This week, the Institute of Medicine, a branch of the US National Academy of Sciences, released a 400-page comprehensive report (prepublication available here; 8 page summary brief available as pdf file here). It notes that the rates of adult smoking has dropped by more than 50% since 1965 and that the rates of high school students starting smoking are at all-time lows, but also that these trends appear to be flattening and that tobacco still accounts for an estimated >400,000 deaths each year in the US. The report calls for several significant changes, suggesting that state and local governments should ban smoking in malls, restaurants, and essentially nearly all public indoor spaces, and that the US FDA should regulate the marketing, packaging, and sale of tobacco products. This report also recommends an increase in federal taxes on cigarettes and a plan to gradually reduce the concentration of nicotine in cigarettes to a point below which they are no longer predictive. Some other highlights of the report recommendations include:
banning internet- and phone-based sales of tobacco products
requiring licensing of retail outlets that sell tobacco products
adding graphic picture warnings on cigarette packs, as is done in Canada now
restricting advertising to black and while only, text-based displays, and prohibiting tobacco companies from using terms like “light” and “mild” in their marketing
mandating all public and private health insurers to make smoking cessation programs a lifetime benefit
in addition to substantially raising federal taxes on tobacco products, raising taxes in states with lower tobacco tax rates in order to reduce the practice of inter-state smuggling
dedicating increased funds to tobacco control efforts
The goal of these efforts, according to Mr. Richard Bonnie, who is a law professor at the University of Virginia (who’d have suspected a Virginian would lead this campaign?) would be “reducing tobacco use so substantially that it no longer has a significant impact on public heath”. A lofty goal, and one we’d all love to see. Let’s hope at least some of these ideas get enough traction to move forward.
posted by Dr. West @ 7:56 am link to this post
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June 1st, 2007 at 10:18 am
Hello,
I have to comment ont his post because I truly beleive that smoking is not good for one, but what about the young adults who smoked for only a short time? what about our grand fathers who smoke no filter ciggarettes for 65 years and never got cancer? what really causes it in non smokers? DNA? family history?? or will we someday in the future find excactly what causes it and then find a CURE!!!!!!!!!! just my thoughts, and also are Dr. who did the biopsy also stated we do not know what causes it? HMMMMM
June 1st, 2007 at 11:01 am
How about: Sending copies of medical bills for LC to tobacco companies or, better, to our Congresspeople? Even as simply a PR/bad-publicity campaign, I like this idea! If and until we find an enveloping “cause” for all LC’s, the fact is that the majority of LC cases are caused by smoking and that no amount of smoking “works.”
June 1st, 2007 at 5:51 pm
It would certainly make life better for those of us trying to recover from lung cancer and are surviving with only one lung.
Right now I have to skirt around smokers who stand outside doorways. I am tired of rolling up my car windows at stop lights because smokers hang their cigarettes outside their cars. I hate staying in hotels because even in smoke free hotels they smoke on the balconies and smoke blows right back in. I can’t even walk down a sidewalk without dodging smokers upwind.
So as someone with impaired lung capacity and a tremendous respect for the consequences of lung cancer, I would welcome a complete ban on the sale of all tobacco products.
Barb
June 1st, 2007 at 8:47 pm
I think we’re experiencing a culture change, and it’s been going on for a couple of decades and is still continuing. I am actually pretty hopeful that there’s a real momentum of change, of more restrictions against smoking, and a general societal view that there isn’t a cool counter-cultural angst about it, but that it’s just unpleasant for other people and not a habit anyone should want to start.
I live in Washington state, which has some of the strongest restrictions on smoking, and because of that I’ve gotten pretty used to not being accosted by second-hand smoke anymore. I had a hard time on a trip up to Vancouver, BC last week, because while it’s a great city, there are too many public areas that are reminiscent of a jazz club — and not in the good way.
On the subject of the tobacco companies, I’m no fan of them, but I’m really disappointed that our state governments have taken millions and millions of dollars in tobacco settlement money and have used next to none of it to fund lung cancer support or research. It goes to all sorts of budget-balancing for projects in the state, for a new tunnel or park (great, love ‘em), but I think LC patients have really gotten a raw deal now from the states who were more than happy to accept settlement money and forget what it was really for.
I agree that we need to learn more about what causes LC in never-smokers, because we really don’t know much yet — some appears to be greater genetic risk, some second-hand smoke, ?radon, but there’s lots we don’t know. The good news is that the differences between LC in smokers and never-smokers is getting greater attention and study all the time. Today was the start of the American Society for Clinical Oncology (ASCO) meeting, the largest cancer conference in the world, and there was a very well-attended educational session on never-smoker lung cancer. It’s looking more and more like there are two distinct diseases. So while we don’t have lots of answers yet, there are a lot more people focusing on these questions than there ever used to be.
-Dr. West