Effective Strategies for Tobacco Cessation Underused

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Quitting Smoking

Of the 44.5 million adult smokers in the United States, 70 percent want to quit and 40 percent make a serious quit attempt of smoking 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. Nicotine is highly addictive and a major public health concern. 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.

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"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.

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