Understanding what consumers think, feel, and do is essential to generating robust evidence on tobacco and nicotine products. In this GFN Science Lab session, Christelle Chrea discusses the role of consumer-reported outcome measures (CROMs) in tobacco and nicotine research, and the challenges involved in measuring consumer perceptions, behaviours, and experiences.
The session explores the distinction between descriptive measures, which capture observable behaviours such as product use and frequency, and psychometric measures, which assess underlying constructs such as risk perception, dependence, and other cognitive, perceptual, and affective dimensions.
Transcription:
GFN Science Lab 2 — Christelle Chrea
2026-06-04 · 14:00-15:30 (Europe/Warsaw) · Global Forum on Nicotine 2026
Carrie Wade 0:00:11
Well, thank you. We will now return to a more traditional GFN Science Lab situation with showing the next video. And Emily Cleric from Philip Morris will be in the video, but Christelle will be answering questions.
Video 0:00:29
As scientists, we are experts at measuring the physical. We can track a temperature, weightogram, or map a genome with certainty. But in product research, such as tobacco or nicotine products, there are hidden human elements that no lab instrument can detect.
How do we actually measure key constructs like risk perception, label comprehension, use behaviour, or the subjective effects of a specific product? How can we accurately capture real-world product use when behaviour occurs outside control environments without direct observation?
Without this information, our understanding of the impact of tobacco and nicotine products on public health is incomplete. To see the invisible, we need a different kind of instrument. We need CROM. So what exactly is CROM?
Consumer-reported outcome measures capture self-reported perceptions and behaviours directly from the consumers, providing data that cannot be obtained through other methods. we differentiate between two kinds of CROM. Descriptive CROM capture observable behaviours, the what, for example, how frequently a product is used.
Psychometric CROM assess underlining constructs, the why, including cognitive, perceptual, and affective dimensions that can't be directly observed. Translating these what and why dimensions into a coherent, scientifically robust framework requires coordinated, consensus-driven efforts at a global level.
For over seven decades, Coresta has brought together researchers with diverse expertise from around the world. Its mission is to promote and facilitate international cooperation and best practices in scientific research, providing the tobacco industry regulators and research groups with publicly available, credible scientific information on tobacco and its derived products.
Regarding CROM, a key challenge remains. A clear set of best practices is required to standardize CROM development, validation, selection and implementation for tobacco research. Coresta established a consortium approach with the CROM Task Force.
This initiative brings together industry scientists, academic researchers and regulatory experts to address methodological challenges through scientific cooperation, global reference and information exchange. By bringing together scientists with various expertise and independent SMEs, we gain a broader perspective.
Through dialogue with academic and regulatory stakeholders, this group identifies best practices for developing, validating and implementing CROM measures scientifically robust and broadly applicable.
The task force has developed two key guidelines grounded in literature review, existing survey frameworks and guidelines, and applied an iterative consensus-based process involving the experts mentioned earlier. Descriptive CROM Guideline provides frameworks for classifying tobacco and nicotine products, including novel categories, and defines conceptual models of use states.
It also includes recommendations for survey design, data collection, analysis and reporting. The Psychometric CROM Guideline focuses on defining constructs of interest and provides guidance on instrument development, validation, implementation and interpretation of results.
To support accessibility and implementation among the scientific community, the task force developed a publicly and freely available CROM repository. The repository was designed using focus group and usability testing to ensure relevance and usability for the research community. The repository has the potential to standardize and harmonize the use of CROM in tobacco research.
It currently includes descriptive CROM with structured survey items, response options, and source references alongside a tool for survey development. It also includes psychometric CROM with detailed information on constructs, measurement properties, and availability. The repository is continuously updated as new evidence emerges.
A current limitation of the repository is that many psychometric rooms have been developed primarily in English and within Western cultural contexts. Expanding linguistic and cultural representation is therefore a key priority to ensure global applicability and inclusivity.
Researchers are therefore encouraged to contribute additional instruments to the repository to strengthen its coverage. CROM are becoming increasingly important in tobacco harm reduction research and in assessing the public health impact of tobacco and nicotine products.
In a rapidly evolving product landscape, there is a clear need for standardized definitions, valid and readable measures, and consistent methodologies. These elements are essential to enable comparability across studies and support robust evidence generation.
and standardized capture of subjective consumer experiences enables robustness of data validity and interpretability of scientific evidence and support transparent and globally applicable regulatory science.
Carrie Wade 0:06:00
Before we take questions.
Christelle Chrea 0:06:02
Well, first of all, I would like to thank Emilie for producing this video. She was supposed to be here today. Unfortunately, she can't. I'm not completely alien to this work because I'm actually the coordinator of the Corestachrom Task Force. So I'm very happy to take any of your questions, but maybe a little bit of background on this initiative.
