Category Archives: Tobacco

Jan 8 2014
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Public Health News Roundup: January 8

Survey: Half of U.S. Adult Smokers Plan to Quit for New Year
More than half of adult smokers in the United States made quitting tobacco a New Year’s resolution for 2014, according to a new survey from Legacy, a national public health nonprofit. These findings are especially significant today, on the eighth day of the new year, as the eighth day of a quit attempt is when a smoker is most vulnerable to a relapse. This month also marks the 50th anniversary of the first Surgeon General’s report on tobacco. Among the survey’s other findings:

  • 41 percent planned to quit smoking "cold turkey" for New Years, which is largely ineffective for the majority of smokers
  • 12 percent planned to switch to electronic cigarettes, an unregulated product whose safety risks remain unknown
  • 37 percent plan to quit to save money
  • 31.7 percent want to quit because they don’t want their clothes and hair to smell

Read more on tobacco.

ACS: Cancer Death Rates Fell 20 Percent Over Two Decades
The combined cancer death rate for men and women fell 20 percent in the two decades from 1991 to 2010, with better prevention, screening and treatment critical to continuing this positive trend, according to a new report from the American Cancer Society. The drop translates to approximately 1,350,400 fewer deaths. The report estimates that the United States will see a total of 1,665,540 new cancer cases and 585,720 deaths from cancer in 2014. From 2006 to 2010, cancer death rates decreased by 1.8 percent annually in men and by 1.4 percent in women. Lung, colon, prostate and breast cancers are the most common causes of cancer death, with lung cancer accounting for approximately one in four deaths. Read more on cancer.

‘Green’ Labels for Healthy, ‘Red’ for Unhealthy Foods Improve Nutritional Selections
The “stop” and “go” colors of traffic signals may be able to improve healthy eating choices in cafeterias, according to a new study in the American Journal of Preventive Medicine. A redesign of the cafeteria at Massachusetts General Hospital combined better locations for health food items with red, yellow and green labels marking the nutritional quality of different foods, with junk foods being red. Over two years, green-labeled items sold at a 12 percent higher rate and sales of red-labeled items dropped by 20 percent. "Our current results show that the significant changes in the purchase patterns...did not fade away as cafeteria patrons became used to them," said study lead author Anne Thorndike, MD, of the division of general medicine at the Boston hospital. "This is good evidence that these changes in healthy choices persist over time." To learn more about the study and concept, go to "Traffic-Light Labels and Choice Architecture: Promoting Healthy Food Choices" at RWJF.org. Read more on nutrition.

Jan 3 2014
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Public Health News Roundup: January 3

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Study: Newly Insured Visit Emergency Departments More Often
While some experts have speculated that expanded insurance under the Affordable Care Act would decrease the rate of emergency department visits, a new study in the journal Science indicates that newly insured people actually visit the departments significantly more than people who were uninsured. The study of 25,000 Medicaid lottery participants in Oregon in 2008 found that people who received expanded coverage increased their visits by 40 percent—or 0.41 visits—over a period of 18 months. The visits encompassed all manner of health issues, included issues that could have been treated by a primary care physician and would have been covered by the insurance. Read more on access to health care.

Electronic Media Use During Family Meals Tied to Poorer Nutrition and Communication
The use of electronic devices—including television, music with headphones and texting—by teens during meals is linked to less nutritious food and poorer family communication, according to a new study in the Journal of the Academy of Nutrition and Dietetics. In a survey of more than 1,800 parents, researchers asked how often adolescent children used a variety of electronics during family meals, whether they had any rules regarding their use and whether they felt family meals were important; the children were asked questions about family communication, such as how often they discussed their problems with their parents. The study found that two thirds of the teens watched television or movies some of the time, with one quarter watching frequently. Other electronic activities were less common, occurring 18 to 28 percent of the time. About 75 percent of the families had limits on mealtime media. "There is no magic number of how many (family meals) to have, not all food at meals has to be 100% healthy and having electronic media at meals is not all bad (e.g., an occasional movie night with dinner) if it facilitates family time," said lead author Jayne A. Fulkerson. "But, parents can take small steps to have quality time with their children by reducing media use at mealtimes." Read more on nutrition.

