Post on 17-Jan-2016
Preventing 3 Million Premature Deaths
Helping 5 Million Smokers Quit
A National Action Plan for Tobacco Cessation
Michael C. Fiore, M.D., M.P.H., ChairSubcommittee on CessationInteragency Committee on Smoking and HealthDecember 11, 2003
University of Wisconsin - Center for Tobacco Research and Intervention
Subcommittee on Cessation
Interagency Committee on Smoking and Health
University of Wisconsin - Center for Tobacco Research and Intervention
Charge
• Make recommendations on how best to promote tobacco use cessation
• Identify specific action steps for DHHS to take and opportunities for public-private partnerships to promote cessation
University of Wisconsin - Center for Tobacco Research and Intervention
Goals
• Reduce prevalence of tobacco use by at least 10%
• Prevent 3 million premature deaths• Help at least 5 million smokers quit
within the first year• Address disparities
University of Wisconsin - Center for Tobacco Research and Intervention
Timeline
• August 2002: Subcommittee established
• February 11, 2003: Interagency Committee on Smoking and Health, chaired by Surgeon General Carmona, unanimously endorsed sending final report to DHHS Secretary Thompson for his consideration
University of Wisconsin - Center for Tobacco Research and Intervention
Members
• Robert Croyle, PhD (NCI)• Susan Curry, PhD (University of Illinois at Chicago)• Charles Cutler, MD, MS (American Association of
Health Plans)• Ronald Davis, MD (Henry Ford Health System and
American Medical Association)• Michael Fiore, MD, MPH (University of Wisconsin
Medical School (chair))• Catherine Gordon, RN, MBA (CMS)• Cheryl Healton, DrPH (American Legacy Foundation)
University of Wisconsin - Center for Tobacco Research and Intervention
Members (continued)
• Rosemarie Henson, MSSW, MPH (CDC)• Howard Koh, MD, FACP (Commonwealth of
Massachusetts)• James Marks, MD, MPH (CDC)• C. Tracy Orleans, PhD (The Robert Wood Johnson
Foundation)• Dennis Richling, MD (Union Pacific Railroad)• David Satcher, MD (Morehouse School of Medicine)• John Seffrin, PhD (American Cancer Society)• Christine Williams, MEd (AHRQ)• Larry Wiliams, DDS, MAGD (Dental Corps, US Navy)
University of Wisconsin - Center for Tobacco Research and Intervention
The National Action Plan for Tobacco Cessation
University of Wisconsin - Center for Tobacco Research and Intervention
Targeted Features
• Meaningful reductions in both tobacco use and the resultant burden of illness, premature death, and economic costs
• Science-based
• Address disparities
• National in scope, regional in application
University of Wisconsin - Center for Tobacco Research and Intervention
Targeted Features (continued)• Public-private partnerships
• Impact should be both immediate and sustained
• Comprehensive and integrated
• Evaluated
• Securely funded
University of Wisconsin - Center for Tobacco Research and Intervention
Recommendations
• Six Federal Initiatives
• Four Public-Private Partnerships
University of Wisconsin - Center for Tobacco Research and Intervention
Federal Initiatives
1. A national tobacco quitline network• Evidence-based• Counseling and medications• Barrier-free• Managed by the states
University of Wisconsin - Center for Tobacco Research and Intervention
Federal Initiatives
2. A national paid media campaign• Promote National Tobacco Quitline
network• Motivate tobacco users to quit• Inform parents about risks of second-
hand smoke
University of Wisconsin - Center for Tobacco Research and Intervention
Federal Initiatives
3. Coverage for evidence-based tobacco cessation counseling and medications for all Federal beneficiaries and in all federally-funded healthcare programs
• Access to treatment for 100 million Americans
• Reduce disparities• Model for private sector
University of Wisconsin - Center for Tobacco Research and Intervention
Federal Initiatives
4. Invest in a new, broad, and balanced research agenda
• Improve long-term successful cessation rates to at least 50%
• Identify treatments for underserved tobacco users (adolescents, low SES, racial and ethnic minorities, pregnant smokers)
University of Wisconsin - Center for Tobacco Research and Intervention
Federal Initiatives
5. Educate clinicians-in-training and practicing clinicians
• Curricula• Licensure and certification
examinations• Advanced training
University of Wisconsin - Center for Tobacco Research and Intervention
Federal Initiatives
6. Establish a Smokers’ Health Fund• Increase the Federal Excise Tax on
cigarettes by $2.00 per pack (from the current rate of $0.39 to $2.39)
• Similar increase in the excise tax on other tobacco products
• Earmark at least 50% of the new revenue ($14 billion of estimated $28 billion) generated to help smokers quit through the steps outlined in the action plan
University of Wisconsin - Center for Tobacco Research and Intervention
Public-Private Partnerships1. Partner with insurers, employers, and
purchasers to include coverage for evidence-based tobacco cessation counseling and medications as part of the basic benefits package
• Improve employee health• Save money (absenteeism, healthcare
costs)
University of Wisconsin - Center for Tobacco Research and Intervention
Public-Private Partnerships2. Utilize systems-level changes and
quality improvement strategies to expand the delivery of evidence-based tobacco dependence treatments
• Systems supports• Enhance access to services• Improve patient care
University of Wisconsin - Center for Tobacco Research and Intervention
3. Establish the provision of evidence-based tobacco dependence treatment as a standard of care
• National quality assurance and health care organizations
• Establish a uniform measurement• Improve patient care
Public-Private Partnerships
University of Wisconsin - Center for Tobacco Research and Intervention
4. Partner with community organizations to support programs and policies at the local level
• Motivate tobacco users to quit• Support use of evidence-based
treatments to increase success• Address disparities in treatment
participation and success
Public-Private Partnerships
University of Wisconsin - Center for Tobacco Research and Intervention
Next Steps