National Institutes of Health Funding for Tobacco Control: 2006 and 2016

Abstract

Purpose:

The study objective was to describe and compare changes in newly funded National Institutes of Health (NIH) tobacco-related awards between fiscal year (FY) 2006 and FY2016.

Design:

Secondary analysis of NIH data.

Setting:

National Institutes of Health Research Portfolio Online Reporting Tool database was used.

Subjects:

National Institutes of Health tobacco-related awards newly funded during FY2006 and FY2016.

Measures:

Search terms included tobacco, smoking, nicotine, secondhand smoke, and e-cigarettes. Grants and funding amounts were retrieved.

Analysis:

We calculated frequency distributions to determine the number and percentage of total NIH grants funded overall and by specific institute, and inflation-adjusted total and median funding amounts. We computed percentage differences in number of new grants, funding amounts, and percentage of funding allocated overall, and by institute.

Results:

There was a 187% increase in the percentage of total NIH funding allocated to new tobacco-related awards from 0.09% in FY2006 to 0.25% in FY2016. Total number of awards increased by 67% in FY2016 (n = 144; $56 015 931) compared to FY2006 (n = 86; $22 076 987), and there was a 154% increase in inflation-adjusted total funding for tobacco control. The top funding institutes were National Institute on Drug Abuse and National Cancer Institute; National Institute on Alcohol Abuse and Alcoholism was third in FY2006; and National, Heart, Lung and Blood Institute in FY2016. Research grants were the most frequently funded. Smoking cessation was a common topic area and increased by 64%.

Conclusion:

NIH funding is critical for advancing the science of nicotine and tobacco research.

Keywords

smoking control tobacco smoke exposure electronic cigarettes smoking cessation National Institutes of Health tobacco control interventions

Purpose

Tobacco control efforts have significantly reduced smoking rates over time, but tobacco use remains a leading cause of preventable morbidity and mortality in the United States.¹ Since 1995, only 1.1% to 1.3% of the total National Institutes of Health (NIH) budget has been allocated toward tobacco research; thus, this area of research has been historically underfunded compared to the funding allocated for other health problems (eg, obesity), despite causing a large disease burden.^2,3 In recent years, there has been an emphasis on tobacco regulatory research.¹ The NIH is the leading funding source for biomedical and behavioral research worldwide. In 2016, of the $32.3 billion NIH budget, 80% was awarded through nearly 50 000 competitive grants to over 300 000 researchers in more than 2500 medical schools, universities, and other research institutions.⁴

Given the competitive funding climate and the uncertainty of future federal budget allocations toward NIH funding,⁵ it is important for applicants to understand the extent to which the NIH is funding new tobacco-related grants in order to continue important work in nicotine and tobacco research. This information will provide prospective applicants with the types and content areas of successfully funded tobacco-related NIH awards. The study objective was to describe and compare changes in newly funded NIH tobacco-related awards between 2 fiscal years (FYs), FY2006 and FY2016.

Methods

Design

All secondary data were accessed using the publicly available NIH Research Portfolio Online Reporting Tool (RePORT) database (https://report.nih.gov/), which includes reporting tools, reports, and data on research activities.

Sample

Similar to prior methodology,^3,6 we used the RePORT Expenditures and Results tool (RePORTER; https://projectreporter.nih.gov/reporter.cfm) to search for new grants. We queried the FY “2006” and “2016” RePORTER database for “Admin” and “Funding” agency/institute/center that included “All NIH Institutes and Centers,” “New” award types, “All” activity codes in “All” organization types (eg, research institutes) located in all “US States and Territories.”

Measures

After reviewing “Project Terms” and “Project Titles” on RePORTER from a sample of funded awards during FY2006 and FY2016, 2 independent raters selected the following key terms for the text search: “Project Title,” “tobacco,” “smoking,” “smoke,” “SHS,” “ETS,” “TSE,” “nicotine,” “ENDS,” “smoker,” “electronic cigarette,” “tobacco use,” “secondhand smoke exposure,” “environmental tobacco smoke,” “tobacco smoke exposure,” “smoke exposure,” “e-cigarettes,” “e-cigarette,” “electronic cigarettes,” “passive smoke exposure,” “passive smoke,” “thirdhand smoke,” “cigarette,” “cigarettes,” “secondhand smoke,” “tobacco smoke,” and “electronic nicotine delivery.”

While performing the search, we retrieved descriptive information on topic area by using the “Data & Visualize Circles” feature.