Smoking Adds $17 Billion to Post-Surgery Costs Each Year
Smoking-related complications following surgery—for both current and former smokers—add an estimated $17 billion in direct U.S. medical costs each year, according to a new study in JAMA Surgery. The study, led by David Warner, MD, of the Mayo Clinic, looked at surgical patients between April 2008 and December 2009. While the costs for initial hospitalizations was relatively consistent for current smokers, former smokers and people who never smoked, post-surgery costs were an estimated $400 higher for current smokers and $273 higher for former smokers. Read more on tobacco.

Jan 2 2014
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Public Health News Roundup: January 2

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NIH: 10 Percent of Driving Time Spent Distracted by Secondary Tasks
About 10 percent of an average driver’s time behind the wheel is spent engaged in something besides focusing on the road, which is especially dangerous for younger drivers, according to a new study in the New England Journal of Medicine. Common distractions include eating, reaching for a phone, texting, or simply taking their eyes off the road. Researchers from the National Institutes of Health (NIH) and Virginia Tech used video technology and in-vehicle sensors to determine their findings. “Anything that takes a driver’s eyes off the road can be dangerous,” said study co-author Bruce Simons-Morton, EdD, MPH, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the NIH institute where the study was conducted. “But our study shows these distracting practices are especially risky for novice drivers, who haven’t developed sound safety judgment behind the wheel.” The study found that novice drivers were:

  • Eight times more likely to crash or have a near miss when dialing
  • Seven to eight times more likely to crash or have a near miss when reaching for a phone or other object,
  • Almost four times more likely to crash or have a near miss when texting, and
  • Three times more likely to crash or have a near miss when eating.

Read more on transportation.

Study: Tripling Global Tobacco Taxes Could Prevent 200M Premature Deaths
Tripling the taxes on tobacco could prevent 200 million premature deaths worldwide while dramatically cutting into the total number of smokers, according to a new study in the New England Journal of Medicine. Approximately 1.3 billion people smoke; tobacco currently kills about 6 million people per year, with that total expected to climb to more than 8 million by 2030, according to the World Health Organization. To support their findings, scientists from Cancer Research UK (CRUK) pointed to success in France, where raising taxes well above inflation reduced smoking by half from 1990 to 2005. "The two certainties in life are death and taxes. We want higher tobacco taxes and fewer tobacco deaths," said Richard Peto, the CRUK epidemiologist who led the study. "It would help children not to start, and it would help many adults to stop while there's still time." Read more on tobacco.

HUD Grants to Help Families Get Access to Education, Job Training, Employment
This week the U.S. Department of Housing and Urban Development (HUD) awarded approximately $57 million in grants as part of its Housing Choice Voucher Program, which will go toward helping residents gain access to education, job training and employment. The grants will be used to hire or retain more than one thousand service coordinators who will work to connect the families with the supportive services. “This is a modest investment that can make a world of difference for families looking to find their path to self-sufficiency,” said HUD Secretary Shaun Donovan. “As America’s economy continues to recover, it’s critical that we work to make sure every American has the skills and resources they need to successfully compete for jobs in the 21st Century.” Under the program, participants sign a five-year contract requiring the head of the household to obtain employment and no longer receive welfare assistance by the end of the contract. Read more on housing.

Dec 10 2013
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Fifteen Years after Tobacco Settlement, States Falling Short in Funding Tobacco Prevention: Q&A with Danny McGoldrick

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On November 23, 1998, 46 states settled their lawsuits against the nation’s major tobacco companies to recover tobacco-related health care costs, joining four states—Mississippi, Texas, Florida and Minnesota—that had reached earlier, individual settlements.

These settlements require the tobacco companies to make annual payments to the states in perpetuity, with total payments estimated at $246 billion over the first 25 years.

