conducting the interview (look for articles by the reporter, search for a bio) Know your audience
  31. 31. Disseminate the evidence Sometimes it's the journalists who are looking for you… CONTROL THE INTERVIEW We can anticipate and know what they are going to ask us. We can prepare the answer with the ideas we want to transmit One question can have different answer…we will give the answer depending on our objectives and what we want to reach
  32. 32. Disseminate the evidence The importance of media advocacy
  33. 33. Disseminate the evidence The result of that email…. El País, May 2018
  34. 34. Disseminate the evidence The result of that email…. National radio: Cadena Ser/Onda cero/COPE International radio: 99.9 Radio Mar de Plata/RADIO COLOMBIA Television News: RTVE/Telecinco/Cuatro/Antena 3 National press: ABC
  35. 35. Disseminate the evidence
  36. 36. Disseminate the evidence National press El País. 1.862.000 ABC 601.000 Radio Cadena Ser. Hoy por Hoy 2.657.000 Onda cero. 573.000 COPE. 2.174.000 Television Cuatro. 588.000 Telecinco. 1.753.000 RTVE 1. 1.552.000 Antena 3. 2.369.000 Audience The importance of media advocacy
  37. 37. Disseminate the evidence The importance of media advocacy: get to the community and policy makers
  38. 38. Disseminate the evidence The importance of media advocacy: get to the community and policy makers
  39. 39. Why we need research to do advocacy? THE ROLE OF TOBACCO RESEARCHER BUILT RELATIONSHIPS GENEREATE EVIDENCE DISSEMINATE THE EVIDENCE  Which evidence is needed?  Which is the impact of our research?  Who is going to be benefit?  Which are the policy implications?  Where can we disseminate it?  How can we disseminate it?  How the information is going to be used?
  40. 40. Built relationships • Build political will/alliances –meeting with decision-makers, develop a multi-sectoral advocacy team Help them to deliver research-informed briefs for managers and ministers when they consider that this can drive to political changes
  41. 41. Built relationships • Built relationships with journalist • Be well connected and collaborate with different scientific organization and other researchers/colleagues, professional organizations, practitioners and community group, celebrities.
  42. 42. Not always is easy….
  43. 43. Not always is easy…. When you are an advocate for controversial policies you will have arguments and opinions against you and your results: by the tobacco industry, hospitality industry, cultural resistance…. Be clear and have your own arguments to answer Philip Morris’ “accommodation” programmes: “The Spanish Model” El País, February 2011
  44. 44. Some tips / reminder to finish… • Get the necessary and useful data  Think about policy-relevant research • Be ready: for getting the data to be published when it is necessary; to show the data that has already been published when it is the appropriate moment • Always be there and accessible to: the media, policymakers, and other stakeholders (including community groups)…
  45. 45. Some tips / reminder to finish… • Have the message you have in mind very clear: simple and less ideas better than more ideas and confusing and complicated • Make “key” friends and involve them: media, citizens, NGOs, politician, public health organizations • Have the arguments ready for the adversaries
  46. 46. Some tips / reminder to finish… • Personal characteristics are also important for doing advocacy: • Be nice, generous, and always helpful • Be patient: successful advocacy takes time • Have passion, determination, persistence, and commitment to advance public health
  47. 47. From tobacco research to tobacco control policies: the role of advocacy Xisca Sureda, BPharm, PhD. Assistant Professor, Department of Surgery, Medical and Social Science, Alcalá University Contacto: francisca.sureda@uah.es Twitter: @HHHproject & @XiscaSureda Web: https://hhhproject.eu/
  48. 48. So, who is involved in advocacy? • Media • Civil Society, community groups • Professional organization • Practitioners • NGOs • Policymakers • Other stakeholders BUT ALSO RESEARCHERS
  49. 49. Generate evidence in tobacco control A Participatory Action Research project to study alcohol environment in Madrid: the use of Photovice Funding: European Research Council Starting Grant 2013 HeartHealthyHoods Agreement n. 336893 and Plan Nacional sobre Drogas (2016I047). • To obtain a community diagnosis of the alcohol environment in the city of Madrid using photovoice • To translate photovoice findings into urban alcohol policy recommendations Objectives in our study:
  50. 50. Generate evidence in tobacco control Research team: epidemiologist, sociologist, photographer Madrid Public Health Institute Citizens Policymakers Who is involved?
  51. 51. Disseminate the evidence Some tips to talk with the media…. 1. Stay on message and keep it simple: Know what you need to say and how to say it concisely. Have 3-4 ideas in mind about what are the key messages of your research. Be clear and simplify. Avoid being very technical and using a lot of numbers and statistics 2. Have credibility: If you don’t know the answer to a question, say so. You may point out that you are not an expert on that particular issue. 3. Be yourself: smile and although you might be nervous, think that probably no one knows the subject better than you
  52. 52. Disseminate the evidence The importance of media advocacy (and social media)

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