OncologyTobacco Control Must Be Elevated As A Public Health Priority
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
Plos Medicine