Purdue public health professor brings scrutiny to the tobacco industry through policy-focused research

Written By: Rebecca Hoffa, rhoffa@purdue.edu

From cigarettes and cigars to chewing tobacco, e-cigarettes and vape pens, the tobacco industry is constantly evolving to lure in new users. Meanwhile, tobacco use remains the leading cause of preventable death and disease in the United States, according to the American Cancer Society.

Bukola Usidame, assistant professor in Purdue University’s Department of Public Health, is looking to change that, one community at a time. Through her policy-focused research within the College of Health and Human Sciences, Usidame is hoping to reduce the risk factors for cancer using tobacco control and public health strategies.

Bukola Usidame(Purdue University Photo/Charles Jischke)

“I’m hoping to get to the point where we can understand that community-level policies are different for different communities because of their demographics, needs and priorities,” Usidame said. “I’m hoping to contribute a lot to that area of community-level policies. I did a lot of work in federal- and state-level policies, which are what we call top-down policies. They work for the general population, but a lot of communities suffer. When you see the overarching results and there’s a decline in cigarettes, you say, ‘Oh, it’s working.’ But you have a lot of communities that are not benefiting from that, so my goal is to work on the bottom-up approach: to see what works for different communities and scale that up and find a balance that works for everyone.”

Usidame is currently working on expanding her skills in spatial analytics and causal inference — a policy-focused statistical method — through a career development grant from the National Cancer Institute to understand how the number and location of retail stores in a given community contribute to the prevalence of cancer. Through preliminary work, Usidame has found a borderline correlation.

“The tobacco industry spends at least 85-90% of their marketing budget in the retail stores, so billions of dollars,” Usidame said. “I wanted to understand the policies that are targeting this group of stores: How effective are they? Which ones are effective? Which ones are not effective? Which ones interact together to produce their effects?”

Prior to joining academia, Usidame worked as an advocate for cancer patients in Nigeria, where she traveled to hospitals and championed low-cost medications. Then, while pursuing her master’s degree and holding an internship at the World Health Organization as a health policy analyst, Usidame found her passion for making a difference in tobacco policy.

“Over the course of that, I decided I wanted to get more into the management, policy and administration because I felt that was where the change was,” Usidame said.

Usidame has seen countless policies come and go, and she said the outcomes of policy often rely on policy enforcement, which comes at a cost to communities. Because of this, Usidame hopes to eventually build a “policy lab” that contains a comprehensive database of successful local policies, which community leaders can review and apply ideas to their own cities or counties.

“It’s always surprising when you find out that a policy actually had no effect,” Usidame said. “You always feel like they go through all of that process to pass the policy, and you finally test it, and it’s not working. There are several options to fine-tune it.”

Recalling one study she did in Canada on a law that banned tobacco displays at the point of sale, which found an increase in tobacco cessation in women, Usidame mentioned policies can sometimes be effective for certain demographics but ineffective for others. This can help communities better tweak their policies to foster healthier citizens and environments.

“It’s always good when you see it’s working for everyone, but what’s more important is to know who it’s working for the most, which we call targeted interventions, and who it’s not working for at all — or who it’s making things worse for — so you can make progress when it comes to policy,” Usidame said.

While Usidame has extensive experience looking at retail stores, she noted there has been a recent shift in purchasing behavior, with more youth and adolescents getting tobacco products online, which has led to additional policy work.

 “It’s loophole after loophole,” Usidame said. “That’s why we keep focusing our research on showing what’s working and what’s not working. If it’s not working, don’t waste your time because that’s one thing the tobacco industry has: time.”

Usidame said she’s become interested in branching out her research into the co-use of tobacco and marijuana, an increasingly common phenomenon. However, she hasn’t made the shift quite yet, with much more work left to be done in tobacco products alone.

“Even though we’re seeing an overall decline in use of cigarettes, people are starting to move to other tobacco substances,” Usidame said. “The tobacco industry keeps evolving and bringing in new products, and then you’re back to the point in understanding how policies apply to those.”