Yesterday a coalition of health advocacy groups released the latest edition of A Broken Promise to Our Kids, an annual report on state use of tobacco funds for tobacco prevention and cessation efforts. As in years past, the report finds that most states fall short in the amount of money they allocate to prevent kids from smoking and to help current smokers quit.

The groups that jointly issued the report include the Campaign for Tobacco-Free Kids, the American Heart Association, American Cancer Society Cancer Action Network, the American Lung Association, the Robert Wood Johnson Foundation and Americans for Nonsmokers’ Rights.

Key findings of the 2013 report include:

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  • Over the past 15 years, states have spent just 2.3 percent of their total tobacco-generated revenue on tobacco prevention and cessation programs.
  • The states this year will collect $25 billion from the tobacco settlement and tobacco taxes, but will spend just 1.9 percent of it—$481.2 million—on tobacco prevention programs. This means the states are spending less than two cents of every dollar in tobacco revenue to fight tobacco use.
  • States are falling short of the U.S. Centers for Disease Control and Prevention’s (CDC) recommended funding levels for tobacco prevention programs. Altogether, the states have budgeted just 13 percent of the $3.7 billion the CDC recommends.
  • Only two states—Alaska and North Dakota—currently fund tobacco prevention programs at the CDC-recommended level.

To discuss the ramifications of the latest edition of the Broken Promises report, NewPublicHealth recently spoke with Danny McGoldrick, vice president of research at the Campaign for Tobacco-Free Kids.

NewPublicHealth: Can you give us some background on the Tobacco Master Settlement Agreement?

Danny McGoldrick: This is the 15th anniversary of the Tobacco Master Settlement Agreement, when 46 states and the District of Columbia settled their lawsuits against the tobacco companies mostly to recover the costs that they’d incurred treating smoking-caused disease in their states. Four other states had settled individually with the tobacco companies prior to the Master Settlement Agreement, and so this provided for some restrictions on tobacco company marketing; they promised never to market to kids again, which is ironic, but it also resulted in the tobacco companies sending about $250 billion over just the first 25 years of the settlement for the states to spend as they saw fit. They left that to the province of the state legislators and governors to decide how those funds should be spent.

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Dec 2 2013
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Recommended Reading: Effectiveness of Public Health Smartphone Apps

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As smartphone technology becomes ever more ubiquitous and the dangers of tobacco become ever more apparent, it's not surprising that there are 414 quit-smoking apps available between iPhones and Androids, with Androids alone seeing about 700,000 downloads of these apps each month.

There's no question that these apps are in demand in the United States, where an estimated 11 million smokers own a smartphone and more than half of smokers in 2010 tried to quit.

The question is: Are they effective?

According to a new study in the American Journal of Preventive Medicine, the answer is too often "no," with many of the most popular apps failing to employ and advocate known and successful anti-tobacco strategies.

"Quit-smoking apps are an increasingly available tool for smokers," said lead author Lorien Abroms, ScD, an associate professor of Prevention and Community Health at the George Washington University School of Public Health and Health Services (SPHHS), according to Health Canal. "Yet our study suggests these apps have a long way to go to comply with practices that we know can help people stub out that last cigarette."

The study looked at the 50 top anti-smoking apps for both iPhones and Androids, analyzing their tactics on a number of fronts, including how well they aligned with guidelines from the U.S. Public Health Service on treating tobacco use. The review found serious issues with the apps' advice, especially concerning clinical practices. It found that:

  • Most lacked basic advice on how to quit smoking and did not help people establish a "quit plan"
  • None recommend calling a quit-line, which can more than double the chances of successfully quitting tobacco
  • Fewer than one in 20 of the apps recommended medications, even though studies show how nicotine replacement therapy can help curb cravings

Taken together these, last two findings are especially troubling, as their pairing has been found to more than triple the chances of a person successfully breaking their nicotine addiction. One of the biggest takeaways from the study, according to Abroms, is that while quit-smoking apps can be important components of a larger plan to quit smoking, there might also be a simpler way to use those fancy smartphones.

"They should simply pick up their smartphone and call a quit-line now to get proven help on how to beat a tobacco addiction."

