Background: We have been studying the relationship between the research and program areas of an Australian Tobacco Control Unit so as to better “engineer” their relationship.

Method: Individual interviews, focus groups, participant observation

Results: Researchers and practitioners have different “practical ontologies”. Practitioners use personal causality, and researchers use impersonal, conceptual causality; e.g. practitioners tell of challenges in helping an individual smoker quit, while scientists elucidate general principles about what influences quitting. For example, science informs us nicotine gum can be effective; it increases the probability of quitting. Scientists assume that this information is sufficient for practitioners to recommend it, and smokers to use it. However, practitioners know it is more complex. They need to know if it will work for each client, how to best apply it to their individual needs in the light of their individual concerns (e.g. interactions with other drugs, taste, beliefs about nicotine, and fears of dependency).

Conclusions: Scientists need to be clearer about the kinds of questions they are and aren't answering. Incorporating the ontology of practitioners may enable them to answer more questions about some of the factors effecting individual responses.

Implications: For some issues, there may be fundamental reasons why science cannot provide answers, but for others, science has just not been asking the right questions. For example, science could provide models of nicotine's interactions with other drugs, understandings about acquired tastes, and the facts about both nicotine and dependency. However, it cannot deliver this understanding to the level of each individual case.