Analysis

We calculated frequency distributions overall and by NIH institute in FY2006 and FY2016 to determine the total number and percentage of new NIH grants for tobacco control, and total and median funding amounts for these grants. We accessed each institute’s budget, with the exception of the US Food and Drug Administration (FDA) which was publicly unavailable. Additionally, the FDA did not begin to fund tobacco regulatory research until after the Family Smoking Prevention and Tobacco Control Act of 2009.⁷ We computed the percentage of NIH funding allocated to new tobacco control awards by each institute and all institutes combined. We calculated percentage differences between FYs in total number of new tobacco-related grants, funding amounts, and percentage of funding allocated to new awards overall, and by institute. To calculate percentage differences, total funding amounts and institute budgets for grants in FY2006 were adjusted to FY2016 equivalent dollars using the US Bureau of Labor Statistics’⁸ Consumer Price Index (CPI) inflation adjustment of 1.1947.

Results

Overall, total NIH funding included in this study decreased by 12% in FY2016 compared to inflation-adjusted FY2006; $24 964 million (M; $20 896 M unadjusted) in FY2006 to $22 075 M in FY2016.⁹ However, a total of 0.09% of the FY2006 budget was spent on new tobacco-related awards, while 0.25% of the FY2016 budget was spent on these awards (Table 1). In total, 230 new tobacco-related awards met inclusion criteria and underwent review: 86 in 2006 and 144 in 2016. There was a 67% increase in total number of new awards in FY2016 compared to FY2006. The data for new tobacco-related awards per institute are presented in Table 1. Inflation-adjusted median amount of funding per year increased from $201 522 in FY2006 compared to $254 711 in FY2016. Inflation-adjusted total funding for new tobacco-related research increased by 154% from $22 076 987 in FY2006 compared to $56 015 931 in FY2016. Institutes increased the percentage of funding allocated to new tobacco-related awards by 187% overall between FYs (see Table 1). In FY2006, the top 3 funding institutes were: National Institute on Drug Abuse (NIDA), National Cancer Institute (NCI), and National Institute on Alcohol Abuse and Alcoholism (NIAAA). In FY2016, NIDA and NCI remained the top 2 funding institutes, and the National, Heart, Lung and Blood Institute (NHLBI) ranked third. These institutes increased the percentage of funding allocated to new tobacco-related awards (see Table 1).

Table 1.

NIH Funding Amounts for New Tobacco-Related Grants by Funding Institute, FY2006 and FY2016.

Institute	FY2006								FY2016					% Change for New Tobacco Grants (n)	% Change for New Tobacco Grants (Total $)^b	% Change for New Tobacco Grants (Total % by Institute)^c
Institute	n (%)	Total $ for New Tobacco Grants	Adjusted Total $ for New Tobacco Grants^a	Median $ for New Tobacco Grants	Adjusted Median $ for New Grants^a	Overall Institute Budget	Overall Adjusted Institute Budget^a	Total % for New Tobacco Grants by Institute Budget	n (%)	Total $ for New Tobacco Grants	Median $ for New Tobacco Grants	Overall Institute Budget	Total % for New Tobacco Grants by Institute Budget	% Change for New Tobacco Grants (n)	% Change for New Tobacco Grants (Total $)^b	% Change for New Tobacco Grants (Total % by Institute)^c
NIDA	51 (59.3)	$10 573 628	$12 632 313	$185 850	$222 035	$1010 M	$1207 M	1.0	65 (45.1)	$22 627 896	$251 250	$1047 M	2.2	+27	+79	+106
NCI	20 (23.2)	$5 059 304	$6 044 350	$166 611	$199 050	$4842 M	$5784 M	0.1	36 (25.0)	$17 632 748	$500 020	$5098 M	0.3	+80	+192	+231
NIAAA	4 (4.7)	$607 808	$726 148	$132 187	$157 924	$440 M	$526 M	0.1	8 (5.5)	$2 063 356	$189 866	$460 M	0.4	+100	+184	+225
NHLBI	3 (3.5)	$383 211	$457 822	$126 225	$150 801	$2951 M	$3526 M	0.01	14 (9.7)	$4 504 667	$267 579	$3072 M	0.1	+367	+884	+1029
NICHD	2 (2.3)	$320 740	$383 188	$160 370	$191 594	$1278 M	$1527 M	0.03	2 (1.4)	$516 342	$258 171	$131 8 M	0.04	0	+35	56
NIMH	2 (2.3)	$703 245	$840 167	$351 623	$420 084	$1418 M	$1694 M	0.05	1 (0.7)	$81 000	$81 000	$148 9 M	0.005	−50	−90	−89
NIEHS	2 (2.3)	$337 359	$403 043	$168 680	$201 522	$648 M	$774 M	0.05	4 (2.8)	$946 308	$223 500	$682 M	0.1	+100	+135	+167
NIAMS	1 (1.2)	$274 560	$328 017	$274 560	$328 017	$513 M	$613 M	0.05	1 (0.7)	$58 002	$58 002	$533 M	0.01	0	−82	−80
NINR	1 (1.2)	$219 250	$261 938	$219 250	$261 938	$139 M	$166 M	0.2	0 (0.0)	–	–	$145 M	0.0	−100	−100	−100
NIDCR	0 (0.0)	–	–	–	–	$393 M	$407 M	–	7 (4.9)	$2 733 025	$401 739	$407 M	0.7	–	–	–
FDA	0 (0.0)	–	–	–	–	–	–	–	2 (1.4)	$3 049 920	$1 524 960	–	–	–	–	–
NIMHD	0 (0.0)	–	–	–	–	$197 M	$282 M	–	1 (0.7)	$791 875	$791 875	$282 M	0.3	–	–	–
NIA	0 (0.0)	–	–	–	–	$1057 M	$1267 M	–	1 (0.7)	$705 749	$705 749	$1267 M	0.06	–	–	–
NIAID	0 (0.0)	–	–	–	–	$4460 M	$5328 M	–	1 (0.7)	$226 443	$226 443	$4615 M	0.005	–	–	–
NINDS	0 (0.0)	–	–	–	–	$1550 M	$1660 M	–	1 (0.7)	$78 600	$78 600	$1660 M	0.005	–	–	–
Total	86	$18 479 105	$22 076 987	$168 680	$201 522	$20 896 M	$24 964 M	0.09	144	$56 015 931	254 711	$22 075 M	0.25	+67	+154	+187

