preventing 3 million premature deaths helping 5 million smokers quit a national action plan for...

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


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


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


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


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)


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)


The National Action Plan for Tobacco Cessation


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


Targeted Features (continued)• Public-private partnerships

• Impact should be both immediate and sustained

• Comprehensive and integrated

• Evaluated

• Securely funded


Recommendations

• Six Federal Initiatives

• Four Public-Private Partnerships


Federal Initiatives

1. A national tobacco quitline network• Evidence-based• Counseling and medications• Barrier-free• Managed by the states


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


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


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)


Federal Initiatives

5. Educate clinicians-in-training and practicing clinicians

• Curricula• Licensure and certification

examinations• Advanced training


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


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)


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


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


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


Next Steps

preventing 3 million premature deaths helping 5 million smokers quit a national action plan for...

Documents

tobacco research

health university of

tobacco cessationmichael

states university of

funded university of

intervention subcommittee

intervention timelineaugust

phd university of illinois