So maybe it's not the standard type of presentation for the science lab. We are not presenting results. We are presenting a framework to improve how we measure the perception and the behaviour of nicotine users. And I think I'm very happy that I come after Adam's presentation.
I don't need a thing to convince you that CROM are very important in the evidence generation for tobacco harm reduction, because the past survey is basically a compilation of CROMs.
Some are descriptive, as explained in the video, so they measure more the observable behaviour, what type of product they are using, how often they are using, how long have they been using it, as well as social demographics.
While the psychometric CROM that you can find also in the past survey are more looking at psychological construct like or even psychiatric disease like depression or it could be risk perception or dependence. And this morning there was in the panel session a comment, or no, it was in the early...
what was the podcast type of, on addiction and a comment that we don't have a good measure to compare different products on dependence, for example.
And this is the type of challenges that have really driven this initiative because Yes, tobacco research on smoking behaviour has been going on for many, many years, and there is an instrument and CROM to measure this behaviour, but we are now looking at a different behaviour and a broader range of products.
So one of the key questions is that how do we know that we can just apply a CROM that was developed to assess behavioural perception of cigarettes to a new alternative.
And so in the guidelines that we have published in contribution to tobacco and nicotine research, we provide some recommendation on how to adapt existing CROM or develop new one and ensure that they are fit for purpose and we often talk about reliability and validity but I think what is really important is to ensure that it measure what it's supposed to measure and it does it with the lowest error possible.
And maybe lastly before you can take any question, the second deliverable that we have within this inter-industry consortium is the CROM repository.
And I have some flyers because I think if you want to look at yourself what is in this repository, how it could be maybe useful, whether you are in clinical research, epidemiology, behavioural research, The impact of such a repository will be only visible if it's known by the researcher and used.
But we are also very interested in getting suggestions from the community on what is missing in this repository. So if you go on the webpage, you have the opportunity to make suggestions. Thank you. Any questions?
Andrew Manson 0:10:18
So the data in this repository, is this free to use for researchers? Yes, it is. For any researchers?
Christelle Chrea 0:10:34
Yes. So just maybe to clarify, we don't provide any data. It's only information on CROM.
So, maybe it was a little bit too fast on the video, but it's basically, if we talk about psychometric CROM, it would be how it was developed, evidence of the psychometric functioning of the questionnaire, how it has been used, so we can list also the reference of key publication for the development.
and, if necessary, some recommendation also on whether it's applicable to different tobacco products or not. So this information is publicly available. What is not available is the questionnaire itself, because for that there is obviously copyright issues, so we cannot provide. But we provide the source, if available, where to find the questionnaire.
Andrew Manson 0:11:38
Okay. And the follow-up question is, how do you recruit consumers? I assume that's different in different countries. There's different rules about engaging consumers in different countries. I mean, I think in Australia you can't at all, but in other countries you can.
Christelle Chrea 0:12:02
So I'm not sure I understand really your question because in the work that we have done, we are not actually collecting data. We are really providing tools for researchers actually to collect their data.
Andrew Manson 0:12:21
Okay, I understand. Thank you.
Norbert Schmidt 0:12:28
Hello. I have noticed that many other consumers had medical data, lung function checks, lung function analysis before when they were smokers and that prompted them to switch to vaping. and the lung function has improved, medically measured, are there any provisions for consumers to upload this kind of data so that this can be evaluated?
Because that's more than anecdotal data, that's medical data that can be of more use
Christelle Chrea 0:13:21
So I think I'm not in position on commenting on that because it's not the purpose of what we have done. What we have done is really to provide guidance and recommendation on how to use what we call CROM, so self-reported tools or surveys.
to go in your research and apply these tools so there is a standardization and harmonization on how data collected to be used then for evidence generation. But I think your question is a valid one, and I don't know if anyone wants to answer.
Adam Lenart 0:14:12
So when it comes to health data, it's actually really difficult to collect it. That's because under GDPR, this is considered sensitive data. And for sensitive data, if we would like to collect this type of data, we would need ethical approval for the research that needs to be conducted. But I mean, of course, I agree with you. It's a really valuable data set.
But this is something that we take very seriously and also the authorities take very seriously.
Carrie Wade 0:14:45
Thank you. And I have one final question for you. What would you consider to be the most difficult measure to capture of the different consumer reported outcomes?
Christelle Chrea 0:14:57
So I think in that link to the presentation of Adam, when it comes to measuring transition and exposure to different products, it really relies on the fact that we can accurately measure what people are using and how often they are using it. And this is really something we can capture only by asking questions.
So already having a harmonized definition on what is a user, what is an experimenter, what do we consider as a transition, switching, initiation, cessation, all these behaviour that are intrinsic to tobacco harm reduction. Thanks.