Abbreviations: FDA, Food and Drug Administration; FY, fiscal year; M, millions; NCI, National Cancer Institute; NHLBI, National Heart, Lung, and Blood Institute; NIA, National Institute on Aging; NIAAA, National Institute on Alcohol Abuse and Alcoholism; NIAID, National Institute of Allergy and Infectious Diseases; NIAMS, National Institute of Arthritis and Musculoskeletal and Skin Diseases; NICHD, Eunice Kennedy Shriver National Institute of Child Health and Human Development; NIDA, National Institute on Drug Abuse; NIDCR, National Institute of Dental and Craniofacial Research; NIEHS, National Institute of Environmental Health Sciences; NIH, National Institutes of Health; NIMH, National Institute of Mental Health; NIMHD, National Institute on Minority Health and Health Disparities; NINDS, National Institute on Neurological Disorders and Stroke; NINR, National Institute of Nursing Research.

^a Adjusted for US Bureau of Statistics’ Consumer Price Index (CPI) inflation (×1.1947).

^b Percentage changes calculated using FY2006 CPI inflation-adjusted total funding amount for new tobacco grants.

^c Percentage changes calculated using FY2006 CPI inflation-adjusted institute budgets.

Of the 86 tobacco-related studies funded in FY2006 and 144 projects funded in FY2016, research grants (R series) were the most frequent award types, accounting for 65 of the grants in FY2006 ($16 540 730) and 119 of the grants in FY2016 ($45 122 458; Figure 1). This represents an increase in number of R awards between FYs. In FY2006, the second most common award type was career development awards (K series) with 11 grants funded ($1 569 535), followed by 10 fellowship program awards (F series; $368 840). In contrast, in FY2016, the second most common award type was F awards (11; $501 270), followed by K awards (8; $1 239 762); the number of F awards slightly increased, but the number of K awards decreased between FYs. In FY2006, no cooperative agreement awards (U series), intramural program awards (Z series), or program project/center awards (P series) were awarded. In FY2016, there were 3 U series, ($4 028 659), 2 Z series ($1 817 580), and 1 P series ($3 306 202) awarded (see Figure 1). Please see Supplemental Table 1 for information on funding opportunity announcements.

Figure 1.

Distribution of NIH funding allocations to new tobacco research by types of grant programs, FY2006 and FY2016. FY indicates fiscal year; NIH, National Institutes of Health.

Smoking cessation was a common topic area and increased 64% from 39 grants in FY2006 to 64 grants in FY2016. Direct comparisons of all topic areas were not possible as descriptors changed in FY2006 and FY2016. In 2006, public health, nicotine addiction, and tobacco control were also the commonly funded topic areas. In 2016, other common topic areas were smoking exposure, young adults, and nicotine content.

Discussion

NIH funding is critically important to support the advancement of science in nicotine and tobacco research. Although there has been great progress in tobacco control over the past 50 years, a significant percentage of Americans continue to use tobacco.¹ In addition, the characteristics of tobacco users and the issues they face in quitting have changed, necessitating continued research in this area.¹⁰ We found a 67% increase in number of new awards related to tobacco research in FY2016 compared to FY2006. Another key finding was a 154% increase in total amount of funding between FYs for tobacco-related research after CPI inflation adjustment. This could be attributed, in part, to the FDA beginning to fund regulatory research between time points; however, we were unable to track the differences in the FDA budget over time. In 2016, the NIH spent approximately $1.42 in new research for each American who is nicotine dependent and $0.18 for all Americans. This is in comparison to funding for cancer ($5589 M; $17.30 per American), cardiovascular health ($2108 M; $6.52 per American), and heart disease ($1289 M; $3.99 per American).¹¹