And the lack of adequate advice and guidance isn't limited to quit-smoking apps. A study by the IMS Institute for Healthcare Informatics found that while apps remain popular, they also remain limited.

"It clearly demonstrated that, to date, most efforts in app development have been in the overall wellness category with diet and exercise apps accounting for the majority available. An assessment finds that healthcare apps available today have both limited and simple functionality--the majority do little more than provide information.

Read the full story at Health Canal.

>>Bonus content: Read the previous NewPublicHealth post, "Public Health: There's An App For That"

>>Bonus link: Mobile Health and FDA Guidance

>>Bonus links: Here's a quick look at a few of the newest apps designed to improve public health in a variety of ways:

  • My Health Apps offers a vast array of apps, sorted by categories such as "Mental Health," "Me and My Doctor" and "Staying Healthy"
  • Hula, which helps people find STD testing, get the results on their phone and even share verified results
  • My Fitness Pal, which combines guidance and community to help people lose weight
  • Planned Parenthood offers a series of teen-focused apps on important issues such as birth control, condoms and even substance abuse
Nov 27 2013
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Public Health News Roundup: November 27

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Study: U.S. Graphic Warning Labels Could Get 8.6M Smokers to Quit
A new study out of Canada indicates that the U.S. Food and Drug Administration may have underestimated the potential impact of graphic warning labels on tobacco products. From 2000 to 2009, the warning labels cut Canada's smoking rate somewhere between 12 and 20 percent, which would be the equivalent of between 5.3 million and 8.6 million U.S. smokers. That's also 33 to 53 times larger than the FDA's estimates when they pushed for the warning labels--and when the tobacco industry successfully challenged the measure, with the court pointing to the low impact as one of the reasons for the ruling. "Our analyses corrected for errors in the FDA's analysis, concluding that the effect of graphic warnings on smoking rates would be much stronger than the FDA found," said Jidong Huang, MD, the study's author. "Our results provide much stronger support for the FDA's revised proposal for graphic warnings, which we hope will be forthcoming in the near future." Read more on tobacco.

Expanding Nurse Practitioner Abilities Could Save Patients $472M by 2015
Expanding which health services nurse practitioners at retail health clinics can provide could save at least $34 per visit, or as much as $472 million in health costs by 2015, according to a new study in the journal Health Affairs. The estimated 6,000 retail health clinics, often found in chain pharmacies or "big box" stores, provide walk-in care for minor health problems. The rules for nurse practitioners vary from state to state, with some allowing them to prescribe medications and practice independently of a doctor's supervision. Researchers looked at insurance claims from 2004 through 2007, finding that the state's that grant wider latitude also tend to see lower costs for the patients:

  • $704 -- Average cost of treatment in the 14 days after a traditional doctor's office visit
  • $543 -- Average cost of care during and after a retail visit in states where nurse practitioners had no independence and could not prescribe medication
  • $484 -- Average cost of care during and after a retail visit in states where nurse practitioners were allowed to practice without the supervision of a doctor
  • $509 -- Average cost of care during and after a retail visit in states where nurse practitioners were allowed to practice without supervision and prescribe medication

Read more on access to health care.

New Estimate Puts 2009 Swine Flu Global Death Toll at More than 200K
The death toll from the 2009 swine flu epidemic was likely far higher than previously believed, according to a new study in the journal PLoS Medicine. Previously, the total stood at about 18,500 laboratory-confirmed deaths, though experts considered that to be a low estimate because it only factored in confirmed cases of H1N1. A new study, bringing together 60 researchers in 26 countries, now places the toll at as many as 203,000 global deaths--or 11 times higher than the previous estimate. "This study confirms that the H1N1 virus killed many more people globally than originally believed," study lead author Lone Simonsen, a research professor in the department of global health at the George Washington University School of Public Health and Health Services. "We also found that the mortality burden of this pandemic fell most heavily on younger people and those living in certain parts of the Americas." Read more on global health.

