May. 24 2007
Washington, DC — The groundbreaking report issued today by the Institute of Medicine - Ending the Tobacco Problem: A Blueprint for the Nation - makes it clear that the United States can eliminate tobacco use as a serious public health problem, but the main obstacle to achieving this goal has been a lack of political will, not a lack of proven solutions. The report makes it equally clear that while state efforts are critical, the states alone cannot solve the tobacco problem. Congress, long absent from the fight to reduce tobacco use, must provide essential leadership by enacting legislation granting the U.S. Food and Drug Administration (FDA) authority over tobacco products.
The report sets an ambitious, but attainable goal for the nation: "To reduce tobacco use so substantially that it is no longer a significant public health problem." However, the report concludes that current efforts, even if fully implemented, are insufficient to achieve this goal and would be hard-pressed to achieve even the far more modest goal of reducing the adult smoking rate from the current 20.9 percent to 15 percent. As the report states, such a modest reduction is not satisfactory because tobacco use would continue to cause a significant amount of premature death and disease.
To eliminate tobacco use as a significant public health problem, the report recommends a two-pronged approach that includes both stepped-up implementation of current strategies, primarily at the state level, and the enactment of federal legislation granting the FDA authority over tobacco products. As the report concludes, "Incremental reforms... will not end the nation's tobacco problem. A more fundamental shift must occur. It is time for Congress and other policy makers to change the legal structure of tobacco policy, thereby laying the foundation for a strategic initiative to end the nation's tobacco problem, that is, reducing tobacco use to a level that is insignificant from a public health standpoint."
The IOM report demands a strong and immediate response by elected officials at all levels:
The report specifically recommends enactment of the bipartisan FDA legislation introduced by U.S. Senators Edward Kennedy (D-MA) and John Cornyn (R-TX) and U.S. Representatives Henry Waxman (D-CA) and Tom Davis (R-VA): "The committee concludes that product regulation by the FDA will advance tobacco control efforts in the United States and around the world. The proposed Tobacco Control legislation embodies the principles that should govern the regulation of tobacco products in the coming years."
The pending legislation would grant the FDA the specific powers recommended in the report. Among other things, the legislation would grant the FDA authority to crack down on tobacco marketing and sales to kids; require that tobacco companies disclose the contents of tobacco products and reduce or remove harmful ingredients; stop tobacco companies from misleading the public about the health risks of their products; and require larger, more effective health warnings on tobacco products. Importantly, and also consistent with the IOM report's recommendations, the legislation would for the first time in 40 years grant states the authority to regulate cigarette marketing. States and localities could impose bans or restrictions on the time, place and manner (but not content) of the advertising or promotion of cigarettes.
The FDA legislation has strong, bipartisan support in both chambers of Congress, with a total of 167 sponsors and co-sponsors in the House and 48 sponsors and co-cosponsors in the Senate. Congress has debated FDA authority over tobacco for nearly a decade. It's time to end the debate and take action that the IOM report concludes is an essential component of eliminating the tobacco problem in the United States.
States also have much to do to meet the report's recommendations:
Other essential recommendations in the report include a national, youth-oriented media campaign; improved public and private sector efforts to help smokers quit, including government and private insurance coverage for smoking cessation products and services; and efforts to reduce youth exposure to smoking in movies.
The report reaches several additional conclusions that should guide efforts to reduce tobacco use in the United States: