Effective Strategies for Tobacco Cessation Underused,
Panel Says
Of the 44.5 million adult smokers in the United States, 70 percent
want to quit and 40 percent make a serious quit attempt each year,
but fewer than 5 percent succeed in any given year. Effective tobacco
cessation interventions are available and could double or triple
quit rates, but not enough smokers request or are being offered
these interventions. Tobacco use is a major public health concern,
and a national, coordinated strategy for tobacco control that casts
a wide net is needed to address this critical gap.
This was a key finding of an NIH state-of-the-science panel convened
this week to assess the available scientific evidence on tobacco
use prevention, cessation, and control. Full text of the panel’s
draft state-of-the-science statement will be available later today
at http://consensus.nih.gov,
including the panel’s identification of promising directions for
future research.
The panel found that smoking cessation interventions/treatments
such as nicotine replacement therapy, telephone quitlines, and
counseling were individually effective, and even more effective
in combination. The panel also concluded that there is strong evidence
to support the effectiveness of economic strategies such as increasing
the cost of tobacco products through taxes and reducing out-of-pocket
costs for effective cessation therapies.
“It’s important to recognize tobacco use as a serious, chronic
health issue that requires sustained attention,” said David F.
Ransohoff, M.D., professor of medicine at the University of North
Carolina at Chapel Hill and chair of the conference panel. “Quitting
is a struggle, but researchers have learned a lot about what works
to help people quit smoking. We need to make sure that effective
interventions reach the people who need them most.”
The panel found that one way to increase the use of effective
treatments would be to better target interventions to address health
disparities, recognizing that generic treatments are not appropriate
for everyone. “To increase demand for treatments we must motivate
smokers to want them, expect them, and use them,” added Ransohoff.
The panel emphasized that preventing initiation to tobacco use
is essential to reducing tobacco-related illness and death. Initiation
to tobacco use occurs primarily during adolescence, with almost
all adult daily smokers trying cigarettes before age 18. In fact,
over 20 percent of 12th graders have smoked in the prior 30 days.
The panel found that programs aimed at preventing tobacco use in
youth are most effective when they utilize multiple approaches
such as mass media campaigns and price increases through taxes
on tobacco products.
The panel concluded that smokeless tobacco products were of great
concern for three reasons: 1) smokeless tobacco use is associated
with numerous health risks, 2) there are limited data about the
effect of smokeless tobacco on public health, and 3) new products
and aggressive marketing may increase use of smokeless tobacco
in the United States. The panel stressed that more research is
needed to determine the overall effect of marketing and use of
these products.
The 14-member panel included experts in the fields of medicine,
general and pediatric psychiatry, addiction medicine, nursing,
social work, population science, cancer prevention, minority health
and health disparities, clinical study methodology, clinical epidemiology,
and a public representative. A listing of the panel members and
their institutional affiliations is included in the draft conference
statement. Interviews with panel members can be arranged by calling
Kelli Marciel at 301-496-4819 or via e-mail to marcielk@od.nih.gov.
In addition to the material presented at the conference by speakers
and the comments and concerns of conference participants presented
during discussion periods, the panel considered pertinent research
from the published literature and the results of a systematic review
of the literature commissioned by the NIH Office of Medical Applications
of Research (OMAR). The systematic review was prepared through
the Agency for Healthcare Research and Quality (AHRQ) Evidence-based
Practice Centers (EPC) program, by the RTI International-University
of North Carolina Evidence-based Practice Center. The EPCs develop
evidence reports and technology assessments based on rigorous,
comprehensive syntheses and analyses of the scientific literature,
emphasizing explicit and detailed documentation of methods, rationale,
and assumptions. The evidence report on Tobacco Use: Prevention,
Cessation, and Control is available at http://www.ahrq.gov/clinic/tp/tobusetp.htm.
The panel’s statement is an independent report and is not a policy
statement of the NIH or the federal government. The NIH Consensus
Development Program, of which this conference is a part, was established
in 1977 as a mechanism to judge controversial topics in medicine
and public health in an unbiased, impartial manner. NIH has conducted
118 consensus development conferences, and 28 state-of-the-science
(formerly “technology assessment”) conferences, addressing a wide
range of issues. A backgrounder on the NIH Consensus Development
Program process is available at http://consensus.nih.gov/forthemedia.htm.
NOTE TO TV EDITORS:
The press conference at 2:00 p.m. on Wednesday, June 14, will be
broadcast live via satellite at the following coordinates:
C-Band Galaxy 3C
Transponder: 23C
Orbital Location: 95 degrees west
Downlink Frequency: 4160 H
Audio: 6.2/ 6.8
Test time: 1:30-2:00 p.m. ET
Broadcast: 2:00-3:00 p.m. ET
NOTE TO RADIO EDITORS:
An audio report of the conference results will be available after
4:00 p.m. Wednesday, June 14, from the NIH Radio News Service
by calling 1-800-MED-DIAL (1-800-633-3425) or visiting http://www.nih.gov/news/radio/index.htm.
The Office of the Director, the central office at NIH, is
responsible for setting policy for NIH, which includes 27 Institutes
and Centers. This involves planning, managing, and coordinating
the programs and activities of all NIH components. The Office
of the Director also includes program offices which are responsible
for stimulating specific areas of research throughout NIH. Additional
information is available at http://www.nih.gov/icd/od/.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov. |