Nov 26 2013
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Public Health News Roundup: November 26

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Chicago Announces Trio of Anti-tobacco Initiatives to Curb Youth Smoking
The city of Chicago and Mayor Rahm Emanuel this morning announced a trio of anti-tobacco initiatives designed to reduce youth access to tobacco. The first would regulate e-cigarettes as tobacco products, while the second would restrict the sale of flavored tobacco products near schools and the third would work to educate the public on the dangers of menthol-flavored cigarettes. Further details:

  • By defining “tobacco products” as products that are made of tobacco or include tobacco-derived nicotine, the city would be able to regulate e-cigarettes as they do any other tobacco product. This would mean that under the Chicago Clean Indoor Air Act, e-cigarette use would be restricted everywhere where smoking is restricted, including almost all public places and places of employment.
  • Flavored tobacco products, including menthol products, could not be sold within 500 feet of schools, and existing stores would not be grandfathered in. This would be the first regulation of menthol-flavored cigarettes anywhere at the federal, state or local levels.
  • Understanding that menthol-cigarettes are often—and wrongly—viewed as less unhealthy than other tobacco products, as well as that fact that the flavoring makes them more appealing to kids, the city is launching a public service advertising campaign on the realities of the products.

“E-cigarettes, as well as flavored products, are gateway tobacco products targeted at our kids,” said Emanuel. “The tobacco industry has spent years developing products that are aimed at hooking our youth on nicotine and getting them smoking for their entire life.” Read more on tobacco.

FDA to Investigate Reports on Weight-related Problems with the Morning-After-Pill
Following yesterday’s report that the European equivalent of the Plan B One-Step “morning after pill,” Norlevo, is less effective for women who weigh 165 pounds or more and ineffective for women who weigh 176 pounds or more, the U.S. Food and Drug Administration (FDA) has announced it will perform its own investigation into the product. The agency is "currently reviewing the available and related scientific information on this issue, including the publication upon which the Norlevo labeling change was based," said FDA spokeswoman Erica Jefferson said in a Monday statement. "The agency will then determine what, if any, labeling changes to approved emergency contraceptives are warranted." By law, the morning-after pill is available to all U.S. women of child-bearing age, over the county and with no point-of-sale restrictions. Read more on sexual health.

Concerns Over Cost, Sexual Activity Keep Many Parents From Having Kids Vaccinated Against HPV
Costs and parental concern over their kids’ sexual activity may be the reason that so view children—both girls and boys—are not being vaccinated against the human papillomavirus (HPV), according to a new review of 55 studies appearing in JAMA Pediatrics. HPV vaccines protect against the strains of genital warts that cause approximately 70 percent of cervical cancers, and they are recommended for girls aged 11 to 12. Boys are recommended to receive the vaccine as young as age 11, as it protects not just against genital warts, but also oral, penis and rectal cancers. However, the review found that many parents put off the vaccination either because they believe their child is not sexually active—so doesn’t “need” the vaccine—or because they fear it will encourage them to become sexually active. Researchers determined that a physician’s recommendation was one of the strongest motivators toward deciding to accept the vaccination, although this did not happen nearly enough. The researchers recommended improving these statistics by educating doctors and parents on the importance of the vaccine. Read more on cancer.

Nov 20 2013
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Public Health News Roundup: November 20

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Kids Today Slower, Less Fit than Their Parents as Kids
An average child in 1975 in a one-mile race with an average child today would win by an average of a minute and a half, according to new research. Kids today are also about 15 percent less aerobically fit, with heart endurance falling an average of 6 percent per decade from 1970 to 2000. That means today’s kids are more likely to be unhealthy in adulthood, with weaker hearts, thinner bones and overall lower quality of life. Grant Tomkinson, a senior lecturer in the University of South Australia's School of Health Sciences, pointed to a number of factors, including communities designed to discourage walking, bicycling and backyard play; reduced or even completely absent physical education in schools; and the prevalence of television, computer, tablet and smartphone screens that keep kids indoors. "We all live in an environment that's toxic for exercise, and our children are paying the price," Tomkinson said. Tomkinson said in order to reverse this trend, kids need at least 60 minutes of serious physical exercise a day, such as running, swimming or cycling. "You want exercise to be fun, but there needs to be some huff and puff there as well," he said. "It needs to make them somewhat tired." Read more on physical activity.

