Tobacco use cessation.
A recent accomplishment is the Public Health Service document, Treating Tobacco Use and Dependence: Clinical Practice Guideline, which identifies treatments with demonstrated effectiveness in helping smokers quit. This resource will be a tremendous aid to Americans trying to quit tobacco use. It is available online at: http://www.surgeongeneral.gov/tobacco.
The FDA approves drugs intended for smoking cessation and has approved over-the-counter use for several of them. These steps have been instrumental in helping people quit smoking. Cessation materials across the Department also have been tailored to more effectively reach specific populations and decrease tobacco-related health disparities. Examples include the National Cancer Institute’s (NCI) La guía para dejar de fumar, a smoking cessation guide written in Spanish, and CDC’s Pathways to Freedom, a smoking cessation guide tailored to the African American community. This CDC guide provides education and guidance for individuals who smoke, helps friends and families be part of the solution, and provides strategies for community members who want to educate people about the dangers of tobacco.
The Centers for Medicare and Medicaid Services’ (CMS) Medicare Stop Smoking Program is a demonstration project on the most effective and cost-effective ways to help Medicare beneficiaries quit smoking. Findings from this project may affect a substantial proportion of the country, and have implications for health plans and other populations.
Programs from across the Department collectively create a comprehensive approach to promoting smoking cessation among women, particularly pregnant women. While women who smoke during pregnancy comprise a small percentage of the overall population, cessation efforts for these women are critical to protect the health and well being of future generations, including opportunities to continue smoking cessation following pregnancy and childbirth. Examples include the National Partnership to Help Pregnant Smokers Quit, a coalition of more than 50 federal, national, state, and local organizations that has developed guiding strategies around issues critical for pregnant women; several National Institute of Nursing Research-funded research projects; and CDC’s Dispelling the Myths About Tobacco: A Community Toolkit for Reducing Tobacco Use Among Women (www.cdc.gov/tobacco/sgr/sgr_forwomen/sgrtool.htm). These studies and programs seek to identify effective cessation and relapse prevention techniques, and to provide timely and relevant tools for community programs, including mass media and print materials. These efforts are critical to ensure that women who quit smoking during pregnancy continue to not smoke.
Examples of successful collaboration among U.S. public health agencies and organizations include: the development of the National Blueprint for Disseminating and Implementing Evidence-based Clinical and Community Strategies to Promote Tobacco use Cessation, a practical guideline for implementation of cessation strategies with demonstrated effectiveness; and the National Blueprint for Action, developed by the Youth Tobacco Cessation Collaborative to guide future research on cessation strategies for youth. NCI has a toll-free “Smoking Quitline” that will connect individuals with information specialists to answer smoking-related questions in English or Spanish.
The Synar program is one example of an effective collaboration between HHS and State governments to effectively prohibit the sale of tobacco products to minors. As a result, the rate at which retailers are willing to sell tobacco products to minors has decreased from a high of 41 percent in 1996 to approximately 14.5 percent in the most recent surveys in 2003.
In February 2004, Secretary Thompson announced plans for a new toll-free telephone number that will serve as a single access point to the national network of “quitlines.” By providing one easy-to-remember number, smokers in every state will have access to the tools they need to quit smoking. The program has three main components: (1) States with existing “quitlines” will receive increased funding to enhance existing state “quitline” services. States could use these supplements to expand their hours of operation, hire bilingual counselors, build referral linkages with local health care systems, or promote “quitlines” to more individuals. (2) States that do not have “quitlines” will receive grants to establish them to provide their residents the tools that they need to quit smoking. (3) HHS' National Cancer Institute (NCI) Cancer Information Service telephone counselors will provide assistance to individuals in states without “quitlines.”
HHS and its partner organizations also have helped state tobacco control programs through the creation of Smokefree.gov, the Web-based cessation tool provided by NCI with support from CDC and others, as well as by providing access to low-cost mass media materials and delivering relevant technical assistance and training through CDC’s Media Campaign Resource Center.
HHS agencies will continue monitoring youth tobacco-related behaviors through such programs as the following. The successful, ongoing surveillance of this ever-changing population through established tools, such as the National Institute on Drug Abuse (NIDA) Monitoring the Future Study, CDC’s Youth Risk Behavior Survey, and the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health, has been vital to determine trends and focus efforts at the federal, state, and local levels. The Synar Regulation, which is implemented and monitored by SAMHSA's Center for Substance Abuse Prevention, and requires States, the District of Columbia and Territories to enact and enforce tobacco access laws that restrict the availability of tobacco products to youth under 18 years of age, has been demonstrated to be effective in reducing illegal sales to minors.
The simple facts about tobacco use – that it causes death and disease and results in a tremendous social and economic burden – are well documented. There is still a great deal to be known. NIH is conducting research aimed at better understanding the biological, genetic, and behavioral aspects of nicotine addiction, which will aid in the development of more effective pharmacological and behavioral treatments.
As new tobacco products and cessation aids become available, many questions arise regarding their efficacy and health effects.
Data collection on youth and adult knowledge, attitudes, and behaviors is conducted through a multi-factorial surveillance system for both adults and youth by CDC, NIH, and SAMHSA. This surveillance remains critical to understanding the impact of tobacco use over time, and to monitor trends in tobacco use among specific populations.
The Department supports an extensive training network to provide technical assistance and expertise to State and local tobacco control program staff to implement the findings of Department-wide research. Examples include the National Conference on Tobacco or Health, CDC’s Annual Leadership Forum, Community Guide Workshops, and Disparities Pilot Training Programs. Through coordinated efforts across the agencies, communication campaigns disseminate key information to the public regarding effective cessation treatments, the hazards of exposure to secondhand smoke, and other prevention messages.