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Committee Member Comments

November 6, 2003: Public and Private Sector Roles in Tobacco Use Reduction

Committee Member Comments

Christine Williams, Agency for Healthcare Research and Quality, stressed the importance of thinking broadly in identifying research needs and considering not only basic research, but also translational research, (e.g., how to get physicians to ask the right questions in the clinical setting).

Jared Jobe, Ph.D., National Heart, Lung and Blood Institute, emphasized the importance of working with marketing and communications professionals to "un-sell" tobacco use. He mentioned that NCI is currently doing some of this work through its communications health research program.

Aron Primack, M.D., M.A., Fogerty International Center, talked about the unfortunate situation in Massachusetts with its decreased tobacco control funding and how it provides a natural "experiment" in determining the effects of funding loss over time.

Scott Leischow, Ph.D., National Cancer Institute, mentioned a public-private meeting underway focusing on surveillance and evaluation of tobacco programs. He also mentioned the challenge of thinking systematically about research and how to most effectively and strategically use the results to move us forward. Dr. Carmona responded by discussing a working group that he is part of consisting of all the country's Surgeons General. This group has identified smoking and obesity as two areas of common interest, and has had discussions about the importance of prevention initiatives that cut across several health risk areas. Dr. Carmona also mentioned that he had had some discussions with CDC and communications experts about Surgeon General reports and whether they are communicating important messages in the most effective manner.

Lynn Haverkos, M.D., National Institute of Child Health and Human Development, mentioned several new tobacco focused initiatives that this Institute was working on. One area is to better understand how behavior change occurs in children and a second area is in physician education about the effects of secondhand smoke.

Michael Fiore, M.D., M.P.H., Center for Tobacco Research and Intervention, University of Wisconsin Medical School, directed a question to Howard Koh regarding the Massachusetts initiative "Tax Tobacco. Save Kids." He asked whether voters believed that they were voting in favor of a tax increase to be dedicated to smoking prevention when in fact, this is not where the tax revenues have been placed. Dr. Koh responded by saying that the initiative included wording that stated that this money would be "subject to appropriation by the legislature." He added that he was interested in other peoples' thoughts about how to make initiative petitions more "iron clad" so that they are not being raided in difficult economic times. Dr. Koh also responded to Dr. Primack's earlier comment regarding the "natural experiment" in Massachusetts and mentioned Stan Glanz's findings in California that when the funding and media stopped, consumption went up, and when the program and media came back, consumption went back down.

Dr. Carmona thanked Dr. Koh for his comments, and agreed that this issue of "competing interests" is a very difficult one. People working in prevention need to unite and not position one group against the needs of another.

Thomas Hertz, Office of the Secretary, HHS, followed the discussion of prevention by talking about how the public health community could do a better job of linking prevention and treatment messages together. He offered the example of the high price of prescription drugs, and how many of the conditions people have that require these drugs are preventable.

Nicolas Trane, M.D., Blank Children's and Methodist Hospital, suggested that the Surgeon General should make statements and policy recommendations specifically targeted and directed toward children and youth. Dr. Carmona responded by saying that he thought it was a good idea, and would be happy to work with a group to determine the correct messages and the appropriate way to reach and motivate children.

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