Of the 44.5 million adult smokers in the United States, 70 percent want to quit and 40 percent make a serious quit attempt each year, but fewer than 5 percent succeed in any given year, according to an independent state-of-the-science panel convened in June by the National Institutes of Health.
Effective tobacco-use cessation interventions are available and could double or triple quit rates, according to the panel, but not enough smokers request or are being offered these interventions. The panel stressed the need for a national, coordinated strategy for tobacco-use control that casts a wide net to address this critical gap.
The 14-member panel assessed the available scientific evidence on tobacco-use prevention, cessation and control. It included experts in the fields of medicine, general and pediatric psychiatry, addiction medicine, nursing, social work, population science, cancer prevention, minority health and health disparities, clinical study methodology and clinical epidemiology, as well as a public representative.
The panel found that interventions and treatments such as nicotine replacement therapy, telephone quit lines and counseling are effective individually, and even more effective in combination. It also concluded that strong evidence exists 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.
Panel members found that one way to increase the use of effective treatments is to better target interventions to address health disparities, while 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," said David F. Ransohoff, MD, professor of medicine, University of North Carolina at Chapel Hill, and chair of the conference panel.
The panel emphasized that preventing tobacco use is essential to reducing tobacco-related illnesses and death. Initiation to tobacco use occurs primarily during adolescence, with almost all daily smokers having tried cigarettes before 18 years of age. More than 20 percent of 12th graders have smoked in the previous 30 days, according to the panel. It found that programs aimed at preventing tobacco use among youth are most effective when they involve multiple approaches, such as mass media campaigns and price increases through taxes on tobacco products.
The panel concluded that smokeless tobacco products are of great concern for three reasons: smokeless tobacco use is associated with numerous health risks; there are limited data about the effect of smokeless tobacco on the public’s health; and new products and aggressive marketing may increase the 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.
