WASHINGTON – A coalition of health groups including the American Academy of Pediatrics, the American Heart Association, and the American Cancer Society Cancer Action Network are urging regulators to help the nation achieve at least an 8% reduction in adult smoking rates by 2024.
Smoking kills 440,000 Americans a year and leads to $193 billion in health costs, according to the coalition, which also includes the American Lung Association, the Campaign for Tobacco-Free Kids, the Legacy Foundation, and Americans for Nonsmokers’ Rights. The groups noted that tobacco is the leading cause of preventable death in the United States.
Tobacco control is effective, Dr. Kenneth E. Warner, a distinguished university professor of public health at the University of Michigan, Ann Arbor, said at a briefing with reporters. He cited just-published data from a JAMA study he conducted with colleagues showing that control efforts had resulted in 8 million saved lives since 1964 and a 30% gain in life expectancy during the same time period (JAMA 2014;311:164-71).
The group said it wants regulators at all levels of government to help reduce smoking from about 18% of adults to less than 10% by 2024, protect all Americans from second-hand smoke within 5 years, and eventually eliminate death and disease caused by tobacco use.
The call to action was issued a week before the release of a new report from the U.S. Surgeon General’s Office on smoking and health that will tabulate the progress in the 50 years since the first Surgeon General’s report on smoking and also lay out the challenges still ahead.
"What has been accomplished in the last 50 years is nothing short of astounding," Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, said in a briefing with reporters. He noted that the adult smoking rate has dropped by more than half, from 42% in 1964 to 18%. Among high school seniors, smoking rates have dropped from 36% in 1997 to 16%. Half of the U.S. population is protected from second-hand smoke by laws that bar smoking in public places.
But 44 million adults and almost 4 million children are still current smokers, and each day, 3,000 children start what usually becomes a lifetime habit. Mr. Myers called smoking a "pediatric epidemic."
Mr. Myers and other speakers decried what they said are continued efforts by tobacco makers to target children. Dr. James M. Perrin, president of the American Academy of Pediatrics, noted that although the Food and Drug Administration halted sales of candy-flavored cigarettes in 2010, other candy-like products have emerged, including dissolvables, cigars, and e-cigarettes that have flavors like cotton candy and grape.
"Strong tobacco regulation by the Food and Drug Administration is essential," said Dr. Perrin.
The coalition said that local, state, and federal governments could also help deter tobacco use by increasing excise taxes on tobacco products and raising the age of purchase. New York City and the big island of Hawaii both have banned sales to anyone under age 21 years. High school students may be friends with 18- and 19-year olds, but they aren’t as likely to have peers older than age 20, said Dr. Perrin. Raising the purchase age thus "limits the exposure of younger children ... to tobacco," he said.
E-cigarettes are also a growing concern, even though they are being pitched as a potential smoking cessation tool by their manufacturers, coalition members said. The products also are being marketed to children in a similar way that tobacco has been, said Mr. Myers. The coalition wants FDA regulation of those products "to ensure that the potential for their use to get people to quit is realized, but the danger of their becoming the next generation’s nicotine addiction is avoided," he said.
The Obama Administration may be poised to give the FDA more power to regulate e-cigarettes, said Paul Billings, senior vice president for advocacy at the Lung Association. "There are no e-cigarette products that have been demonstrated to be safe and effective to the Food and Drug Administration," said Mr. Billings.
The rules have been under review for more than 90 days, said Mr. Billings, adding "it’s time for action."
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