Study: Symptoms of ‘Sudden’ Cardiac Arrest Can Be Seen Up to a Month Earlier
Symptoms of “sudden” cardiac arrest can be seen up to a month beforehand in middle-age men, according to new findings presented this week at the annual scientific sessions of the American Heart Association, held this year in Dallas. Researchers looked at the medical records of 567 men, ages 35-65, who had out-of-hospital heart attacks, finding that approximately 53 percent showed symptoms beforehand. They included chest pain (56 percent); shortness of breath (13 percent); and dizziness, fainting or palpitations (4 percent). Sumeet Chugh, senior author of the study and associate director for genomic cardiology at the Cedars-Sinai Heart Institute in Los Angeles, said the “entirely unexpected” findings show that people may be able to prevent heart attacks if they seek treatment earlier for these symptoms. "The findings were entirely unexpected," said "We never thought more than half of these middle-aged men would have had warning signs so long before their cardiac arrests,” Chugh said. “Previously we thought most people don't have symptoms so we can't do anything about it." Read more on heart health.

ACS Tips on Quitting Tobacco for Tomorrow’s ‘Great American Smokeout’
Tomorrow is the American Cancer Society (ACS) Great American Smokeout, held every year on the third Thursday of November. The annual event was founded to encourage people to quit using tobacco—perhaps to stop smoking on that day, or to make a plan on how to quit at a later date—and to provide the tools and resources that can help the decision stick. According to ACS, research shows that people are most successful at quitting tobacco when they have support, and recommends combing two or more of the following tactics to improve the odds:

  • Telephone smoking-cessation hotlines
  • Stop-smoking groups
  • Online quit groups
  • Counseling
  • Nicotine replacement products
  • Prescription medicine to lessen cravings
  • Guide books
  • Encouragement and support from friends and family members

People can call 1-800-227-2345 for more information or go to "Stay Away from Tobacco" at Cancer.org. Read more on tobacco.

Nov 18 2013
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Public Health News Roundup: November 18

Six Killed, Dozens Injured as Tornados Sweep Across the U.S. Midwest
At least six people were killed and dozens left injured after a flurry of tornados swept through the American Midwest yesterday. Tornado watches were announced for Illinois, Indiana, Iowa, Michigan, Missouri, Ohio and Wisconsin; by the end of the day, an estimated 77 had touched down, mostly in Illinois, according to the National Weather Service. The severe weather left thousands without power (approximately 89,000 in Northern Illinois alone) and leveled entire neighborhoods. “I went over there immediately after the tornado, walking through the neighborhoods, and I couldn’t even tell what street I was on,” said Tyler Gee, an alderman on the Chicago City Council, to radio station WBBM in Chicago. “It just completely flattened some of the neighborhoods here in town, hundreds of homes.” Read more on disasters.

NHTSA: 2012 Highway Fatalities Up for the First Time Since 2005
While highway traffic fatalities continue to hover around historic lows, the total number of deaths increased by 1,082 from 2011 to 2012, to a total of 33,561, the first increase since 2005. The findings are part of the U.S. Department of Transportation's National Highway Traffic Safety Administration’s (NHTSA) 2012 Fatality Analysis Reporting System (FARS) data. "Highway deaths claim more than 30,000 lives each year and while we've made substantial progress over the past 50 years, it's clear that we have much more work to do," said U.S. Transportation Secretary Anthony Foxx. "As we look to the future, we must focus our efforts to tackle persistent and emerging issues that threaten the safety of motorists, cyclists and pedestrians across the nation." Read more on safety.

