Special Populations

Adaptation of the FLU-FOBT Program to Increase Colorectal Screening in Underserved Populations

Lawrence Green, DrPH, MPH

Offering a fecal occult blood test in conjunction with flu vaccination has proved successful in raising the rate of screening in various types of clinics, including a public health center in Chinatown, San Francisco. Further adaptations are being evaluated. The concepts and strategies tested in this project might be applicable to other health interventions, such as smoking cessation. In such cases, visits for vaccinations or other periodic clinical care services could offer opportunities for clinicians to address neglected problems.

Addressing Tobacco through Organizational Change

Joe Guydish, PhD

Tobacco dependence continues to be the single most preventable cause of morbidity and mortality in the United States. Persons entering drug abuse treatment smoke at 3-4 times the rate, and staff in publicly funded programs smoke at twice the rate, of the general population. Although the burden of illness and associated economic costs of nicotine addiction are elevated in the drug treatment population, treatment programs rarely address comorbid nicotine addiction.

Bay Area Young Adult Health Study (BAYahs)

Pamela Ling, MD, MPH

This is a household survey of young adults in San Francisco and Alameda counties to examine how changes in the current policy context affect tobacco use and other health behaviors. The study includes retail and neighborhood audits.

California Vietnamese Adult Tobacco Use Survey

Tung Nguyen, MD

This is a telephone survey funded by the California Tobacco Control Section to evaluate current smoking-related behaviors among Vietnamese Americans in California.  

CEASE California

Jyothi Marbin, MD

 "CEASE California": The project disseminates and evaluates the CEASE California program (Clinical Effort Against Secondhand Smoke Exposure). CEASE is a clinic intervention for pediatric offices to screen for secondhand smoke exposure (SHSE) in patients, and help parents quit by offering NRT and a referral to the CA Smokers Helpline. This training intervention is focused on busy clinics serving low income populations.

Current and Emerging Tobacco Products in a Rural Context: Influences of Product Characteristics on Perceptions, Behaviors, and Biologic Exposures (2.0)

Benjamin Chaffee, DDS, MPH, PhD

Cigarette smoking among U.S. adolescents has declined, but similar declines have not occurred in youth smokeless tobacco (ST) use. There is also a growing trend among adolescents and young adults of poly-use of multiple tobacco products in combination. In recent decades, ST use has shifted from an older to a younger demographic, coincident with increasing industry marketing and expanding diversity in ST product characteristics. These new ST products include different types, brands, flavors, and varying levels of bioavailable nicotine and cancer-causing nitrosamines.

Designing a Quit Smoking Tool in Safety Net Clinics

Jyothi Marbin, MD

Designing a Quit Smoking Tool in Safety Net Clinics: Developing and evaluating the efficacy of enhanced EHR screening and tobacco cessation intervention tools for safety net clinics in Alameda County. In partnership with the Lifelong Medical Care clinics in Alameda county, which serve Alameda County's neediest residents, we are developing, implementing, and evaluating changes to the NextGen electronic health record around tobacco cessation.

Development of a Tobacco Control Intervention for Older African American Homeless Adults

Maya Vijayaraghavan, MD, MAS

In this study, funded by the Center for Aging in Diverse Communities, we will conduct in-depth, semi-structured interviews of a sub-sample of a cohort of older, African American homeless adults (PI: Dr. Margot Kushel) to develop a smoking cessation intervention unique to the needs of this population. Using these formative data, we will pilot test the smoking cessation intervention among target participants to obtain preliminary data in support of a larger RCT.  

Environmental Contamination from Tobacco, Vaping and Cannabis Waste

Jeremiah Mock, MSc, PhD

This sentinel surveillance garbology study documents environmental contamination from e-cigarette product waste, combustible tobacco product waste, and cannabis product waste at public high schools with in Alameda, Contra Costa, Marin, and San Francisco counties. The study shows that e-cigarette waste and combustible tobacco product waste contaminate the Bay Area high schools, confirming use of these products by high school students. Cannabis product waste represents an emerging issue.

Evaluation of a Smoke-Free Policy in Permanent Supportive Housing

Maya Vijayaraghavan, MD, MAS

In partnership with one of the largest permanent supportive housing programs for homeless and low-income adults with special needs in San Diego County, we will conduct a pre- and post-policy evaluation a smoke-free policy that includes restrictions on smoking in indoor and shared outdoor areas. The study will examine tobacco use behaviors, exposure to secondhand smoke, knowledge of, adherence to, and attitudes toward the smoke-free policy among the clientele of 4 permanent supportive housing programs.

Evaluation of Tobacco Treatment Strategies for Inpatient Psychiatry

Tung Nguyen, MD

Individuals with mental illness or addictive disorders account for a staggering 44% to 46% of the US tobacco market. The overall goal of this research is to identify efficacious strategies for treating tobacco dependence among adult smokers hospitalized with severe mental illness.

