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Congress must not weaken nation’s fight against tobacco

While the United States has made tremendous progress in reducing smoking, tobacco use continues to take an enormous toll not just on the nation’s health, but on its finances as well. 

Tobacco use is still the leading preventable cause of death, claiming the lives of more than 480,000 Americans each year and sickening millions more.               

{mosads}Less well known is the fact that smoking costs the nation about $170 billion in annual healthcare expenditures, about 60 percent of which is paid by taxpayers through government programs such as Medicare and Medicaid. According to a December 2014 study in the American Journal of Preventive Medicine, smoking-related diseases each year account for 9.6 percent of Medicare expenditures, 15.2 percent of Medicaid expenditures and nearly a third of expenditures from other federal government-sponsored insurance programs. 

Given tobacco’s huge health and financial toll, including on the federal budget, it is good news that the federal government in recent years has taken several strong steps to accelerate progress against tobacco use. 

The 2009 increase in the federal tobacco tax helped jumpstart smoking reductions among both youth and adults. Also in 2009, the Family Smoking Prevention and Tobacco Control Act provided the Food and Drug Administration (FDA) with long-sought authority over the manufacturing, marketing and sale of tobacco products. In 2012, the Centers for Disease Control and Prevention (CDC) launched the first federally-funded national mass media campaign to reduce smoking, called Tips from Former Smokers (Tips), and has continued it since. 

To keep making progress, such science-based tobacco control strategies should be sustained and expanded. 

Given this, it is deeply troubling that two of the fiscal year 2016 appropriations bills approved by the House Appropriations Committee would instead weaken the strong measures implemented in recent years. 

One bill would cut funding by more than half for the CDC’s programs that prevent kids from smoking and help smokers quit. This proposed cut would likely eliminate the CDC’s Tips campaign, while also reducing funding for federal grants that support state tobacco prevention programs and telephone quit-lines. 

The second bill would undermine a key provision of the 2009 Tobacco Control Act that requires an FDA scientific review of new or changed tobacco products to determine their impact on public health. The bill would exempt certain products that have been introduced in recent years from such review, including sweet-flavored little cigars and electronic cigarettes that have proven popular with youth. 

Both provisions are steps backward in the fight against tobacco and should be rejected by Congress. 

The CDC’s tobacco research, prevention and cessation initiatives are the lynchpin of the nation’s tobacco control efforts and must be continued, including the successful and cost-effective Tips campaign. In its first year alone (2012), Tips helped an estimated 100,000 smokers to quit permanently and averted about 17,000 premature deaths, according to another December 2014 study in the American Journal of Preventive Medicine.

Impressively, the study found that the Tips campaign spent only $480 per smoker who quit and $393 per year of life saved, far less than the $50,000 per year of life saved that is the commonly accepted threshold for cost-effectiveness of a public health intervention. In short, the Tips campaign works, and it is a great buy for taxpayers.

The Tips campaign helps counter the huge sums – $9.6 billion a year, or more than $1 million an hour – the tobacco companies spend to market their deadly and addictive products. This relentless tobacco marketing is why the Surgeon General recommended that national media campaigns like Tips be sustained “at a high frequency level and exposure for 12 months a year for a decade or more.” 

Another tobacco industry tactic is to continually modify their products to make them more attractive or more addictive and to introduce new products, brands and styles that appeal to specific market segments, including children. The Tobacco Control Act sought to stop these practices by requiring FDA scientific review of these products. 

Congress should not weaken this review requirement for cigars, e-cigarettes and other products the FDA is currently seeking to regulate. In recent years, tobacco companies have introduced cheap, sweet-flavored cigars to get around the federal ban on flavored cigarettes, while e-cigarettes have become available in thousands of flavors, including many with kid-friendly names such as gummy bear and cotton candy. The FDA must retain the authority to determine the impact of these products on public health and to take action against products and marketing that appeal to kids.

By rejecting these harmful appropriations provisions, Congress can move the nation’s fight against tobacco forward. That is the right thing to do for the nation’s health and the fiscally responsible thing to do as well.

Chaloupka is a Distinguished Professor at the University of Illinois at Chicago and Director of the UIC Health Policy Center. He has published extensive research on the impact of economic, policy and environmental influences on health behaviors, including tobacco use.


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