) This proposal outlines a plan for ascertaining the vital status and re- interviewing the original 22,046 U.S. cohort participants in the National Cancer Institute's Community Intervention Trial for Smoking Cessation study (COMMIT). Data collected on the cohort will be used to assess mortality outcomes, changes in tobacco use behaviors, and exposure and response to community/state tobacco control programming and policies implemented since 1993. Follow-up of the original participants of the COMMIT smoker cohort will allow testing of the long-term impact of the COMMIT intervention on community tobacco control policies and the tobacco use practices of adult smokers. This project also offers an opportunity to quantify the impact of recently implemented state-based programs such as those implemented in California [1989], Massachusetts [1994], and Oregon [1998]. Variation in the public policies governing tobacco use across the 20 U.S. COMMIT communities also will permit us to investigate the impact of tobacco control policies such as boosting tobacco excise taxes, public smoking regulations, insurance coverage for smoking cessation on adult smoking behavior. By the year 2001, 13 years will have passed from the recruitment of the cohort and enough deaths will have occurred to give us adequate statistical power to do a mortality analysis. The proposed study is unique in its capacity to investigate the contribution of individual-level and community-level predictors of mortality in a population-based sample of smokers. We have retained Westat to conduct the follow-up survey work for this project. Westat conducted the original survey work for the COMMIT study. Telephone interviewing operations will be conducted in Westat's Telephone Research Centers and will take place over a five-month period between January and May, 2001. Westat will also ascertain the vital status of cohort members using the National Death Index. In summary, the proposed study represents a highly cost-effective way to utilize data from previously conducted community-level study to investigate the impact of ongoing tobacco control programming and policies on the tobacco use practices and mortality outcomes in a large cohort of adult smokers.
