Tobacco Control Must Be Elevated As A Public Health Priority

Main Category: Smoking / Quit Smoking
Article Date: 17 May 2009 - 1:00 PDT

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An Essay published this week in the open access journal PLoS Medicine calls for the President Obama to "make a strong public commitment" to tobacco control by mobilizing US Government departments and agencies to achieve a coherent policy after eight years of neglect.

In their paper, Thomas Novotny and Joshua Yang, researchers in tobacco control and public health from San Diego State University and University of California San Francisco respectively, emphasize the huge potential for the US Government to reduce tobacco mortality and morbidity if action is co-ordinated across agencies. Presently tobacco use is the leading preventable cause of death in the United States - responsible for at least 443,000 deaths between 2002 and 2004 - and exacerbates health disparities in the country, with African Americans, Native Americans, people in poverty and those with lower educational attainment suffering from a higher burden of the diseases and disabilities that result from smoking.

Critically the authors argue that simple tobacco control measures - such as creating smoke-free environments, and engaging a mass media public education campaign - can come at little cost to the government. Programs that do require investment, such as providing comprehensive smoking cessation services and expanding regulation over tobacco products, marketing and promotion, could eventually yield economic return. Smoking is currently a huge fiscal burden, resulting in the loss of $96.8 billion in productivity losses and over $75 billion in annual US medical expenditures.

The paper outlines the agencies that can play an important part in a revitalized approach and stress three key tobacco control issues that should be prioritized to frame a national policy coherence plan. Firstly, the ratification of the first ever global health treaty, the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC) - which was not sent to the Senate by President George W. Bush - could act as a framework for national policy. The bill to grant the US Food and Drug Administration (FDA) regulatory authority over tobacco products, recently passed by the US House of Representatives, should contain the strongest possible language without concessions to the tobacco industry. And thirdly, the authors point towards settling the case that the Department of Justice brought against the tobacco industry, currently in appeal, which orders the industry to cease false and deceptive activities.

"We believe this change in direction is based on sound science, is acceptable to the almost 80% of non-smoking Americans and the 70% of smoking Americans who want to quit, and in the best fiscal and health interests of the United States", say the authors. Furthermore, by implementing the FCTC the United States can demonstrate international commitment to tobacco control and spur other countries to implement the treaty.

Funding: Financial support for this project was provided by National Cancer Institute Fellowship Funding CA-113710-02 (JSY). The funder had no role in the preparation of the manuscript.

Citation: "Policy Coherence in US Tobacco Control: Beyond FDA Regulation."
Yang JS, Novotny TE (2009)
PLoS Med 6(5): e1000079. doi:10.1371/journal.pmed.1000079

Source
Plos Medicine