Forty Years of Secondhand Smoke Research. The Gap Between Discovery and Delivery

Context: Public health initiatives often focus on the discovery of risk factors associated with disease and death. Although this is an important step in protecting public health, recently the field has recognized that it is critical to move along the continuum from discovery of risk factors to delivery of interventions, and to improve the quality and speed of translating scientific discoveries into practice. Evidence acquisition: To understand how public health problems move from discovery to delivery, citation network analysis was used to examine 1877 articles on secondhand smoke (SHS) published between 1965 and 2005. Data were collected and analyzed in 2006-2007. Evidence synthesis: Citation patterns showed discovery and delivery to be distinct areas of SHS research. There was little cross-citation between discovery and delivery research, including only nine citation connections between the main paths. A discovery article was 83.5% less likely to cite a delivery article than to cite another discovery article (OR=0.165 [95% CI=0.139, 0.197]), and a delivery article was 64.3% less likely (OR=0.357 [95% CI=0.330, 0.386]) to cite a discovery article than to cite another delivery article. Research summaries, such as Surgeon General reports, were cited frequently and appear to bridge the discovery-delivery gap. Conclusions: There was a lack of cross-citation between discovery and delivery, even though they share the goal of understanding and reducing the impact of SHS. Reliance on research summaries, although they provide an important bridge between discovery and delivery, may slow the development of a field.