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The Framework Convention on Tobacco Control (FCTC) is a seminal event in tobacco control and in global health. Scientific evidence guided the creation of the FCTC, and as the treaty moves into its implementation phase, scientific evidence can be used to guide the formulation of evidence-based tobacco control policies. The International Tobacco Control Policy Evaluation Project (ITC Project) is a transdisciplinary international collaboration of tobacco control researchers who have created research studies to evaluate and understand the psychosocial and behavioural impact of FCTC policies as they are implemented in participating ITC countries, which together are inhabited by over 45% of the world's smokers. This introduction to the ITC Project supplement of Tobacco Control presents a brief outline of the ITC Project, including a summary of key findings to date. The overall conceptual model and methodology of the ITC Project--involving representative national cohort surveys created from a common conceptual model, with common methods and measures across countries--may hold promise as a useful paradigm in efforts to evaluate and understand the impact of population-based interventions in other important domains of health, such as obesity.

Objective: To determine the prevalence of smoking policies in indoor work environments as reported by a nationally representative sample of workers in the United States., Design: Cross-sectional survey of households within the United States., Setting: All 50 state and the District of Columbia, 1992-93., Participants: Currently employed indoor workers 15 years of age and older who responded to the National Cancer Institute's Tobacco Use Supplement to the Current Population Survey (n = 100,561)., Main Outcome Measures: The prevalence and restrictiveness of workplace smoking policies as reported by workers currently employed in indoor workplaces in the United States., Results: Most of the indoor workers surveyed (81.6%) reported that their place of work had an official policy that addressed smoking in the workplace; 46.0% reported that their workplace policy did not permit smoking in either the public/common areas--for example, restrooms and cafeterias--or the work areas of the workplace. The reporting of these "smoke-free" policies varied significantly by gender, age, race/ethnicity, smoking status, and occupation of the worker., Conclusions: Although nearly half of all indoor workers in this survey reported that they had a smoke-free policy in their workplace, significant numbers of workers, especially those in blue-collar and service occupations, reported smoke-free rates well below the national average. If implemented, the US Occupational Safety and Health Administration's proposed regulation to require worksites to be smoke-free has the potential to increase significantly the percentage of American workers covered by these policies and to eliminate most of the disparity currently found across occupational groups.

U.S. efforts to control tobacco use and tobacco-related morbidity and mortality have been reasonably successful over the past 3 decades, during which there has been a 34% reduction in adult smoking. Nevertheless, tobacco use remains a significant public health problem in the U.S., with more than 430,000 tobacco-related deaths per year and over one fourth of the population continuing to smoke. Many organizations are involved in tobacco-use control activities, the most broadly focused of which is that of the National Cancer Institute (NCI). The NCI's program is described and its emphasis on a data-based decision matrix in its approach to tobacco and cancer control research and applications of research is discussed. Finally, future approaches to tobacco-use control in the U.S. are suggested.

The Health Promotion and Disease Prevention component of the 1985 National Health Interview Survey allowed us to measure the progress made toward achieving the 1990 objectives for the nation concerning cigarette smoking. The first smoking-related objective, namely, to reduce to below 25 percent the proportion of the U.S. population who smoke, has not been achieved. Today 31 percent of the population smoke. More than 85 percent are aware of the special risk of developing and worsening chronic obstructive lung disease, chronic bronchitis, and emphysema among smokers. More than 90 percent are aware that smoking is a major cause of lung cancer; however, awareness of the risk of laryngeal, esophageal, bladder, and other kinds of cancer from smoking is not so great. More than 85 percent are aware that cigarette smoking is one of the major risk factors for heart disease. In general, then, the 1990 objectives concerning the population's knowledge of the health consequences of cigarette smoking have been met.