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Future Directions

July 28, 2011: Cessation: Emerging Interventions and Innovations

Moderator: Timothy McAfee, M.D., M.P.H., Director, Office on Smoking and Health, Centers for Disease Control and Prevention Helping Smokers Quit: What's Happening? What Works? What's Next?

Before delivering his prepared remarks, Dr. McAfee began by thanking the Surgeon General for her leadership on tobacco control issues and reminded panelists that the next Surgeon General's Report would focus on youth tobacco use. Dr. McAfee also thanked Committee members for their time and commitment and Monica Swann for all her hard work to organize logistics for the day's meeting.

Dr. McAfee began his prepared remarks by discussing the need to change the cost-benefit calculus of tobacco use from one where tobacco is easily available, tobacco products are heavily promoted and marketed and cessation assistance is difficult to access, to a paradigm where tobacco is less accessible, more expensive, harder to access and not as addictive. We know that the majority of smokers want to quit (70 percent plan to quit, 45 percent try to quit each year and only 4–7 percent succeed) but only a small number use evidence-based assistance with a large variation in state and plan coverage.

The challenge is to increase the number of long-term quits in the population with both more people trying to quit and more use of highly effective evidence-based treatments. The way to reach this "sweet spot" is through policy changes such as price increases, comprehensive smoke-free policies, hard-hitting media and graphic warning labels, health system changes, including barrier-free coverage with promotion as well as quality improvement, funding for comprehensive programs, and de-normalizing tobacco use.

Dr. McAfee continued by talking about several emerging issues including an increasing percentage of smokers who are "light" and "intermittent" smokers who may require different approaches to increase motivation to make quit attempts and success since they may not think of themselves as smokers or at risk for disease. Poly-tobacco use is a second emerging issue with the introduction of so many new products that enable smokers to sustain their addiction when they are in smoke-free settings. It appears that there are an increasing number of people who are dual or poly-tobacco users. A third area of concern relates to the new promotion techniques being undertaken by the tobacco industry with more money spent on discounting to offset the effects of tax increases as well as more product promotion in the retail environment.

Dr. McAfee concluded by stating that the ultimate goal should be to make tobacco use a minor public health nuisance.

Following his introductory remarks, Dr. McAfee introduced the next three panelists.

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