Accelerating tobacco regulatory science in the United States: The center for rapid surveillance of tobacco.

The U.S. tobacco marketplace has undergone rapid and profound change over the past decade, marked by the emergence of new product categories, brands, and marketing strategies that challenge traditional public health surveillance. Delays in identifying and responding to early signals-most notably during the rapid rise of JUUL-highlighted critical gaps in the timeliness, flexibility, and scope of existing surveillance approaches. In response, the National Cancer Institute and the U.S. Food and Drug Administration funded the Center for Rapid Surveillance of Tobacco (CRST) to support near real-time monitoring of tobacco marketing, the tobacco marketplace (i.e., availability and sales), and behaviors. This paper provides a high-level overview of CRST's conceptual framework, which is grounded in public health surveillance principles and organized around signal generation, refinement, and evaluation. CRST leverages and triangulates diverse data sources, including marketing data, point-of-sale audits, retail sales data, non-traditional data streams, and behavioral surveys of youth and adults, to detect emerging public health concerns and inform regulatory action. We also highlight examples from this special issue that illustrate the application of rapid surveillance methods and demonstrate how multi-source triangulation can strengthen the validity and actionability of emerging signals in a rapidly evolving tobacco landscape.