Impact of Changing Tobacco Product Use on Healthcare Costs for General and Vulnerable Populations (2.0)

Wendy Max, PhD, Hai-Yen Sung, PhD, Tingting Yao, PhD

Healthcare costs play a central role in FDA regulatory impact analysis. Many factors contribute to tobacco- attributable healthcare costs, including changing tobacco product use patterns, sociodemographic characteristics, health status, and socioeconomic status (SES). The central goal of this project is to develop economic models that analyze the impact of new patterns of tobacco product use on healthcare costs for different populations including those that are particularly vulnerable.

Institute for International Internet Interventions for Health (i4Health)

Ricardo Munoz, PhD

This site, i4Health, is being used to construct a bilingual (Spanish/English), Digital Apothecary to develop, evaluate, and disseminate Massive Open Online Interventions available to anyone, anywhere, any time at no charge.  


1. Muñoz, R. F., Bunge, E. L., Chen, K., Schueller, S. M., Bravin, J. I., Shaughnessy, E. A., & Pérez-Stable, E. J. (2016). Massive Open Online Interventions: A novel model for delivering behavioral-health services worldwide. Clinical Psychological Science, 4, 194–205.

Mapping Menthol

Pamela Ling, MD, MPH

This pilot project is part of the Center for Health and Risk in Minority Youth and Young Adults (CHARM) in partnership with Streetwyze. We are working with community members to map places in their neighborhoods that impact smoking behavior, with special interest in menthol and flavored tobacco.

Mobile Health Tool for Lung Cancer (mHealthTLC)

Lung cancer is the leading cause of cancer death in both men and women. Lung cancer is unique because of racial disparity, persistent mortality rate, and social stigma. African- Americans are more likely than whites to avoid an evaluation for lung cancer, be diagnosed later with more advanced lung cancer, wait longer after diagnosis to receive treatment, refuse treatment, and more likely to die in the hospital after surgery.

Online Training for Pediatricians to Help Parents Quit Smoking

Jyothi Marbin, MD

Online Training for Pediatricians to Help Parents Quit Smoking: This project developed on online training module for pediatricians based on the CEASE model around reducing SHSE. The online module is a more cost effective way to train clinics interested in the CEASE intervention. We are currently evaluating the differences in efficacy and cost between in-person and online trainings for pediatricians.

Pharmacologic Basis of Racial Difference in Nicotine Dependence

Neal Benowitz, MD, Gideon St Helen, PhD

AA and EA smokers undergo detailed monitoring of smoking behavior, receive known doses of nicotine to establish nicotine metabolic rate, undergo DNA testing, and have their responses to not smoking for several hours studied. Exposure to carcinogens and other tobacco smoke toxins is also measured.  It is hypothesized that there are racial differences in metabolism that may explain different patterns of smoking, and that this in turn influences the reasons why smokers continue to self-administer nicotine (i.e., continue to smoke).

Rate of Nicotine Metabolism and Withdrawal Symptoms in Adolescent Light Smokers

The goal of this study was to examine the associations between the rate of nicotine metabolism and cigarette consumption, addiction and withdrawal symptoms.

Secondhand Smoke Exposure Reduction in Hospitalized Children

Jyothi Marbin, MD

Secondhand Smoke Exposure Reduction in hospitalized children: This project is being done in conjunction with UCSF Benioff Children's Hospitals in Oakland and San Francisco. We are seeking to create a multidisciplinary, systematic approach to screening for and reducing secondhand smoke exposure in hospitalized children. We are helping to develop universal screening for SHSE in all admitted children, and then working with physicians, respiratory therapists, pharmacy and nurses to provide appropriate counseling and medication to caregivers.

SF CAN - Commune Smokefree Social

Pamela Ling, MD, MPH

This project is part of the Helen Diller Comprehensive Cancer Center’s program to decrease cancer in San Francisco. The goal is to increase smoking cessation among young adults, as quitting before age 30 avoids almost all the health consequences of smoking. Commune Smokefree Social groups are advertised and held on Facebook for Bay Area young adults to support smoking cessation.

Smoking in the Movies

Exposure to onscreen smoking in movies is the largest single factor promoting youth smoking in the United States, accounting for about 44% of all new smokers.  This project seeks to understand the effects of smoking in the movies on youth and young adults, the historical links between the tobacco and entertainment industries, and to develop and promote effective policy responses to this problem.  The research forms the basis for the Smoke Free Movies educational and advocacy campaign.

The Healthy Family Project: A Family-Based Intervention to Promote Smoking Cessation among Asian American Smokers

Janice Tsoh, PhD
Dr. Tsoh is conducting several projects to promote smoking cessation among Asian American smokers in community and clinical settings. The projects focus on identifying effective channels for delivering smoking cessation treatment, developing comprehensive and culturally-sensitive treatment approaches, and disseminating intervention technology developed from research to the community and clinical practice settings.