On July 27, along with the Advisory Committee to the Director, I had the privilege of receiving the report and recommendations of the Women, Tobacco, and Cancer Working Group during a teleconference with the working group's co-chairs, distinguished scientists Drs. Ellen R. Gritz and C. Tracy Orleans. The report, available at http://planning.cancer.gov/whealth/reports/wtobacco.htm, represents the collaborative efforts of an outstanding team of scientists, clinicians, and advocates who participated in a public/private partnership to map an achievable solution to the problem of tobacco-related morbidity and mortality among women.

Under the leadership and guidance of Ms. Anna Levy, deputy director of NCI's Office of Women's Health, and Dr. Michele Bloch, medical officer in NCI's Tobacco Control Research Branch, the working group's starting point was the 2001 report of the Surgeon General, Women and Smoking - a comprehensive, scientific review of smoking's effects on women's health and strategies to reduce smoking by women. In February 2003, some of the most knowledgeable and experienced experts in the fields of tobacco-related disease and women's health met in Houston, Texas to discuss this topic. Their collective wisdom, experience, and creative ideas form the substance of this report.

In the United States, lung cancer mortality for white women increased by more than 600 percent between 1950 and 1997, exceeding mortality from breast cancer. Today it is estimated that 1 in 5 U.S. women smoke and 170,000 women die each year from diseases directly related to smoking. While prevalence rates have decreased in the last decade overall, they remain stubbornly high in specific minority and economically disadvantaged populations. For instance, 40 percent of Native American women smoke, compared with 22 percent of white women. Higher smoking rates are related to lower educational levels.

In its report, Women, Tobacco, and Cancer: An Agenda for the 21st Century, the working group recommends strategies to meet five overall goals in the areas of discovery, development, delivery, partnerships, and evaluation and surveillance that will contribute to reducing and ultimately eliminating the harmful health effects of smoking in women.

The recommendations include 1) increasing understanding of sex and gender differences that affect tobacco use and related cancers among women, women's perceptions of risk, and women's responses to health interventions; 2) developing new and more effective interventions to prevent and treat tobacco use and environmental tobacco smoke (ETS) exposure, especially in high-risk populations; 3) ensuring widespread delivery of the most effective interventions to target groups; 4) harnessing existing collaborations and building new partnerships to maximize development and dissemination of effective interventions; and 5) monitoring tobacco use and exposure to ETS and evaluating progress toward reducing the impact of tobacco use and tobacco-related disease.

The report issues a challenge to federal and non-federal organizations, communities, and individuals alike to carry forward the strategies outlined within it. I have confidence that its significance and impact on preventing needless suffering for women, girls, and their families will more than prove itself with time. We welcome your input into the possible strategies for successful implementation of these important recommendations.

Dr. Andrew C. von Eschenbach
Director, National Cancer Institute