May. 7 2008
Washington, D.C. — The guidelines for smoking cessation released today by the U.S. Public Health Service provide an important reminder to the nation's 45 million smokers that they have more scientifically proven tools available to help them quit smoking and protect their health than ever before, including safe and effective medications, counseling and telephone quitlines. Combining counseling and medication is especially effective in helping smokers quit. These findings are based on a thorough review of the evidence and have critical implications for policymakers as well as medical providers.
Unfortunately, while most smokers want to quit, and millions try each year, most do not avail themselves of the evidence-based treatments that improve success rates. While the guidelines address actions clinicians can take, policy makers at all levels, as well as employers, also need to take action to prevent kids from smoking in the first place, encourage smokers to quit, enhance awareness of the treatments available and provide affordable access to these live-saving interventions. As the guidelines emphasize, providing insurance coverage for these evidence-based treatments increases both the rates that smokers use these treatments and the rates that smokers quit.
Federal government: Congress and the Administration should implement the National Action Plan for Tobacco Cessation recommended by an expert scientific advisory panel to the U.S. Department of Health and Human Services. 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 paid media campaign encouraging cessation (such a campaign should also include a strong youth prevention component); providing coverage for smoking-cessation counseling and FDA-approved medicines under federally funded health care programs including Medicare and Medicaid; increased investment in research to improve smoking cessation therapies; and training for health care providers in treating tobacco dependence. The only portion of this plan the Administration has implemented is a network of state quitlines.
Congress should also pass legislation giving the U.S. Food and Drug Administration (FDA) authority to regulate tobacco products. Tobacco companies take advantage of the current lack of regulation to manipulate their products to create and sustain addiction to nicotine and engage in marketing that discourages smokers from quitting. The pending legislation would grant the FDA authority to stop these harmful practices, including setting standards for the contents of tobacco products, banning misleading terms such as "light" and "low-tar," and prohibiting health claims about so-called "reduced risk" products that are not scientifically proven or that would discourage current tobacco users from quitting. The bill would also crack down on tobacco marketing and sales to kids.
State and local government: At the state and local level, elected officials should fund tobacco prevention and cessation programs at the levels recommended by the U.S. Centers for Disease Control and Prevention. Effective programs not only provide counseling and medication to smokers, they also motivate smokers to quit and educate them about the best ways to do so. State governments should also provide full smoking cessation benefits to Medicaid recipients and all government employees.
States and localities should also continue the strong momentum in support of higher tobacco taxes and smoke-free workplace laws, which are scientifically proven to motivate smokers to quit and increase the number who succeed in doing so.
Employers: The private sector should implement the recommendations of the CEO Roundtable on Cancer, a group of corporate, political and public health leaders that has established recommendations to fight cancer called the CEO Cancer Gold Standard. These recommendations include establishing and enforcing tobacco-free workplace policies; ensuring that health benefit plans include coverage at no cost for evidence-based tobacco cessation treatments (counseling and medications); and establishing workplace-based tobacco cessation initiatives. Studies have found that such initiatives save business money by reducing tobacco-related health care costs, while creating a healthier and more productive workforce.
The benefits of quitting smoking are dramatic. In just the first few weeks and months after quitting, blood circulation improves, carbon monoxide levels in the blood decrease, the risk of heart attack decreases, lung function and breathing are improved, and coughing decreases. Pregnant women who quit smoking before their second trimester decrease the chances that they will give birth to a low-birth-weight baby. Over the long term, quitting will reduce a person's risk of heart disease and stroke, improve symptoms of chronic obstructive pulmonary disease (COPD), reduce the risk of developing smoking-caused cancer, and extend life expectancy.
Tobacco use is the leading preventable cause of death in our nation, claiming more than 400,000 lives and costing us nearly $100 billion annually in health care bills. While adult smoking rates have been declining slowly in the United States, 20.8 percent of American adults still smoke, and the number of smokers is declining much too slowly to achieve the goal set by the federal government of reducing adult smoking to 12 percent or less by the year 2010. We cannot achieve this goal without significant national and state commitments to helping smokers quit.
The Public Health Service guidelines — Treating Tobacco Use and Dependence: 2008 Update — can be found at www.surgeongeneral.gov/tobacco.