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5 Critical Advances to Combat Tobacco Use

Fifty years ago, the U.S. Surgeon General jumpstarted America’s efforts to combat lung cancer and other diseases caused by smoking with the release of the 1964 U.S. Surgeon General’s Report on Smoking and Health.

The landmark report shined the light on the dangerous consequences of smoking and causally linked it to lung cancer and several other health diseases and complications. It led to mandatory health warnings on tobacco products and the eventual ban of smoking ads on TV and radio. Not only did the report have a major impact on public attitudes, it mobilized individual smokers and non-smokers, communities, health care organizations, policy makers, and educators to join forces and address the issue.

“This document was the first of its kind and was followed by many other reports of the Surgeon General on Smoking and Health,” says Ellen R. Gritz, PhD, a professor and chair of behavioral science at University of Texas M. D. Anderson Cancer Center.

As a contributor to the first Surgeon General’s Report on Women and Smoking (1980) and eight additional Surgeon General Reports on Smoking and Health, Gritz has witnessed many advances in smoking-cessation since the initial report.

Its impact was reflected recently in a paper published in The Journal of the American Medical Association that showed eight million lives were saved as a result of tobacco control efforts.

Five key areas contributed to smoking decline

Several antitobacco efforts have contributed to the smoking decline in the United States. Fifty years ago, more than 50 million Americans smoked cigarettes and other tobacco products. Today, adult smoking rates have decreased by more than half since 1965, and there is a steady decline among children and adolescent smokers. Rates have been reduced by one-half, but still about 43 million people smoke due to the increased population and millions more exposed.

MD Anderson experts have identified five critical developments to curb smoking and combat lung cancer.

• Taxation. Excise tax increases at the federal and state level have made the products less affordable and accessible to youths and lower-income people.

“Taxation is the single most important factor in reducing smoking rates,” says Gritz.

• Regulation and legislation. Key laws and regulations have played a major role in helping smokers quit. Regulations include imposing mandated warnings on tobacco products and prohibition of TV and radio advertisements. Most recently, bans on smoking in public places and further restrictions on the sale and distribution of cigarettes to minors are considered victories.

“We are making progress with actions like insurance coverage for smoking cessation treatment and federal community transformation grants like the one implemented in Austin promoting comprehensive tobacco control programs,” says Lewis Foxhall, MD, vice president of health policy at MD Anderson.

• Medications to help smokers quit. The FDA approved three over-the-counter nicotine replacement agents (patch, gum, lozenge), two prescription nicotine replacement agents (inhaler and nasal spray), and two prescription drugs—bupropion and varenicline—all shown to have a strong positive effect on smokers trying to quit.

• Educational programs for kids and adults. Programs like the national effort with Tobacco Free Kids and MD Anderson’s ASPIRE and Tobacco Free Teens app—all aimed at educating youth and adolescents on smoking prevention—have a significant impact in reducing the number of new smokers. Broadbased widely disseminated comprehensive education campaigns addressing the serious harms of tobacco to the general public have been effective.

“Educational programs, along with policies and campaigns have changed the social norms in our society making tobacco use less socially acceptable, particularly among youth,” says Alexander Prokhorov, MD, PhD, a professor of behavioral science at MD Anderson.

• Cessation programs for smokers. There are variousf resources and programs to help smokers quit. MD Anderson’s Tobacco Treatment Program uses counseling and pharmacotherapy tailored to the individual patient.

“Together, these different efforts create a comprehensive package to help people quit smoking and prevent them from starting,” says Gritz. “Continuation of the combined strategies and bold actions will be critical to reversing this epidemic.”

— Source: University of Texas M. D. Anderson Cancer Center