Tobacco & Nicotine
CHARTing the Future Course of Tobacco-Cessation Interventions for Hospitalized SmokersEight articles in this issue give readers the unusual opportunity of seeing together the results of multiple clinical trials with a common goal—in this case, identifying effective strategies for implementing tobacco-cessation interventions among hospitalized cigarette smokers. Seven trials are included in a Theme Issue that reports the findings of the NIH-funded Consortium of Hospitals to Advance Research on Tobacco (CHART).1–8 An additional paper outside the Theme Issue reports the findings of an independently funded trial with the same goal.
A Brief History of the Tobacco Settlement in OklahomaThe 1998 national multistate Master Settlement Agreement (MSA) with the major cigarette manufacturers in the U.S. cultivated hope that payments from that settlement would be used to fund proven programs to prevent and reduce tobacco use. By 2002, tobacco prevention funding across all states reached an all-time high of nearly $750 million per year. However, that early promise was not sustained. Within just 2 years, state funding for tobacco prevention was reduced by more than $200 million.
Oklahoma’s Success in Reducing the Toll of TobaccoAs Governor of the State of Oklahoma, my goal is to create and maintain a happy, healthy, and productive state, but we cannot expect to improve the health of Oklahomans without addressing our state’s number one killer: tobacco. In fact, both of my parents died from smoking-related illnesses. After years of smoking, my father died from heart disease when he was younger than I am today. My mother smoked her whole life. At the age of 73 she had heart surgery, suffered a stroke, and was bedridden for five years before passing away.
Strategies to Reduce Youth Tobacco Use: Opportunities for Local GovernmentThis issue of the American Journal of Preventive Medicine examines factors associated with youth tobacco use–a timely topic given that this year is the 50th anniversary of the first Surgeon General’s Report on Tobacco. In 1960, the outlook was grim. The probability that a boy born in 1960 would be smoking by the time he was 20 years old was about 35%.1 After more than a dozen Surgeon General’s Reports describing the health consequences of tobacco use, the youth smoking rate in 1991 was still 27.5%.
Adapting to a Changing Tobacco Landscape: Research Implications for Understanding and Reducing Youth Tobacco UsePatterns of youth tobacco use in the U.S. are becoming increasingly complex with the greater availability, marketing, and promotion of a diverse set of tobacco products. Using data from the 2012 National Youth Tobacco Survey (NYTS), the series of papers in this issue present a multifaceted examination of the attitudes and behaviors surrounding the diversity of tobacco products with a nationally representative sample of middle and high school students. Taken together, these papers represent one of the most comprehensive pictures of adolescent tobacco use in the U.S.
Teen Tobacco Use: Research and Regulatory GapsCigarettes are the greatest single threat to public health in the U.S.1 and worldwide.2 The good news is that teen cigarette smoking has been trending down in recent years.3 The bad news is that teen use of other tobacco products may be taking up the slack.
Enhancing Youth Tobacco Surveillance to Inform Tobacco Product Regulation: Findings from the 2012 National Youth Tobacco SurveyDecreasing youth tobacco use is a significant public health priority. In the U.S., nearly one in 15 middle school students and one in four high school students were current tobacco users in 2012,1 and 5.6 million youth aged under 18 years today are projected to die prematurely from smoking-related disease.2 The Family Smoking Prevention and Tobacco Control Act (FSPTCA), signed into law on June 22, 2009, amended the Federal Food Drug and Cosmetic Act (FD&C Act) to provide the U.S. Food and Drug Administration (FDA) with the authority to regulate the manufacturing, distribution, and marketing of tobacco products to protect public health.
Maximizing the Public Health Impact of Alcohol and Tobacco TaxesSignificant increases in alcohol and tobacco taxes are among the most effective policies governments have for improving public health. Higher alcohol taxes reduce the prevalence, frequency, and intensity of drinking,1 as well as the traffic crashes, liver cirrhosis, violence, and other health and social consequences of harmful drinking.2 Likewise, increases in tobacco taxes promote cessation among adult users, prevent young people from taking up tobacco use, and reduce the death, disease, and economic consequences caused by tobacco.
The Food and Drug Administration's Regulation of Tobacco: The Center for Tobacco Products' Office of ScienceThe Family Smoking Prevention and Tobacco Control Act (TCA) was signed into law on June 22, 2009, and provided the Food and Drug Administration (FDA) broad regulatory authority with respect to the manufacture, marketing, and distribution of tobacco products. The three public health goals of the Center for Tobacco Products (CTP), FDA, are to prevent youth initiation of tobacco use, decrease harm and/or addictiveness of tobacco products, and encourage tobacco use cessation. The CTP has established an Office of Science to ensure that sound science exists with which to develop regulatory actions.
Minnesota's Investment in Tobacco Control: Research Findings to Inform Practice and PolicyMinnesota has a long history of leadership in tobacco control, dating back to a 1975 Clean Indoor Air law limiting smoking indoors. In 1998, a settlement was reached to a lawsuit the state and Blue Cross and Blue Shield of Minnesota had brought against cigarette manufacturers and related trade associations accusing them of failing to disclose information about the dangers and addictive qualities of cigarettes. As part of the settlement, the nonprofit organization ClearWay MinnesotaSM was created to reduce tobacco use and exposure to secondhand smoke through research, action, and collaboration.
Realizing the Vision for Tobacco ControlEnding the tobacco epidemic represents an aspirational, yet achievable, public health vision for our nation. Fulfilling that vision requires national commitment and collaboration. To date, the nation has certainly witnessed much progress, with adult cigarette use prevalence dropping by more than 50% from the peak levels of the 1960s.1,2 But tobacco dependence remains the leading preventable cause of mortality in our country, causing more than 400,000 deaths annually. To accelerate progress, we need a greater commitment to action and science than ever before.
Smokefree Community Policies Promote Home Smoking Bans: Unknown Mechanisms and Opportunities for Preventive MedicineStudies by Mills and colleagues1 and Cheng and colleagues2 in this issue of the American Journal of Preventive Medicine have added to the empirical foundation for secondhand smoke exposure (SHSe) reduction through public policies and rules in private homes.3 Each study employed population-based samples to address questions concerning the beneficial and unintended effects of policies and social processes on home bans, suggesting external validity.
Where There's an App, There's a Way?The National Tobacco Cessation Collaborative identified six core strategies as part of its Consumer Demand Roundtable with the overarching goal of increasing the demand, reach, and use of evidence-based cessation treatments.1 Two of the six core strategies are especially relevant to the paper by Abroms and her colleagues2 in this issue of the American Journal of Preventive Medicine: (1) redesigning evidence-based products and services to better meet consumers' needs and wants and (2) marketing and promoting cessation products and services in ways that reach smokers.