Welcome, Introductions, and Charge
July 28, 2011: Cessation: Emerging Interventions and Innovations
Dana Shelton, M.P.H., Associate Director, Policy, Planning, and Coordination Unit, CDC's Office on Smoking and Health, and Designated Federal Official for the Interagency Committee on Smoking and Health (ICSH)
Dana Shelton, Designated Federal Official for the ICSH, welcomed participants and introduced VADM and U.S. Surgeon General Regina Benjamin. The Surgeon General added her welcome and asked ICSH Committee Members to introduce themselves. (See attached list of ICSH members and representatives.)
VADM Regina Benjamin, M.D., M.B.A., U.S. Surgeon General, U.S. Department of Health and Human Services
Surgeon General Regina Benjamin welcomed Committee members and reviewed the purpose of the meeting: to hear from leaders in the field of tobacco use cessation; review what is known and what more needs to be understood; and what is needed in both research and practice to make further progress to help tobacco users quit. Because most smokers begin to use tobacco while they are in their teens, youth prevention efforts are critical. At the same time, helping current smokers quit provides obvious health gains and saves lives. In fact, if half of all smokers were to quit today, 20 million deaths over the next 50 years would be prevented.
It has been 21 years since the publication of the first Surgeon General's report on the health benefits of tobacco use cessation. Conclusions from this report include:
- Smoking cessation has major and immediate health benefits for men and women of all ages;
- Former smokers live longer than continuing smokers; and
- Smoking cessation decreases the risk of lung cancer, other cancers, heart attack, stroke, and chronic lung disease.
In the two decades since the report's release, the evidence supporting these major conclusions has grown stronger thanks to advances in the neurosciences that help us better understand how nicotine affects the brain and the body.
Fortunately, the tobacco control field has also made a lot of progress in understanding effective approaches to helping tobacco users quit. Publications such as the Task Force for Community Preventive Services' Guide to Community Preventive Services identifies a number of evidence-based effective tobacco control interventions and the U.S. Public Health Service Clinical Practice Guideline Treating Tobacco Use and Dependence: 2008 Update identifies effective, experimentally validated tobacco dependence treatments and practices. In addition, there is a wider array of FDA-approved cessation medications available including five forms of nicotine replacement therapy (NRT) and two non-nicotine medicines. Behavioral interventions that help people quit and stay quit include individual, group and telephone counseling including toll-free telephone quitlines that are now available in every state and can be accessed by calling 1-800-QUIT NOW.
Over time there has been a growing understanding that nicotine addiction is a chronic condition that requires repeated support and intervention and that an effective cessation strategy must maximize the number of quit attempts and at the same time the success of these attempts. It is also known that policy interventions such as smoke-free environments and increasing the price of tobacco products are critical in creating a climate that supports smokers' efforts to quit.
While a lot has been learned since the first Surgeon General's Report on tobacco use cessation and for the first time in this country former smokers out-number current smokers, there is still a long way to go. Although 70 percent of smokers report wanting to quit and 40 percent try to quit each year, only about one-third of those trying to quit use an evidence-based cessation treatment and only one out of 20 smokers who try to quit actually succeed. If these smokers used proven behavioral and pharmacological aids, they could double or triple their chances of successfully quitting.
Because tobacco use is still the nation's leading preventable cause of death, delivering evidence-based tobacco use cessation is a priority of the U.S. Department of Health and Human Services. Recently the Centers for Medicare and Medicaid Services (CMS) announced that tobacco cessation treatment would be a covered benefit. Through the Affordable Care Act, Medicaid provides comprehensive cessation services to pregnant women. In addition, the Indian Health Service Cancer Program promotes clinical cessation efforts and the Health Resources and Services Administration's Bureau of Primary Health Care Community Health Center grantees have begun to implement tobacco cessation counseling services.
Despite much progress, it is important to continue to expand the science base to address gaps in our knowledge and to keep up with changes in the tobacco product landscape. The emergence of new tobacco products that come in unconventional forms and are often marketed with implied health or smoking cessation claims must be carefully monitored. It is also crucial that there is a better understanding of how to assist those smokers who come from disadvantaged and marginalized sectors of society—those who are poor, have been diagnosed with mental illness, or who are experiencing other substance abuse problems. Reaching these populations and providing access to cessation services through policy and systems change is the focus of today's ICSH meeting.
Surgeon General Benjamin concluded her remarks with a charge to the Committee—to chart the next steps that are needed to better assist tobacco users in their efforts to quit in the context of comprehensive tobacco control efforts.
Following her introductory remarks, Surgeon General Benjamin introduced Rosie Henson, Senior Advisor to the Assistant Secretary for Health, to provide an overview of the Department of Health and Human Services' tobacco prevention and control activities.
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