Mar. 9 2004
Washington, DC — Tobacco use remains the leading preventable cause of death in the United States, with smoking and exposure to secondhand smoke accounting for 435,000 deaths in 2000, according to a study in the March 10 issue of The Journal of the American Medical Association (JAMA). The study, conducted by researchers at the Centers for Disease Control and Prevention (CDC), finds that annual tobacco-caused deaths have increased since 1990 and concludes, “The most disappointing finding may be the slow progress in reducing tobacco-related mortality.”
While this study also identifies poor diet and physical inactivity as growing problems that must be addressed, it clearly shows that we must step up efforts to reduce tobacco use and its devastating consequences. The tobacco epidemic is truly unique both in the lethality of the product that causes it and the extensive scientific evidence to support the solutions we have developed. We know what works to prevent and reduce tobacco use, but elected officials have failed to implement these solutions with a level of commitment and resources that even remotely approach the scope of the problem. The current Administration has failed to provide national leadership in the fight against tobacco use, and most states have squandered the unprecedented opportunity presented by the 1998 state tobacco settlement to fund tobacco prevention and cessation programs that are proven to reduce smoking and save lives.
The need for greater leadership in fighting tobacco use starts in our nation’s Capital. It is mind-boggling that cigarettes and other tobacco products remain virtually unregulated to protect consumers’ health and safety because Congress and the Administration have failed to grant the U.S. Food and Drug Administration meaningful authority to regulate them.
Despite a recent recommendation by its own expert scientific advisory committee to implement a National Action Plan to help smokers quit, the Administration has failed to implement most elements of this plan or to devote new resources to doing so. The plan calls for increasing the federal cigarette tax by $2 per pack and using at least half the revenue for smoking cessation initiatives, including a national telephone quitline through which smokers could obtain cessation medication and counseling, a national media campaign to encourage cessation, coverage for smoking-cessation therapies under federally funded health care programs like Medicaid and Medicare, and enhanced research and health provider training. The Administration has rejected the cigarette tax increase and announced support only for the quitline proposal without identifying funding for it. As the JAMA study emphasizes, we will not significantly reduce tobacco’s toll without a national cessation campaign to accelerate the very slow declines in adult smoking rates.
States and communities have done more, but not nearly enough. A handful of states have shown that we can dramatically reduce smoking among both youth and adults by implementing comprehensive, science-based measures, including tobacco prevention and cessation programs, tobacco tax increases that discourage consumption, and smoke-free workplaces and public places that protect everyone from secondhand smoke. But these solutions have been applied unevenly and sporadically. It is public health malpractice that only four states currently fund tobacco prevention and cessation programs at even the minimum levels recommended by the CDC. Despite collecting record amounts of revenue from the tobacco settlement and tobacco taxes, states have cut funding for their tobacco prevention programs by more than a quarter over the past two years. This failure to use the tobacco settlement for its intended purpose is truly tragic because states that have implemented well-funded tobacco prevention programs have not only reduced smoking, but saved lives and saved money by reducing smoking-caused health care costs.
Few areas of public health can match tobacco control in having identified scientifically proven strategies that work to save lives and improve health. Our solutions – comprehensive prevention and cessation programs, tobacco tax increases, smoke-free policies and regulation of tobacco products – are the equivalent of a vaccine that works to protect our children from tobacco addiction, disease and death. It is no more acceptable that we fail to provide this vaccine to everyone in our country than it would be to fail to provide them with a proven vaccine for a deadly infectious disease. Unfortunately, too many politicians would prefer to pretend that the tobacco problem has been solved than implement real solutions. As the JAMA study so clearly demonstrates, the tobacco problem is far from solved. And it won’t be unless elected leaders finally begin to close the growing chasm between what we know works to reduce tobacco use and what we are actually doing to fight it.