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Welcome, Introductions, and Charge

December 8, 2008: The Role of Nicotine Addiction in Tobacco Use

Dana Shelton, Associate Director, Policy, Planning, and Coordination Unit, CDC's Office on Smoking and Health, and Executive Secretary for the Interagency Committee on Smoking and Health (ICSH)

Dana Shelton, Executive Secretary for the ICSH, welcomed participants, thanked the meeting planning committee and Partnership for Prevention for sponsoring the lunch and introduced RADM and Acting Surgeon General Steven Galson. Ms. Shelton asked ICSH Committee Members to introduce themselves.

RADM Steven Galson, M.D., M.P.H., Acting U.S. Surgeon General, U.S. Department of Health and Human Services

Acting Surgeon General RADM Steven Galson began by welcoming the Committee and thanking the field of tobacco control for providing so much "brand recognition" to the Surgeon General name because of cigarette package warning labels.

Dr. Galson continued by describing the purpose of the day's meeting: to hear from researchers about what is known about nicotine's role in tobacco use, what we still need to learn, how far we have come and what is needed in further research and practice to make additional progress to help tobacco users overcome addiction. In the 20 years since the first Surgeon General's Report on nicotine addiction evidence supporting its three major conclusions has only grown stronger: cigarettes and other forms of tobacco are addicting; nicotine is the drug in tobacco that causes addiction; and the pharmacologic and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. Since 1988 we have also learned much more about effective approaches to help people quit and a much wider array of quit aids are available today. There are seven FDA-approved cessation medications, including five forms of nicotine replacement therapy (NRT) and two non-nicotine medicines. There are also proven behavioral interventions to help people quit and stay quit including individual, group and telephone counseling. Toll-free telephone quitlines are now available in every state and can be accessed through the National Network of Quitlines at 1-800-QUIT NOW.

RADM Galson continued by describing some of the challenges that lay ahead in our efforts to help people quit. While about 70% of smokers report wanting to quit and more than 40% of them try to quit each year, only about one in three use evidence-based cessation treatments. Yet only about one out of twenty smokers who try to quit on their own succeed. If these smokers used proven behavioral and pharmacological cessation aids, they could double or triple these probabilities. Proven cessation treatments must be more widely available, and the Partnership for Prevention's recent call for every tobacco user to be provided with barrier-free access to comprehensive cessation treatments points to concrete steps to make this happen.

Although we have come a long way, there is still a need to expand the science base to address gaps in knowledge and keep pace with new challenges. For example, the emergence of a new generation of tobacco products, some of which are being marketed with implied health or cessation claims, has created new challenges for the field. In addition, many people who smoke come from marginalized sectors of society or have been diagnosed with mental illness or who may be experiencing other substance abuse problems. To this end, there is a need for research that answers questions such as:

  • How nicotine affects the developing brain chemistry of youth, and what age groups are most vulnerable to these effects
  • How nicotine interacts with other drug use, and what this means for the addiction process
  • How nicotine and cessation treatments affect people with mental health problems
  • How to make existing cessation treatments more attractive and how to make smokers want, expect and request these treatments
  • How to further increase the efficacy of cessation treatments

RADM Galson concluded his remarks with a charge to the Committee. He asked that ICSH chart the next steps to be taken to tackle the problem of nicotine addiction.

Following his introductory remarks, RADM Galson introduced the first speaker.

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