Although the total NIH budget slightly decreased over time, the percentage of the total new tobacco-related grants increased by 187% between FYs. The number of institutes funding tobacco-related research increased over time, with 9 institutes funding new tobacco-related research in FY2006, and 14 in FY2016. Similar to prior research,² NIDA and NCI were the 2 top funding institutes, with a 106% and 231% respective increase in percentage of funds allocated to new tobacco-related research between FYs. The third-ranked institute was NIAAA in FY2006 and NHLBI in FY2016; both institutes had a significant increase in total amount funded, but NHLBI had a much larger increase (+884%) than NIAAA (+184%), potentially due to a low base rate of new grants (n = 3) funded in FY2006. Further, R grants were the most frequent award types funded. F awards slightly increased from 10 to 11 awards, but K awards decreased from 11 to 8 awards from FY2006 to FY2016. Tobacco-related U awards, Z awards, and P awards were funded in FY2016, but none were reported in FY2006. It is important to note that a possible reason for the difference in these awards is that only a few of these mechanisms are available each FY.

The only common topic area was smoking cessation with a 64% increase between FYs. The other topic areas differed from FY2006 (public health, nicotine addiction, tobacco control) to FY2016 (smoking exposure, young adults, and nicotine content). One potential explanation for the descriptive differences in topic areas is the introduction of e-cigarettes to the US market in 2007, leading to a substantial increase in use of this emerging product especially among youth and young adults.¹²

Another possible reason for the differences in topic areas between FYs is the Family Smoking and Prevention Tobacco Control Act.⁷ This law gives the FDA authority to monitor and regulate tobacco product manufacturing, marketing, and distribution in order to reduce tobacco product-related risks and exposures, which requires restricted tobacco product marketing to youth, more visible warning labels on smokeless tobacco products and advertisements, and disclosure of tobacco product ingredients.⁷ However, we were unable to directly compare FDA tobacco-related funding between FYs because the FDA was not funding tobacco-related regulatory research in FY2006. Further, despite substantial progress in smoke exposure reduction in the past 2 decades, one-fourth of Americans remain exposed to secondhand smoke.¹³ Although these issues may explain the differences in most common topic areas funded between FYs, there is a possibility that the topic areas were added or changed by the NIH over time.

Limitations

This study is not without limitations. While the keywords were limited to the project titles, grants could have been related to other disease burdens (eg, tobacco and alcohol) and not solely tobacco related. We were unable to provide differences between all topic areas since these differed between FYs. Despite this, smoking cessation will likely remain a common term as the majority of tobacco research focuses on treatment and tobacco control. We were unable to filter results by new investigator or early stage investigator status; this information would have been informative for those early in their career. Finally, our analyses focused solely on NIH funding and did not assess other potential funding sources.

Significance

Successfully funded tobacco-related research applications related to topic areas of interest are needed to decrease the health burden tobacco places on the United States. Future investigation is recommended to continue to assess funding for this critical scientific area over time. This investigation informs researchers on the types and content areas of new NIH-funded tobacco-related research awards.

So What? Implications for Health Promotion Practitioners and Researchers

What is Already Known on this Topic?

Only 1.1% to 1.3% of the total National Institutes of Health (NIH) budget has been allocated toward tobacco research, thus this area has been historically underfunded compared to other health problems.

What does this Article Add?

New tobacco-related awards increased between FY2006 and FY2016, with research grants being the most commonly funded. Successfully funded tobacco-related research is critically needed to continue to decrease the health burden tobacco places on the United States. Smoking cessation was a common topic area with a 64% increase between FYs.

What are the Implications for Health Promotion Practice or Research?

This study provides information on the types and content areas of newly funded nicotine and tobacco-related research funded by the NIH, and how those content areas and the amount of dollars allocated to this research have changed over time.

Supplemental Material

Supplemental Material, Supplementary_Table_1_-_NIH_Funding_Tobacco_(4-23-18) - National Institutes of Health Funding for Tobacco Control: 2006 and 2016

Supplemental Material, Supplementary_Table_1_-_NIH_Funding_Tobacco_(4-23-18) for National Institutes of Health Funding for Tobacco Control: 2006 and 2016 by Ashley L. Merianos, Judith S. Gordon, Kelsi J. Wood, and E. Melinda Mahabee-Gittens in American Journal of Health Promotion

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH Grant Number 1R01HD083354) and National Institute on Drug Abuse (NIH Grant Number 1K01DA044313).

ORCID iD

Ashley L. Merianos, PhD, CHES

Supplemental Material

Supplemental material for this article is available online.

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Supplementary Material

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