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How Can We Reduce Tobacco Use?


What steps need to be taken to reduce the growing use of tobacco both in America and around the world? That’s a question that is addressed in a new American Cancer Society report which provides suggested policies, activities, and interventions designed to help make reduced tobacco use a reality.

The report, which was headed by Thomas Glynn, PhD, the American Cancer Society director of Cancer Science and Trends, notes that tobacco is used by at least 1.3 billion people around the world and that more than 14,500 people die each day as a direct result of its use. Based on figures from the National Cancer Institute, an estimated 430 people died of lung cancer each day in the United States in 2009.

The new report includes a list of 21 challenges for governments, advertisers, healthcare providers, policy makers, and others to take up and follow through on to help reduce tobacco use. Among the items is one that the report says is the one most important action: increase and maintain support for the Framework Convention on Tobacco Control (FCTC). The FCTC, which is the first treaty negotiated under the auspices of the World Health Organization (WHO), was formed in response to the global problem of rising tobacco use to develop regulatory strategies. The treaty has been embraced by 168 parties thus far, according to the FCTC website.

Another challenge mentioned in the report is to reduce targeting of youth by tobacco company advertising. Youth-specific marketing is a top priority for the tobacco industry because they need to establish “replacement smokers” for those tobacco users who quit or die. It is also a well-established fact that the younger people begin to smoke, the more likely they are to continue smoking into adulthood.

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Currently, the rate of tobacco smoking among teenagers is higher than it is among adults. According to a 2007 survey from the Centers for Disease Control and Prevention (CDC), 50 percent of high school students had tried smoking cigarettes. In 2008, more than 25 percent of children age 12 or older were using tobacco, which equals about 71 million teens who were smoking cigarettes.

Increasing tobacco taxes is another challenge noted in the report. This tactic is considered perhaps the most effective way to reduce tobacco use. A 10 percent increase in the price of cigarettes is generally accepted to result in at least a 7 percent reduced demand for tobacco among youth and 4 percent among adults, according to the CDC.

Do you want to stop smoking? The report states a need for increased access to comprehensive treatment for tobacco smokers. If just 50 percent of current smokers were able to quit by 2020, the World Bank estimates that more than 180 million lives could be saved by mid-century.

Some of the other challenges presented in the report include: reduce tobacco use by physicians and other healthcare professionals, decrease tobacco targeting of women, reduce exposure to secondhand smoke, decrease illicit smuggling and trade of cigarettes, increase regulation of all tobacco products, and make health warnings on tobacco packaging more graphic. On this latter point, the FCTC guidelines call for graphic warnings on at least 50 percent of the cigarette package.

While the American Cancer Society provides a comprehensive list of challenges to reduce tobacco use, the authors also note that there are still additional items that could be included. The report notes that “Tobacco control is unique in the public health and disease control field because it encompasses such a wide range of issues.” These issues make reducing tobacco use a challenge that will require the efforts and talents of many people, working together, for quite some time to come. The complete list of 21 challenges is detailed in the report, published in CA: Cancer Journal for Clinicians.

Centers for Disease Control and Prevention
Glynn T et al. The globalization of tobacco use: 21 challenges for the 21st century. CA Cancer Journal for Clinicians 2010
National Cancer Institute
World Health Organization