End-game within reach
A new report proposes the immediate and accelerated implementation of three actions aimed at ending cigarette use by US adults.
* Increase excise taxes at the federal level and in many states with four goals: lowering smoking rates, harmonizing taxes across state borders to reduce the illegal trade, covering the costs of smoking-related disease, and encouraging a shift from cigarettes to reduced-risk products and complete cessation.
* Encourage health and life insurers, employers, and health professionals actively to promote smoking cessation measures supported by the US Preventive Services Task Force and the 2014 US Surgeon General’s Report.
* Establish a more rational tobacco, nicotine, and alternative products regulatory framework that is based on their relative risks, and that is adaptable to the increased speed of innovation in new technology development.
The report, Ending cigarette use by adults in a generation is possible, was the work of a team of tobacco control and health experts whose goal was to assess the views of 120 US tobacco control experts about what they saw as some of the key areas and priorities for significantly reducing or eliminating the use of the cigarette.
According to the report’s executive summary, each year cigarette smoking directly kills 480,000 Americans. ‘It also harms many millions more through secondary effects,’ it says. ‘The economic toll is enormous and costly, with an annual medical bill of over $170 billion. Yet, the public and media’s focus has largely shifted to other health issues. Mainstream tobacco control largely centers on measures to slow youth uptake, which will yield mortality and health gains, but will only reach its full impact 50 years from now.
‘There is an urgent need to accelerate progress to end cigarette smoking in adults. That requires fully implementing historically-validated tobacco control measures – especially tobacco taxes – and integrating new science-based reduced-risk products into tobacco control. Simultaneously, we need to pursue a long-term approach to nicotine that is coherent with, and proportionate to, the risks associated with other public health measures required to address psychoactive substances.
‘We consulted 120 key tobacco control leaders across the United States… They represent a broad swath of tobacco control experience and expertise, ranging from researchers and academics, to advocates, state and urban tobacco control staff, government officials, and local front-line workers. Their input is integrated into a proposed strategy to achieve the goal of reducing cigarette smoking in adults to less than 10 percent in all communities nationwide by 2024.
‘This is not a consensus report. We considered all inputs, and focus here on what represents the needed balance between what has worked to reduce smoking in the US, and additional steps that are now needed. These steps draw upon advances in technology and deeper insights into what drives behavior change.’