Heart Groups’ New Risk Guidelines, Calculator Apparently Flawed
The risk guidelines and calculator released last week by the American Heart Association and the American College of Cardiology, meant to improve the assessment of potential cardiovascular disease, could possibly instead greatly overestimate the risk and as built could lead to millions of unnecessary statin prescriptions. The potential problems, first identified by two Harvard Medical School professors, will be published today in The Lancet. One possible explanation for the problem is that the system relies on old data, while populations and their behaviors have changed. Steven Nissen, MD, chief of cardiovascular medicine at the Cleveland Clinic and a past president of the American College of Cardiology, called the findings “stunning,” adding “We need a pause to further evaluate this approach before it is implemented on a widespread basis.” However, after emergency meetings at the American Heart Association’s annual meeting this weekend in Dallas, both organizations said despite the apparent flaws the guidelines are still a major step forward, noting that patients are also advised to speak with their doctors, and not simply follow the results of the calculator. Read more on heart health.

CDC: Emerging Tobacco Products Gaining Popularity among Middle and High School Students
A new report from the U.S. Centers for Disease Control and Prevention (CDC) finds that emerging tobacco products such as e-cigarettes and hookahs are quickly gaining popularity among middle- and high-school students, but with no significant decline in students’ cigarette smoking or overall tobacco use. The new report was culled from data in the 2012 National Youth Tobacco Survey, which shows that electronic cigarette use rose among middle school students from 0.6 percent in 2011 to 1.1 percent in 2012 and among high school students from 1.5 percent to 2.8 percent. Hookah use among high school students rose from 4.1 percent to 5.4 percent from 2011 to 2012. 

The study authors say the increase in the use of electronic cigarettes and hookahs could be due to an increase in marketing, availability and visibility of the products, as well as the perception that they may be safer alternatives to cigarettes. While electronic cigarettes, hookahs, cigars and certain other new types of tobacco products are not currently subject to regulation by the U.S. Food and Drug Administration, the agency has said recently that it plans to issue a proposed rule that would deem products meeting the statutory definition of a "tobacco product" to be subject to the Federal Food, Drug, and Cosmetic Act—as cigarettes are.

The researchers say cigar use in young adults is of particular concern. During 2011-2012, cigar use increased dramatically among non-Hispanic black high school students from 11.7 percent to 16.7 percent, and has more than doubled since 2009, and similar to the rate of cigarette use among high school males (16.3 percent). Read more on tobacco.

Nov 6 2013
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Regulating Tobacco: Q&A with FDA's Mitch Zeller

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Tobacco featured prominently as a public health issue at the American Public Health Association (APHA) meeting this week, including a regulatory update from Mitch Zeller, JD, who became director of the U.S. Food and Drug Administration’s (FDA) Center for Tobacco Products earlier this year. Zeller previously worked on tobacco issues in government as associate commissioner and director of FDA’s first Office of Tobacco Programs, and also as a U.S. delegate to the World Health Organization (WHO) Working Group for the Framework Convention on Tobacco Control.

NewPublicHealth spoke with Zeller ahead of the APHA meeting.

Mitch Zeller, JD, Director of the FDA’s Center for Tobacco Products Mitch Zeller, JD, Director of the FDA’s Center for Tobacco Products

Mitch Zeller: I think most broadly my goals are to help give the center and the agency the greatest chance of fulfilling the public health mission behind the law passed in 2009 giving the Food and Drug Administration authority over tobacco. This really is an important piece of legislation. It’s really stunning that in 2013—with everything that we know about the harms associated with tobacco use—that it remains the leading cause of preventable death and disease both in this country and globally.

There are some very powerful tools that Congress has given FDA to use wisely and supported by evidence. That’s where I think, the greatest opportunity lies: to use the tools relying on regulatory science to try to protect consumers and reduce the death and disease toll from tobacco.

There are two areas where I think these tools can make a profound positive impact on public health. The first is something called product standards, which is basically the power to ban, restrict or limit the allowable levels of ingredients in tobacco or tobacco smoke. We are exploring potential product standards in three areas: toxicity, addiction and appeal. And we are funding research in all three areas and working very hard behind the scenes to find out what our options are for potential product standards in those three areas.

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